Three infection clusters related with potential pre-symptomatic transmission of coronavirus disease (COVID-19), Shanghai, China, January to February 2020

Author:

Gong Xiaohuan12ORCID,Xiao Wenjia12,Cui Yan31,Wang Yuanping41,Kong Dechuan2,Mao Shenghua2,Zheng Yaxu2,Xiang Lunhui5,Lu Lu6,Jiang Chenyan2,Yu Xiao2,Zhu Yiyi2,Fang Qiwen2,Pan Hao7,Wu Huanyu2

Affiliation:

1. These authors contributed equally to this work

2. Department of Infectious Disease Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China

3. Putuo District Center for Disease Control and Prevention, Shanghai, China

4. Pudong District Center for Disease Control and Prevention, Shanghai, China

5. Baoshan District Center for Disease Control and Prevention, Shanghai, China

6. Huangpu District Center for Disease Control and Prevention, Shanghai, China

7. Shanghai Institutes of Preventive Medicine, Shanghai, China

Abstract

We report three clusters related with potential pre-symptomatic transmission of coronavirus disease (COVID-19) between January and February 2020 in Shanghai, China. Investigators interviewed suspected COVID-19 cases to collect epidemiological information, including demographic characteristics, illness onset, hospital visits, close contacts, activities’ trajectories between 14 days before illness onset and isolation, and exposure histories. Respiratory specimens of suspected cases were collected and tested for SARS-CoV-2 by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) assay. The interval between the onset of illness in the primary case and the last contact of the secondary case with the primary case in our report was 1 to 7 days. In Cluster 1 (five cases), illness onset in the five secondary cases was 2 to 5 days after the last contact with the primary case. In Cluster 2 (five cases) and Cluster 3 (four cases), the illness onset in secondary cases occurred prior to or on the same day as the onset in the primary cases. The study provides empirical evidence for transmission of COVID-19 during the incubation period and indicates that pre-symptomatic person-to-person transmission can occur following sufficient exposure to confirmed COVID-19 cases. The potential pre-symptomatic person-to-person transmission puts forward higher requirements for prevention and control measures.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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