Cluster of Coronavirus Disease 2019 (COVID-19) in the French Alps, February 2020.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
28 07 2020
Historique:
received: 05 03 2020
accepted: 09 04 2020
pubmed: 12 4 2020
medline: 11 8 2020
entrez: 12 4 2020
Statut: ppublish

Résumé

On 7 February 2020, French Health authorities were informed of a confirmed case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an Englishman infected in Singapore who had recently stayed in a chalet in the French Alps. We conducted an investigation to identify secondary cases and interrupt transmission. We defined as a confirmed case a person linked to the chalet with a positive reverse-transcription polymerase chain reaction sample for SARS-CoV-2. The index case stayed 4 days in the chalet with 10 English tourists and a family of 5 French residents; SARS-CoV-2 was detected in 5 individuals in France, 6 in England (including the index case), and 1 in Spain (overall attack rate in the chalet: 75%). One pediatric case, with picornavirus and influenza A coinfection, visited 3 different schools while symptomatic. One case was asymptomatic, with similar viral load as that of a symptomatic case. Seven days after the first cases were diagnosed, 1 tertiary case was detected in a symptomatic patient with from the chalet a positive endotracheal aspirate; all previous and concurrent nasopharyngeal specimens were negative. Additionally, 172 contacts were monitored; all contacts tested for SARS-CoV-2 (N = 73) were negative. The occurrence in this cluster of 1 asymptomatic case with similar viral load as a symptomatic patient suggests transmission potential of asymptomatic individuals. The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children. Finally, the dissociation between upper and lower respiratory tract results underscores the need for close monitoring of the clinical evolution of suspected cases of coronavirus disease 2019.

Sections du résumé

BACKGROUND
On 7 February 2020, French Health authorities were informed of a confirmed case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an Englishman infected in Singapore who had recently stayed in a chalet in the French Alps. We conducted an investigation to identify secondary cases and interrupt transmission.
METHODS
We defined as a confirmed case a person linked to the chalet with a positive reverse-transcription polymerase chain reaction sample for SARS-CoV-2.
RESULTS
The index case stayed 4 days in the chalet with 10 English tourists and a family of 5 French residents; SARS-CoV-2 was detected in 5 individuals in France, 6 in England (including the index case), and 1 in Spain (overall attack rate in the chalet: 75%). One pediatric case, with picornavirus and influenza A coinfection, visited 3 different schools while symptomatic. One case was asymptomatic, with similar viral load as that of a symptomatic case. Seven days after the first cases were diagnosed, 1 tertiary case was detected in a symptomatic patient with from the chalet a positive endotracheal aspirate; all previous and concurrent nasopharyngeal specimens were negative. Additionally, 172 contacts were monitored; all contacts tested for SARS-CoV-2 (N = 73) were negative.
CONCLUSIONS
The occurrence in this cluster of 1 asymptomatic case with similar viral load as a symptomatic patient suggests transmission potential of asymptomatic individuals. The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children. Finally, the dissociation between upper and lower respiratory tract results underscores the need for close monitoring of the clinical evolution of suspected cases of coronavirus disease 2019.

Identifiants

pubmed: 32277759
pii: 5819060
doi: 10.1093/cid/ciaa424
pmc: PMC7184384
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

825-832

Investigateurs

Elise Brottet (E)
Delphine Casamatta (D)
Yves Gallien (Y)
Scarlett George (S)
Delphine Viriot (D)
Fatima Ait Belghiti (F)
Sibylle Bernard-Stoecklin (S)
Jean-Claude Desenclos (JC)
Coralie Giese (C)
Didier Ghislain (D)
Magali Gounon (M)
Nathalie Grangeret (N)
Cécile Marie (C)
Bruno Morel (B)
Muriel Deher (M)
Anne-Sophie Ronnaux Baron (AS)
Geneviève Courbis (G)
Nathalie Ragozin (N)
Monika Wolska (M)
Eric Serange (E)
Delphine Mercatello (D)
Soraya Aiouaz (S)
Martine Valette (M)
Emilie Frobert (E)
Laurence Josset (L)
Vanessa Escuret (V)
Florence Morfin (F)
Geneviève Billaud (G)
Myriam Blanc (M)
Julie Arata-Bardet (J)
Marie Froidure (M)
Marion Le Maréchal (M)
Patricia Pavese (P)
Isabelle Pierre (I)
Agathe Becker (A)
Pierre Chauvelot (P)
Anne Conrad (A)
Tristan Ferry (T)
Patrick Miailhes (P)
Thomas Perpoint (T)
Cécile Pouderoux (C)
Sandrine Roux (S)
Florent Valour (F)
Marie-France Lutz (MF)
Anne Pouvaret (A)
Virginie Vitrat (V)
Mylène Maillet (M)
Cécile Janssen (C)
Emilie Piet (E)
Alexie Bosch (A)
Anne-Laure Destrem (AL)
Margaux Isnard (M)
Thibault Challan-Belval (T)
Chloe Wackenheim (C)
Alice Couturier (A)
Gael Gheno (G)
Thierry Roupioz (T)
Nicolas Lucet (N)
Stéphane Ayouni (S)
Mireille Vincent (M)
Servicio de Epidemiología (S)
Dirección General de Salud Pública Del Gover Balear (D)
Virginie Masserey Spicher (V)
Catherine Bourquin (C)
Jeanine Stoll (J)
Pascal Chaud (P)
Anne-Laure Mounayar (AL)

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

Auteurs

Kostas Danis (K)

French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France.

Olivier Epaulard (O)

Infectious Diseases Department, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.
Fédération d'infectiologie multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, Grenoble, France.
Unité Mixte de Recherche 5075 (UMR 5075), Institut de biologie structurale, Grenoble, France.

Thomas Bénet (T)

French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France.

Alexandre Gaymard (A)

Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France.

Séphora Campoy (S)

Regional Health Agency of Auvergne Rhône Alpes, Lyon, France.

Elisabeth Botelho-Nevers (E)

Infectious Diseases Department, University Hospital of Saint-Etienne, Lyon, France.
Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, St-Etienne, France.

Maude Bouscambert-Duchamp (M)

Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France.

Guillaume Spaccaferri (G)

French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France.

Florence Ader (F)

Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.

Alexandra Mailles (A)

French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France.

Zoubida Boudalaa (Z)

Regional Health Agency of Auvergne Rhône Alpes, Lyon, France.

Violaine Tolsma (V)

Infectious Diseases Unit, Centre Hospitalier Annecy Genevois, Annecy, France.

Julien Berra (J)

Regional Health Agency of Auvergne Rhône Alpes, Lyon, France.

Sophie Vaux (S)

French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France.

Emmanuel Forestier (E)

Infectious Disease Department, Centre Hospitalier Metropole Savoie, Chambery, France.

Caroline Landelle (C)

Service d'Hygiène Hospitalière et de Gestion des Risques, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.
Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques, Applications, Grenoble, Unité Mixte de Recherche 5525 (TIMC-IMAG UMR5525), CNRS, Université Grenoble Alpes, Grenoble, France.

Erica Fougere (E)

French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France.

Alexandra Thabuis (A)

French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France.

Philippe Berthelot (P)

Infectious Diseases Department, University Hospital of Saint-Etienne, Lyon, France.
Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, St-Etienne, France.

Raphael Veil (R)

Public Health Emergency Operations Center, French Ministry of Health, Paris, France.

Daniel Levy-Bruhl (D)

French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France.

Christian Chidiac (C)

Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.
Maladies Infectieuses et Tropicales, Université Claude Bernard Lyon 1 (UCBL1), Unité de formation et de recherche (UFR) Lyon Sud-Charles Mérieux, Lyon, France.

Bruno Lina (B)

Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France.

Bruno Coignard (B)

French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France.

Christine Saura (C)

French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France.

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