High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice - Skagit County, Washington, March 2020.
2020 年 3 月，华盛顿斯卡吉特县，合唱团练习曝光后的高SARS-CoV-2 罹患率。
- 作者列表："Hamner L","Dubbel P","Capron I","Ross A","Jordan A","Lee J","Lynn J","Ball A","Narwal S","Russell S","Patrick D","Leibrand H
:On March 17, 2020, a member of a Skagit County, Washington, choir informed Skagit County Public Health (SCPH) that several members of the 122-member choir had become ill. Three persons, two from Skagit County and one from another area, had test results positive for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Another 25 persons had compatible symptoms. SCPH obtained the choir's member list and began an investigation on March 18. Among 61 persons who attended a March 10 choir practice at which one person was known to be symptomatic, 53 cases were identified, including 33 confirmed and 20 probable cases (secondary attack rates of 53.3% among confirmed cases and 86.7% among all cases). Three of the 53 persons who became ill were hospitalized (5.7%), and two died (3.7%). The 2.5-hour singing practice provided several opportunities for droplet and fomite transmission, including members sitting close to one another, sharing snacks, and stacking chairs at the end of the practice. The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization (1). Certain persons, known as superemitters, who release more aerosol particles during speech than do their peers, might have contributed to this and previously reported COVID-19 superspreading events (2-5). These data demonstrate the high transmissibility of SARS-CoV-2 and the possibility of superemitters contributing to broad transmission in certain unique activities and circumstances. It is recommended that persons avoid face-to-face contact with others, not gather in groups, avoid crowded places, maintain physical distancing of at least 6 feet to reduce transmission, and wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.
: 2020 年 3 月 17 日，华盛顿斯卡吉特县的一名成员，合唱团通知斯卡吉特县公共卫生 (SCPH)，由 122 人组成的合唱团的几名成员生病了。三个人，两名来自斯卡吉特县，一名来自另一个领域，测试结果呈阳性，SARS-CoV-2，病毒导致冠状病毒病毒疾病 2019 (新型冠状病毒肺炎).另有 25 人出现相容症状。SCPH获得了合唱团的成员名单，并于 3 月 18 日开始调查。在参加 3 月 10 日合唱团实践的 61 人中，已知有 1 人有症状，确定了 53 例，包括 33 例确诊病例和 20 例可能病例 (确诊病例病例的继发性罹患率为 53.3%，所有病例的继发性罹患率为 86.7%)。53 例患者中有 3 例住院治疗 (5.7%)，2 例死亡 (3.7%)。2.5 小时的歌唱练习为液滴和fomite传输提供了几个机会，包括成员坐在一起，分享小吃，并在练习结束时堆放椅子。歌唱行为本身可能通过气溶胶的排放促进传播，这受到发声响度的影响 (1)。某些人，被称为超级发射器，他们在演讲中释放比同龄人更多的气溶胶粒子，可能对此做出了贡献，并且之前报道过新型冠状病毒肺炎超级扩散事件 (2-5)。这些数据表明，在某些独特的活动和环境中，传染性的高SARS-CoV-2 和超发射体可能有助于广泛传播。建议人员避免与他人面对面接触，不要聚集在一起，避免拥挤的地方，保持至少 6英尺的身体距离以减少传播，在其他社会疏远措施难以维持的公共场所佩戴布面覆盖物。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.