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Nat Med . Clustering and superspreading potential of SARS-CoV-2 infections in Hong Kong

tetano

Editor, Senior Moderator
Nat Med


. 2020 Sep 17.
doi: 10.1038/s41591-020-1092-0. Online ahead of print.
Clustering and superspreading potential of SARS-CoV-2 infections in Hong Kong


Dillon C Adam[SUP] 1 2 [/SUP], Peng Wu[SUP] 3 [/SUP], Jessica Y Wong[SUP] 1 [/SUP], Eric H Y Lau[SUP] 1 [/SUP], Tim K Tsang[SUP] 1 [/SUP], Simon Cauchemez[SUP] 4 [/SUP], Gabriel M Leung[SUP] 1 [/SUP], Benjamin J Cowling[SUP] 1 [/SUP]



Affiliations

Abstract

Superspreading events (SSEs) have characterized previous epidemics of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infections[SUP]1-6[/SUP]. For SARS-CoV-2, the degree to which SSEs are involved in transmission remains unclear, but there is growing evidence that SSEs might be a typical feature of COVID-19[SUP]7,8[/SUP]. Using contact tracing data from 1,038 SARS-CoV-2 cases confirmed between 23 January and 28 April 2020 in Hong Kong, we identified and characterized all local clusters of infection. We identified 4-7 SSEs across 51 clusters (n = 309 cases) and estimated that 19% (95% confidence interval, 15-24%) of cases seeded 80% of all local transmission. Transmission in social settings was associated with more secondary cases than households when controlling for age (P = 0.002). Decreasing the delay between symptom onset and case confirmation did not result in fewer secondary cases (P = 0.98), although the odds that an individual being quarantined as a contact interrupted transmission was 14.4 (95% CI, 1.9-107.2). Public health authorities should focus on rapidly tracing and quarantining contacts, along with implementing restrictions targeting social settings to reduce the risk of SSEs and suppress SARS-CoV-2 transmission.
 
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