- Min Kang1,* , Hualei Xin2,* , Jun Yuan3 , Sheikh Taslim Ali2,4 , Zimian Liang5 , Jiayi Zhang1 , Ting Hu1 , Eric HY Lau2,4 , Yingtao Zhang1 , Meng Zhang1 , Benjamin J Cowling2,4
, Yan Li1,** , Peng Wu2,4,**
Background
The Delta variant of SARS-CoV-2 had become predominant globally by November 2021.
Aim
We evaluated transmission dynamics and epidemiological characteristics of the Delta variant in an outbreak in southern China.
Methods
Data on confirmed COVID-19 cases and their close contacts were retrospectively collected from the outbreak that occurred in Guangdong, China in May and June 2021. Key epidemiological parameters, temporal trend of viral loads and secondary attack rates were estimated. We also evaluated the association of vaccination with viral load and transmission.
Results
We identified 167 patients infected with the Delta variant in the Guangdong outbreak. Mean estimates of latent and incubation period were 3.9 days and 5.8 days, respectively. Relatively higher viral load was observed in infections with Delta than in infections with wild-type SARS-CoV-2. Secondary attack rate among close contacts of cases with Delta was 1.4%, and 73.1% (95% credible interval (CrI): 32.9–91.4) of the transmissions occurred before onset. Index cases without vaccination (adjusted odds ratio (aOR): 2.84; 95% CI: 1.19–8.45) or with an incomplete vaccination series (aOR: 6.02; 95% CI: 2.45–18.16) were more likely to transmit infection to their contacts than those who had received the complete primary vaccination series.
Discussion
Patients infected with the Delta variant had more rapid symptom onset compared with the wild type. The time-varying serial interval should be accounted for in estimation of reproduction numbers. The higher viral load and higher risk of pre-symptomatic transmission indicated the challenges in control of infections with the Delta variant.
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