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Community Transmission of SARS-CoV-2 at Two Family Gatherings - Chicago, Illinois, February-March 2020.
2020 年 2-3 月伊利诺伊州芝加哥市两次家庭聚会上SARS-CoV-2 的社区传播。
- 影响因子:7.42
- DOI:10.15585/mmwr.mm6915e1
- 作者列表:"Ghinai I","Woods S","Ritger KA","McPherson TD","Black SR","Sparrow L","Fricchione MJ","Kerins JL","Pacilli M","Ruestow PS","Arwady MA","Beavers SF","Payne DC","Kirking HL","Layden JE
- 发表时间:2020-04-17
Abstract
:SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), has spread rapidly around the world since it was first recognized in late 2019. Most early reports of person-to-person SARS-CoV-2 transmission have been among household contacts, where the secondary attack rate has been estimated to exceed 10% (1), in health care facilities (2), and in congregate settings (3). However, widespread community transmission, as is currently being observed in the United States, requires more expansive transmission events between nonhousehold contacts. In February and March 2020, the Chicago Department of Public Health (CDPH) investigated a large, multifamily cluster of COVID-19. Patients with confirmed COVID-19 and their close contacts were interviewed to better understand nonhousehold, community transmission of SARS-CoV-2. This report describes the cluster of 16 cases of confirmed or probable COVID-19, including three deaths, likely resulting from transmission of SARS-CoV-2 at two family gatherings (a funeral and a birthday party). These data support current CDC social distancing recommendations intended to reduce SARS-CoV-2 transmission. U.S residents should follow stay-at-home orders when required by state or local authorities.
摘要
: SARS-CoV-2 是引起冠状病毒病毒病 2019 (新型冠状病毒肺炎) 的病毒,自 2019 年末首次被识别以来,该病毒已在全球迅速传播。大多数人与人SARS-CoV-2 传播的早期报告是家庭接触者,二级罹患率估计超过 10% (1),医疗保健设施 (2),和在聚集设置 (3)。然而,广泛的社区传播,正如目前在美国观察到的那样,需要非家庭接触者之间更广泛的传播事件。在 2020 年 2 月和 3 月,芝加哥公共卫生部门 (CDPH) 调查了一个大的、多家庭的新型冠状病毒肺炎。对确诊新型冠状病毒肺炎的患者及其密切接触者进行访谈,以更好地了解SARS-CoV-2 的非家庭、社区传播。本报告描述了 16 例确诊或可能的新型冠状病毒肺炎,包括 3 例死亡,可能是在两次家庭聚会 (葬礼和生日聚会) 上传播SARS-CoV-2 造成的。这些数据支持目前CDC的社交距离建议,旨在减少SARS-CoV-2 传播。当州或地方当局要求时,美国居民应该遵循居家订单。
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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.
呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。