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Public Health Rep . Lack of Serologic Evidence of Infection Among Health Care Personnel and Other Contacts of First 2 Confirmed Patients With COVID

tetano

Editor, Senior Moderator
Public Health Rep


. 2020 Oct 27;33354920966064.
doi: 10.1177/0033354920966064. Online ahead of print.
Lack of Serologic Evidence of Infection Among Health Care Personnel and Other Contacts of First 2 Confirmed Patients With COVID-19 in Illinois, 2020


Tristan D McPherson[SUP] 1 2 [/SUP], Isaac Ghinai[SUP] 1 2 3 [/SUP], Alison M Binder[SUP] 4 [/SUP], Brandi D Freeman[SUP] 5 6 [/SUP], Chantel Hoskin Snelling[SUP] 3 [/SUP], Jennifer C Hunter[SUP] 4 [/SUP], Kristin M Anderson[SUP] 7 [/SUP], Polly Davenport[SUP] 7 [/SUP], Deborah L Rudd[SUP] 7 [/SUP], Mujeeb Zafer[SUP] 7 [/SUP], Demian Christiansen[SUP] 8 [/SUP], Kiran Joshi[SUP] 8 [/SUP], Rachel Rubin[SUP] 8 [/SUP], Stephanie R Black[SUP] 2 [/SUP], Marielle J Fricchione[SUP] 2 [/SUP], Massimo Pacilli[SUP] 2 [/SUP], Kelly A Walblay[SUP] 2 [/SUP], Jacqueline Korpics[SUP] 9 10 [/SUP], Darcie Moeller[SUP] 9 10 [/SUP], Pearl Quartey-Kumapley[SUP] 9 [/SUP], Chen Wang[SUP] 9 10 [/SUP], E Matt Charles[SUP] 3 [/SUP], Judy Kauerauf[SUP] 3 [/SUP], Megan T Patel[SUP] 3 [/SUP], Vishal S Disari[SUP] 4 11 [/SUP], Marc Fischer[SUP] 4 [/SUP], Max W Jacobs[SUP] 6 12 [/SUP], Sandra N Lester[SUP] 6 13 [/SUP], Claire M Midgley[SUP] 6 [/SUP], Mohammed Ata Ur Rasheed[SUP] 6 13 [/SUP], Heather E Reese[SUP] 1 6 [/SUP], Jennifer R Verani[SUP] 6 [/SUP], Megan Wallace[SUP] 1 6 [/SUP], John T Watson[SUP] 6 [/SUP], Natalie J Thornburg[SUP] 6 [/SUP], Jennifer E Layden[SUP] 2 [/SUP], Hannah L Kirking[SUP] 6 [/SUP]



Affiliations

Abstract

Objectives: Widespread global transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing coronavirus disease 2019 (COVID-19), continues. Many questions remain about asymptomatic or atypical infections and transmission dynamics. We used comprehensive contact tracing of the first 2 confirmed patients in Illinois with COVID-19 and serologic SARS-CoV-2 antibody testing to determine whether contacts had evidence of undetected COVID-19.
Methods: Contacts were eligible for serologic follow-up if previously tested for COVID-19 during an initial investigation or had greater-risk exposures. Contacts completed a standardized questionnaire during the initial investigation. We classified exposure risk as high, medium, or low based on interactions with 2 index patients and use of personal protective equipment (PPE). Serologic testing used a SARS-CoV-2 spike enzyme-linked immunosorbent assay on serum specimens collected from participants approximately 6 weeks after initial exposure to either index patient. The 2 index patients provided serum specimens throughout their illness. We collected data on demographic, exposure, and epidemiologic characteristics.
Results: Of 347 contacts, 110 were eligible for serologic follow-up; 59 (17% of all contacts) enrolled. Of these, 53 (90%) were health care personnel and 6 (10%) were community contacts. Seventeen (29%) reported high-risk exposures, 15 (25%) medium-risk, and 27 (46%) low-risk. No participant had evidence of SARS-CoV-2 antibodies. The 2 index patients had antibodies detected at dilutions >1:6400 within 4 weeks after symptom onset.
Conclusions: In serologic follow-up of the first 2 known patients in Illinois with COVID-19, we found no secondary transmission among tested contacts. Lack of seroconversion among these contacts adds to our understanding of conditions (ie, use of PPE) under which SARS-CoV-2 infections might not result in transmission and demonstrates that SARS-CoV-2 antibody testing is a useful tool to verify epidemiologic findings.

Keywords: COVID-19; SARS-CoV-2; antibodies; epidemiology; serology.
 
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