Familial cluster of COVID-19 infection from an asymptomatic

Zhang, Jinjun; Tian, Sijia; Lou, Jing; Chen, Yuguo

doi:10.1186/s13054-020-2817-7

Cited by 113 publications

(107 citation statements)

References 4 publications

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“…The effects of pre/asymptomatic population on the spread of COVID-19 during quarantine has not yet been studied extensively. Clinical observations and lab tests have confirmed the existence of a pre/asymptomatic population infecting others [6,7,8]. It is not easy to give precise estimates of the size of this population, yet the DP outbreak provides very useful real world data for this.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical findings have suggested that the viral load in asymptomatic patients is similar to that in symptomatic patients [5]. Evidence suggests that these asymptomatic patients can infect others before they manifest any symptoms [6,7,8]. In an early study of cases in Wuhan [9], 200 individuals out of 240 (83%) reported no exposure to an individual with respiratory symptoms, which suggests presymptomatic/asymptomatic infection is common [10].…”

Section: Introductionmentioning

confidence: 99%

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Taking Account of Asymptomatic Infections – A Modeling Study on the COVID-19 Outbreak on the Diamond Princess Cruise Ship

Huang

Dunn

et al. 2020

Preprint

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We take the case of the Diamond Princess (DP) cruise ship as an experimental model for studying the transmission potential of COVID-19 in a closed environment. We investigate the changes in R0 for COVID-19 on the DP from January 21 to February 19, 2020 with a chainbinomial model at different times under two scenarios: no quarantine assuming a random mixing condition, and quarantine of passengers in cabins -passengers may get infected either by an infectious case in a shared cabin or by asymptomatic crew who continued to work. Our modeling approach takes account of the asymptomatic ratio of crew members during the quarantine of passengers, which has not been explored in the literature. Assuming an asymptomatic ratio 0.505 and the proportion of infections in cabins 0.2, R0 at the beginning of the epidemic was 3.27 (95% CI (3.02, 3.54)) and 3.78 (95% CI (3.49, 4.09)) respectively for serial intervals of 5 and 6 days, and increased for passengers in contact with asymptomatic crew during quarantine. We find evidence to support a CDC report that "a high proportion of asymptomatic infections could partially explain the high attack rate among cruise ship passengers and crew." This emphasizes the importance of improved reporting and quarantine of asymptomatic cases, and raises questions on quarantine procedures in closed environments such as military vessels, cruise ships, dormitories, prisons, and other enclosed living complexes with high population densities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Taking Account of Asymptomatic Infections – A Modeling Study on the COVID-19 Outbreak on the Diamond Princess Cruise Ship

Huang

Dunn

et al. 2020

Preprint

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“…It seems that asymptomatic infection could be detected at every age, although it was frequent at younger ages [14]. These asymptomatic patients could cause familial clusters [15]. According to Tian et al, asymptomatic infection rate was 5%, whereas in Diamond Princess Cruise Ship berthed at Tokyo Bay, Japan, it was nearly 18% [16,17].…”

Section: Asymptomatic Infectionmentioning

confidence: 99%

Epidemiology of COVID-19

Bulut¹,

Kato²

2020

Turk J Med Sci

321

280

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IntroductionCoronoviruses have been reported as causes of mild and moderate respiratory infections forover 50 years [1]. Even though this group of viruses have been isolated from many different animals, bats are accepted major natural reservoir of coronaviruses [2,3].Four human coronavirus, 229E, HKU1, NL63 and OC43, are known as causes of common cold in humans [1]. However, recently-detected coronaviruses, SARS CoV (2002), MERS-CoV (2012) completely altered all known approaches about this virus group because these viruses caused severe acute respiratory infections and nosocomial outbreaks. In the end of 2019, a novel coronavirus, now known as SARS-CoV-2 (2019), suddenly emerged in Wuhan, China. The World Health Organization declared that the epidemic is a public health emergency of international concern on January 31, 2020. As of April 16, 2020, the emerging coronavirus infection, COVID-19, has been spreading worldwide, causing over 2 million cases and over 137 thousand of death.In as much as this disease recently taken a significant place in our daily practice, as a new group of respiratory diseases, due to their higher rates of transmissibility, hospitalization, intensive care unit admission, severity of disease, mortality and so on, we should pay more attention than past to prevention and treatment of coronavirus infection. Origin of the SARS CoV-2 virusThe first cases of coronavirus disease COVID-19 were directly related to an animal market in Wuhan, China. Early investigations suggested that the origin of SARSCoV-2 may be bats. Zhou et al. demonstrate that SARS CoV-2 possesses 96% nucleotide identity with a bat coronavirus, for instance BetaCoV/RaTG13/2013 [4]. Epidemic curve of infectionAn epidemic curve of infection is a statistical chart used in epidemiology to visualize the onset of the coronavirus outbreak. In an epidemic curve, there are three zones: increasing, plateau, and declining phases.Increasing phase: This period is affected by many different parameters such as country demographics, age distribution, preparedness of health system to an outbreak, implementation of some preventive measures, country reaction time to a pandemic, reaction of society to new implementing rules. Different countries can exhibit quite different curve patterns and these facts could complicate

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“…− Nasopharyngeal swab test for SARS-CoV-2 reverse transcriptase ribonucleic acid (RT-DNA PCR) before the procedure (if available). Asymptomatic carriage is a significant source of transmission during the pandemic [10,11]. − The patient should be categorized according to their COVID-19 status as (1) Confirmed, (2) Probable, (3) Not Probable, or (4) Negative.…”

Section: Considerations Before Bronchoscopymentioning

confidence: 99%