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Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia.
中国武汉新型冠状病毒感染肺炎的早期传播动态。
- 影响因子:16.10
- DOI:10.1056/NEJMoa2001316
- 作者列表:"Li Q","Guan X","Wu P","Wang X","Zhou L","Tong Y","Ren R","Leung KSM","Lau EHY","Wong JY","Xing X","Xiang N","Wu Y","Li C","Chen Q","Li D","Liu T","Zhao J","Liu M","Tu W","Chen C","Jin L","Yang R","Wang Q","Zhou S","Wang R","Liu H","Luo Y","Liu Y","Shao G","Li H","Tao Z","Yang Y","Deng Z","Liu B","Ma Z","Zhang Y","Shi G","Lam TTY","Wu JT","Gao GF","Cowling BJ","Yang B","Leung GM","Feng Z
- 发表时间:2020-03-26
Abstract
BACKGROUND:The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. METHODS:We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. RESULTS:Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). CONCLUSIONS:On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.).
摘要
背景: 2019 年 12 月和 2020 年 1 月,新型冠状病毒 (2019-nCoV) 感染肺炎 (NCIP) 首发病例发生在中国湖北省武汉市。我们分析了武汉市前 425 确诊病例的资料,以确定NCIP的流行病学特征。 方法: 我们收集了截至 2020 年 1 月 22 日报告的NCIP实验室确诊病例的人口统计学特征、接触史和疾病时间表信息。我们描述了病例的特征,并估计了关键的流行病学时间延迟分布。在指数增长的早期,我们估计了流行倍增时间和基本生殖数。 结果: 在前 425 例确诊的NCIP患者中,中位年龄为 59 岁,56% 为男性。55% 年 1 月 1 日前发病的大多数病例 (2020) 与华南海鲜批发市场有关,而随后的病例为 8.6%。平均潜伏期为 5.2 天 (95% 置信区间 [CI],4.1 ~ 7.0),12.5 天的分布百分位数。在其早期阶段,这种流行病的规模每 7.4 天增加一倍。平均连续间隔 7.5 天 (95% CI,5.3 ~ 19),估计基本生殖数为 2.2 (95% CI,1.4 ~ 3.9)。 结论: 根据这些信息,有证据表明自 2019 年 12 月中旬以来,密切接触者中发生了人传人。如果类似的动态适用于其他地方,需要做出相当大的努力来减少传播,以控制疫情。应在风险人群中实施预防或减少传播的措施。(教育部资助的科学和技术的中国和其他国家..
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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。