Epidemiological investigation of a COVID-19 family cluster outbreak transmitted by a 3-month-old infant

Abstract

Objective To investigate the clinical characteristics, epidemiological characteristics, and transmissibility of coronavirus disease 2019 (COVID-19) in a family cluster outbreak transmitted by a 3-month-old confirmed positive infant. Methods Field-based epidemiological methods were used to investigate cases and their close contacts. Real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) was used to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) for all collected specimens. Serum SARS-CoV-2 IgM and IgG antibodies were detected by Chemiluminescence and Gold immnnochromatography (GICA). Results The outbreak was a family cluster with an attack rate of 80% (4/5). The first case in this family was a 3-month-old infant. The transmission chain was confirmed from infant to adults (her father, mother and grandmother). Fecal tests for SARS-CoV-2 RNA remained positive for 37 days after the infant was discharged. The infant’s grandmother was confirmed to be positive 2 days after the infant was discharged from hospital. Patients A (3-month-old female), B (patient A’s father), C (patient A’s grandmother), and D (patient A’s mother) had positive serum IgG and negative IgM, but patients A’s grandfather serum IgG and IgM were negative. Conclusion SARS-CoV-2 has strong transmissibility within family settings and presence of viral RNA in stool raises concern for possible fecal–oral transmission. Hospital follow-up and close contact tracing are necessary for those diagnosed with COVID-19.

Child transmission of SARS-CoV-2: a systematic review and meta-analysis

“…Of the 40 articles included, 13 studies were conducted in the North America [ 13 – 25 ], 14 in Europe [ 4 , 10 , 26 – 37 ], 12 from Asia [ 38 – 49 ], and 1 from Australia [ 50 ]. Of the 40 articles, 23 identified household child-to-adult or child-to-child transmission [ 10 , 13 – 15 , 18 , 19 , 24 – 27 , 29 , 32 – 34 , 38 – 42 , 45 – 48 ].…”

“…Of the 40 articles included, 13 studies were conducted in the North America [ 13 – 25 ], 14 in Europe [ 4 , 10 , 26 – 37 ], 12 from Asia [ 38 – 49 ], and 1 from Australia [ 50 ]. Of the 40 articles, 23 identified household child-to-adult or child-to-child transmission [ 10 , 13 – 15 , 18 , 19 , 24 – 27 , 29 , 32 – 34 , 38 – 42 , 45 – 48 ]. Seventeen articles documented transmission at a school [ 4 , 17 – 23 , 28 – 30 , 35 – 37 , 43 , 44 , 50 ], 6 in a childcare setting, [ 19 , 28 , 29 , 31 , 49 , 50 ] and 5 from other social gatherings [ 16 , 17 , 23 , 24 , 47 ] (Table 1 ).…”

COVID-19 transmission: a rapid systematic review of current knowledge

“…There are sufficient data to prove the presence of viral genetic material in patients’ stool [ 84 ], making the fecal-oral route a serious candidate for viral shedding. Moreover, viral clearance in stool seems to be even more prolonged than its clearance in nasopharyngeal swabs [ 14 , 84 ], and this fact suggests that patients (especially children) potentially transmit the virus via contaminated feces even after they have been discharged and recovered [ 48 , 53 , 54 ]. Virus shedding via stool is present even in patients without gastrointestinal symptoms, a fact with significant implications for pandemic control [ 85 ].…”

CrowdMed-II: a blockchain-based framework for efficient consent management in health data sharing

“…The new coronavirus COVID-19 has a strong transmission and infection capacity [ 24 ], and has infected about 229 million people in more than 200 countries or territories. However, the panic caused by the disease’s strong infectivity is more disturbing than the illness itself.…”