Epidemiology of SARS-CoV-2 transmission and superspreading in Salt Lake County, Utah, March-May 2020.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 17 01 2022
accepted: 10 09 2022
medline: 26 6 2023
pubmed: 23 6 2023
entrez: 23 6 2023
Statut: epublish

Résumé

Understanding the drivers of SARS-CoV-2 transmission can inform the development of interventions. We evaluated transmission identified by contact tracing investigations between March-May 2020 in Salt Lake County, Utah, to quantify the impact of this intervention and identify risk factors for transmission. RT-PCR positive and untested symptomatic contacts were classified as confirmed and probable secondary case-patients, respectively. We compared the number of case-patients and close contacts generated by different groups, and used logistic regression to evaluate factors associated with transmission. Data were collected on 184 index case-patients and up to six generations of contacts. Of 1,499 close contacts, 374 (25%) were classified as secondary case-patients. Decreased transmission odds were observed for contacts aged <18 years (OR = 0.55 [95% CI: 0.38-0.79]), versus 18-44 years, and for workplace (OR = 0.36 [95% CI: 0.23-0.55]) and social (OR = 0.44 [95% CI: 0.28-0.66]) contacts, versus household contacts. Higher transmission odds were observed for case-patient's spouses than other household contacts (OR = 2.25 [95% CI: 1.52-3.35]). Compared to index case-patients identified in the community, secondary case-patients identified through contract-tracing generated significantly fewer close contacts and secondary case-patients of their own. Transmission was heterogeneous, with 41% of index case-patients generating 81% of directly-linked secondary case-patients. Given sufficient resources and complementary public health measures, contact tracing can contain known chains of SARS-CoV-2 transmission. Transmission is associated with age and exposure setting, and can be highly variable, with a few infections generating a disproportionately high share of onward transmission.

Sections du résumé

BACKGROUND
Understanding the drivers of SARS-CoV-2 transmission can inform the development of interventions. We evaluated transmission identified by contact tracing investigations between March-May 2020 in Salt Lake County, Utah, to quantify the impact of this intervention and identify risk factors for transmission.
METHODS
RT-PCR positive and untested symptomatic contacts were classified as confirmed and probable secondary case-patients, respectively. We compared the number of case-patients and close contacts generated by different groups, and used logistic regression to evaluate factors associated with transmission.
RESULTS
Data were collected on 184 index case-patients and up to six generations of contacts. Of 1,499 close contacts, 374 (25%) were classified as secondary case-patients. Decreased transmission odds were observed for contacts aged <18 years (OR = 0.55 [95% CI: 0.38-0.79]), versus 18-44 years, and for workplace (OR = 0.36 [95% CI: 0.23-0.55]) and social (OR = 0.44 [95% CI: 0.28-0.66]) contacts, versus household contacts. Higher transmission odds were observed for case-patient's spouses than other household contacts (OR = 2.25 [95% CI: 1.52-3.35]). Compared to index case-patients identified in the community, secondary case-patients identified through contract-tracing generated significantly fewer close contacts and secondary case-patients of their own. Transmission was heterogeneous, with 41% of index case-patients generating 81% of directly-linked secondary case-patients.
CONCLUSIONS
Given sufficient resources and complementary public health measures, contact tracing can contain known chains of SARS-CoV-2 transmission. Transmission is associated with age and exposure setting, and can be highly variable, with a few infections generating a disproportionately high share of onward transmission.

Identifiants

pubmed: 37352280
doi: 10.1371/journal.pone.0275125
pii: PONE-D-22-01628
pmc: PMC10289415
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0275125

Informations de copyright

Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Joseph Walker (J)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Tiffany Tran (T)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Brooke Lappe (B)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Paul Gastanaduy (P)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Prabasaj Paul (P)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Ian T Kracalik (IT)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Victoria L Fields (VL)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Adriana Lopez (A)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Amy Schwartz (A)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Nathaniel M Lewis (NM)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Utah Department of Health, Salt Lake City, Utah, United States of America.

Jacqueline E Tate (JE)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Hannah L Kirking (HL)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Aron J Hall (AJ)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Eric Pevzner (E)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Ha Khong (H)

Salt Lake County Health Department, Salt Lake City, Utah, United States of America.

Maureen Smithee (M)

Salt Lake County Health Department, Salt Lake City, Utah, United States of America.

Jason Lowry (J)

Salt Lake County Health Department, Salt Lake City, Utah, United States of America.

Angela Dunn (A)

Utah Department of Health, Salt Lake City, Utah, United States of America.

Tair Kiphibane (T)

Salt Lake County Health Department, Salt Lake City, Utah, United States of America.

Cuc H Tran (CH)

COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

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