tetano
Editor, Senior Moderator
J Infect Chemother
. 2022 Feb 11;S1341-321X(22)00043-5.
doi: 10.1016/j.jiac.2022.02.003. Online ahead of print.
A case report of breakthrough infection with the SARS-CoV-2 delta variant and household transmission: Role of vaccination, anti-spike IgG and neutralizing activity
Yuki Moriyama[SUP] 1 [/SUP], Masahiro Ishikane[SUP] 2 [/SUP], Mikako Ueno[SUP] 3 [/SUP], Akihiro Matsunaga[SUP] 3 [/SUP], Yukihito Ishizaka[SUP] 3 [/SUP], Takeshi Arashiro[SUP] 4 [/SUP], Takayuki Kanno[SUP] 5 [/SUP], Tadaki Suzuki[SUP] 5 [/SUP], Kenjiro Kimura[SUP] 6 [/SUP]
Affiliations
Abstract
There have been several reports of breakthrough infections, which are defined as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among individuals who had received at least two doses of vaccine at least 14 days before the onset of infection, but data on the antibody titers, including SARS-CoV-2 neutralizing antibody activity, and the clinical course of individuals with breakthrough infections are limited. We encountered a case of breakthrough infection with the SARS-CoV-2 delta variant in a 31-year-old female healthcare worker (the index case, Case 1) and a secondary case (Case 2) in her unvaccinated 33-year-old husband. We studied the role of the anti-spike immunoglobulin G (IgG) and neutralizing antibody activity in the two case patients. Case 1 had high anti-spike IgG detected on day 3 of the illness, with low neutralizing antibody activity. The neutralizing antibody activity started to increase on day 5 of the illness. In Case 2 both the anti-spike IgG and the neutralizing antibody activity remained low from days 4-11 of illness, and the anti-spike IgG gradually increased from day 9. In Case 1, the fever broke within 4 days of onset, coinciding with the rise in neutralizing antibodies, whereas the fever took 7 days to resolve in Case 2. SARS-CoV-2 infection can occur even in vaccinated individuals, but vaccination may contribute to milder clinical symptoms because neutralizing antibodies are induced earlier in vaccinated individuals than in unvaccinated individuals.
Keywords: Anti-spike IgG; BNT162b2 vaccine; Breakthrough infection; Delta variant; Neutralizing antibodies; SARS-CoV-2 infection.
. 2022 Feb 11;S1341-321X(22)00043-5.
doi: 10.1016/j.jiac.2022.02.003. Online ahead of print.
A case report of breakthrough infection with the SARS-CoV-2 delta variant and household transmission: Role of vaccination, anti-spike IgG and neutralizing activity
Yuki Moriyama[SUP] 1 [/SUP], Masahiro Ishikane[SUP] 2 [/SUP], Mikako Ueno[SUP] 3 [/SUP], Akihiro Matsunaga[SUP] 3 [/SUP], Yukihito Ishizaka[SUP] 3 [/SUP], Takeshi Arashiro[SUP] 4 [/SUP], Takayuki Kanno[SUP] 5 [/SUP], Tadaki Suzuki[SUP] 5 [/SUP], Kenjiro Kimura[SUP] 6 [/SUP]
Affiliations
- PMID: 35461768
- DOI: 10.1016/j.jiac.2022.02.003
Abstract
There have been several reports of breakthrough infections, which are defined as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among individuals who had received at least two doses of vaccine at least 14 days before the onset of infection, but data on the antibody titers, including SARS-CoV-2 neutralizing antibody activity, and the clinical course of individuals with breakthrough infections are limited. We encountered a case of breakthrough infection with the SARS-CoV-2 delta variant in a 31-year-old female healthcare worker (the index case, Case 1) and a secondary case (Case 2) in her unvaccinated 33-year-old husband. We studied the role of the anti-spike immunoglobulin G (IgG) and neutralizing antibody activity in the two case patients. Case 1 had high anti-spike IgG detected on day 3 of the illness, with low neutralizing antibody activity. The neutralizing antibody activity started to increase on day 5 of the illness. In Case 2 both the anti-spike IgG and the neutralizing antibody activity remained low from days 4-11 of illness, and the anti-spike IgG gradually increased from day 9. In Case 1, the fever broke within 4 days of onset, coinciding with the rise in neutralizing antibodies, whereas the fever took 7 days to resolve in Case 2. SARS-CoV-2 infection can occur even in vaccinated individuals, but vaccination may contribute to milder clinical symptoms because neutralizing antibodies are induced earlier in vaccinated individuals than in unvaccinated individuals.
Keywords: Anti-spike IgG; BNT162b2 vaccine; Breakthrough infection; Delta variant; Neutralizing antibodies; SARS-CoV-2 infection.