scholarly journals Household Transmission of SARS-COV-2: Insights from a Population-based Serological Survey

2020 ◽  
Author(s):  
Qifang Bi ◽  
Justin Lessler ◽  
Isabella Eckerle ◽  
Stephen A Lauer ◽  
Laurent Kaiser ◽  
...  
Keyword(s):  
Population Based ◽  
Infection Risk ◽  
Household Member ◽  
Transmission Model ◽  
Risk Of Infection ◽  
Household Transmission ◽  
Working Age ◽  
Community Transmission ◽  
Household Members ◽  
Asymptomatic Infections

AbstractImportanceKnowing the transmissibility of asymptomatic infections and risk of infection from household and community exposures is critical to SARS-CoV-2 control. Limited previous evidence is based primarily on virologic testing, which disproportionately misses mild and asymptomatic infections. Serologic measures are more likely to capture all previously infected individuals.ObjectiveEstimate the risk of SARS-CoV-2 infection from household and community exposures, and identify key risk factors for transmission and infection.DesignHousehold serosurvey and transmission model.SettingPopulation-based serosurvey in Geneva, SwitzerlandParticipants4,524 household members five years and older from 2,267 households enrolled April-June 2020.ExposuresSARS-CoV-2 infected (seropositive) household members and background risk of community transmission.Main outcomes and measuresPast SARS-CoV-2 infection confirmed through anti-SARS-CoV-2 IgG antibodies by ELISA. Chain-binomial models based on the number of infections within households were used to estimate extra-household infection risk by demographics and reported extra-household contacts, and infection risk from exposure to an infected household member by demographics and infector’s symptoms. Infections attributable to exposure to different types of infectious individuals were estimated.ResultsThe chance of being infected by a single SARS-CoV-2 infected household member was 17.2% (95%CrI 13.6-21.5%) compared to a cumulative extra-household infection risk of 5.1% (95%CrI 4.5-5.8%). Infection risk from an infected household member increased with age, from 7.5% (95%CrI 1.3-20.3%) among 5-9 years to 30.2% (95%CrI 14.3-48.2%) among those ≥65 years. Working-age adults (20-49 years) had the highest extra-household infection risk. Seropositive household members not reporting symptoms had 74.8% lower odds (95%CrI 43.8-90.3%) of infecting another household member compared to those reporting symptoms, accounting for 19.6% (95%CrI 12.9-24.5%) of all household infections.Conclusions and RelevanceThe risk of infection from exposure to a single infected household member was four-times that of extra-household exposures over the first wave of the pandemic. Young children had a lower risk from infection from household members. Asymptomatic infections are far less likely to transmit than symptomatic ones but do cause infections. While the small households in Geneva limit the contribution of household spread, household transmission likely plays a greater role in other settings.

scholarly journals Insights into household transmission of SARS-CoV-2 from a population-based serological survey

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Qifang Bi ◽  
Justin Lessler ◽  
Isabella Eckerle ◽  
Stephen A. Lauer ◽  
Laurent Kaiser ◽  
...  
Keyword(s):  
Population Based ◽  
Household Member ◽  
Risk Of Infection ◽  
Cross Sectional ◽  
Household Transmission ◽  
Working Age ◽  
Household Members ◽  
Asymptomatic Infections ◽  
Pandemic Wave ◽  
Transmission Models

AbstractUnderstanding the risk of infection from household- and community-exposures and the transmissibility of asymptomatic infections is critical to SARS-CoV-2 control. Limited previous evidence is based primarily on virologic testing, which disproportionately misses mild and asymptomatic infections. Serologic measures are more likely to capture all previously infected individuals. We apply household transmission models to data from a cross-sectional, household-based population serosurvey of 4,534 people ≥5 years from 2,267 households enrolled April-June 2020 in Geneva, Switzerland. We found that the risk of infection from exposure to a single infected household member aged ≥5 years (17.3%,13.7-21.7) was more than three-times that of extra-household exposures over the first pandemic wave (5.1%,4.5-5.8). Young children had a lower risk of infection from household members. Working-age adults had the highest extra-household infection risk. Seropositive asymptomatic household members had 69.4% lower odds (95%CrI,31.8-88.8%) of infecting another household member compared to those reporting symptoms, accounting for 14.5% (95%CrI, 7.2-22.7%) of all household infections.

scholarly journals Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study

BMJ ◽  
2021 ◽  
pp. n2060
Author(s):  
Lynda Fenton ◽  
Ciara Gribben ◽  
David Caldwell ◽  
Sam Colville ◽  
Jen Bishop ◽  
...  
Keyword(s):  
General Population ◽  
Hospital Admission ◽  
Healthcare Workers ◽  
Population Based ◽  
Positive Test ◽  
Positive Test Result ◽  
Working Age ◽  
Household Members ◽  
Test Result ◽  
Control Study

Abstract Objective To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. Design Population based nested case-control study. Setting Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. Participants All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. Main outcome measures The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. Results Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. Conclusion Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.

Household carriage and acquisition of extended-spectrum β-lactamase–producing Enterobacteriaceae: A systematic review

2019 ◽  
Vol 41 (3) ◽  
pp. 286-294 ◽  
Author(s):  
Romain Martischang ◽  
Maria E. Riccio ◽  
Mohamed Abbas ◽  
Andrew J. Stewardson ◽  
Jan A. J. W. Kluytmans ◽  
...  
Keyword(s):  
Model Potential ◽  
Multiple Sources ◽  
Cross Sectional ◽  
Household Transmission ◽  
Language Restriction ◽  
Community Transmission ◽  
Household Members ◽  
And Control ◽  
Acquisition Rates

AbstractObjective:The epidemiology of ESBL-producing Enterobacteriaceae (ESBL-PE) has been extensively studied in hospitals, but data on community transmission are scarce. We investigated ESBL-PE cocarriage and acquisition in households using a systematic literature review.Methods:We conducted a systematic literature search to retrieve cross-sectional or cohort studies published between 1990 and 2018 evaluating cocarriage proportions and/or acquisition rates of ESBL-PE among household members, without language restriction. We excluded studies focusing on animal-to-human transmission or conducted in nonhousehold settings. The main outcomes were ESBL-PE cocarriage proportions and acquisition rates, stratified according to phenotypic or genotypic assessment of strain relatedness. Cocarriage proportions of clonally related ESBL-PE were transformed using the double-arcsine method and were pooled using a random-effects model. Potential biases were assessed manually.Results:We included 13 studies. Among 863 household members of ESBL-PE positive index cases, prevalence of ESBL-PE cocarriage ranged from 8% to 37%. Overall, 12% (95% confidence interval [CI], 8%–16%) of subjects had a clonally related strain. Those proportions were higher for Klebsiella pneumoniae (20%–25%) than for Escherichia coli (10%–20%). Acquisition rates of clonally related ESBL-PE among 180 initially ESBL-PE–free household members of a previously identified carrier ranged between 1.56 and 2.03 events per 1,000 person weeks of follow-up. We identified multiple sources of bias and high heterogeneity (I2, 70%) between studies.Conclusions:ESBL-PE household cocarriage is frequent, suggesting intrafamilial acquisition. Further research is needed to evaluate the risk and control of ESBL-PE household transmission.

scholarly journals The impact of household transmission on duration of outpatient colonization with methicillin-resistantStaphylococcus aureus

2010 ◽  
Vol 138 (5) ◽  
pp. 683-685 ◽  
Author(s):  
E. LAUTENBACH ◽  
P. TOLOMEO ◽  
I. NACHAMKIN ◽  
B. HU ◽  
T. E. ZAOUTIS
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Household Member ◽  
Household Transmission ◽  
The Mean ◽  
Household Members ◽  
The Impact ◽  
Mrsa Colonization ◽  
Index Cases

SUMMARYWe identified eight consecutive patients who presented with a skin or soft tissue infection due to MRSA. Of seven household members of these cases, three were colonized with MRSA. The mean duration of MRSA colonization in index cases was 33 days (range 14–104), while mean duration of colonization in household cases was 54 days (range 12–95). There was a borderline significant association between having a concurrent colonized household member and a longer duration of colonization (mean 44 daysvs. 26 days,P=0·08).

scholarly journals Household Transmission and Clinical Features of SARS-CoV-2 Infections by Age in 2 US Communities

2021 ◽  
Author(s):  
Huong Q McLean ◽  
Carlos G Grijalva ◽  
Kayla E Hanson ◽  
Yuwei Zhu ◽  
Jessica E Deyoe ◽  
...  
Keyword(s):  
Age Differences ◽  
Secondary Infection ◽  
Infection Risk ◽  
Transmission Risk ◽  
Age Group ◽  
Primary Case ◽  
Household Contacts ◽  
Household Transmission ◽  
Age Related ◽  
Asymptomatic Infections

OBJECTIVES. Examine age differences in SARS-CoV-2 transmission risk from primary cases and infection risk among household contacts, and symptoms among those with SARS-CoV-2 infection. METHODS. People with SARS-CoV-2 infection in Nashville, Tennessee and central and western Wisconsin and their household contacts were followed daily for 14 days to ascertain symptoms and secondary transmission events. Households were enrolled between April 2020 and April 2021. Secondary infection risks (SIR) by age of the primary case and contacts were estimated using generalized estimating equations. RESULTS. The 226 primary cases were followed by 197 (49%) secondary SARS-CoV-2 infections among 404 household contacts. Age group-specific SIR among contacts ranged from 35% to 53%, with no differences by age. SIR was lower from primary cases aged 12-17 years than from primary cases 18-49 years (risk ratio [RR] 0.42; 95% confidence interval [CI] 0.19-0.92). SIR was 56% and 45%, respectively, among primary case-contact pairs in the same versus different age group (RR 1.54; 95% CI 1.03-2.31). SIR was highest among primary case-contacts pairs aged ≥65 years (77%) and 5-11 years (70%). Among secondary SARS-CoV-2 infections, 19% were asymptomatic; there was no difference in the frequency of asymptomatic infections by age group. CONCLUSIONS. Both children and adults can transmit and are susceptible to SARS-CoV-2 infection. SIR did not vary by age, but further research is needed to understand age-related differences in probability of transmission from primary cases by age.

scholarly journals Low SARS-CoV-2 seroprevalence in the Austrian capital after an early governmental lockdown

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marie-Kathrin Breyer ◽  
Robab Breyer-Kohansal ◽  
Sylvia Hartl ◽  
Michael Kundi ◽  
Lukas Weseslindtner ◽  
...  
Keyword(s):  
Population Based ◽  
Capital City ◽  
Cumulative Number ◽  
Household Transmission ◽  
Confirmatory Assay ◽  
Austrian Capital ◽  
Household Members ◽  
Polymerase Chain ◽  
Taste And Smell ◽  
Lead Study

AbstractWe analyzed SARS-CoV-2 seroprevalence in a large, well-described representative Viennese cohort after an early governmental lockdown with respect to the occurrence of symptoms and household transmission. Participants of the LEAD Study, a population-based cohort study from Vienna, Austria, were invited along with their household members (April 20th to May20th 2020). Sera were analyzed using anti-SARS-CoV-2 immunoassay including a neutralization test as a confirmatory assay. A total of 12,419 individuals participated (5984 LEAD participants; 6435 household members), 163 (1.31%; 59 LEAD cohort members) of whom were SARS-CoV-2 antibody positive. The estimated number of COVID-19 cases projected from our findings by age and sex for Vienna was 21,504 (1.13%). Cumulative number of positively tested cases in Vienna until May 20th 2020 was 3020, hence 7.1 times (95% confidence interval 5.5–9.1) lower than projected. Relative risk (RR) of seropositivity by age was highest for children aged 6–9 years [RR compared to age group 20–49: 1.21 (CI 0.37–4.01)], lowest for ≥ 65 years [RR 0.47 (CI 0.21–1.03)]. Half of the positive individuals developed no or mild symptoms. In a multivariate analysis, taste and smell disturbances were most strongly related to SARS-CoV-2 positivity. Infection probability within households with one confirmed SARS-CoV-2-specific antibody-positive person was 31%. Although seroprevalence was very low (1.13%) for a central European capital city, due to an early governmental lockdown, SARS-CoV-2 infections were more prevalent than officially reported polymerase chain reaction-positive cases. Of note, seroprevalence was highest in young children. Half of SARS-CoV-2 antibody-positive subjects had no or only mild symptoms. Taste and smell disturbances were most prominent, possibly guiding clinicians in diagnosing SARS-CoV-2 infection.

scholarly journals Seroepidemiology of SARS-CoV-2 infections in an urban Nicaraguan population

2021 ◽  
Author(s):  
Fredman González ◽  
Nadja A. Vielot ◽  
Michael Sciaudone ◽  
Christian Toval-Ruíz ◽  
Lakshmanane Premkumar ◽  
...  
Keyword(s):  
Population Based ◽  
Household Member ◽  
Preventive Behaviors ◽  
Household Transmission

ABSTRACTIn a Nicaraguan population-based cohort, SARS-CoV-2 seroprevalence was 34%, with higher prevalence in children compared to adults. Having a seropositive household member was associated with a two-fold probability of individual seropositivity, suggesting a role for household transmission. Co-morbidities and preventive behaviors were not associated with SARS-CoV-2 seroprevalence.

scholarly journals Development and validation of a clinical risk score to predict the risk of SARS-CoV-2 infection from administrative data: A population-based cohort study from Italy

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0237202
Author(s):  
Valentina Orlando ◽  
Federico Rea ◽  
Laura Savaré ◽  
Ilaria Guarino ◽  
Sara Mucherino ◽  
...  
Keyword(s):  
High Risk ◽  
Kidney Diseases ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Infection Risk ◽  
Risk Of Infection ◽  
Clinical Predictors ◽  
Retrospective Case ◽  
Campania Region ◽  
Increased Risk

Background The novel coronavirus (SARS-CoV-2) pandemic spread rapidly worldwide increasing exponentially in Italy. To date, there is lack of studies describing clinical characteristics of the people at high risk of infection. Hence, we aimed (i) to identify clinical predictors of SARS-CoV-2 infection risk, (ii) to develop and validate a score predicting SARS-CoV-2 infection risk, and (iii) to compare it with unspecific scores. Methods Retrospective case-control study using administrative health-related database was carried out in Southern Italy (Campania region) among beneficiaries of Regional Health Service aged over than 30 years. For each person with SARS-CoV-2 confirmed infection (case), up to five controls were randomly matched for gender, age and municipality of residence. Odds ratios and 90% confidence intervals for associations between candidate predictors and risk of infection were estimated by means of conditional logistic regression. SARS-CoV-2 Infection Score (SIS) was developed by generating a total aggregate score obtained from assignment of a weight at each selected covariate using coefficients estimated from the model. Finally, the score was categorized by assigning increasing values from 1 to 4. Discriminant power was used to compare SIS performance with that of other comorbidity scores. Results Subjects suffering from diabetes, anaemias, Parkinson’s disease, mental disorders, cardiovascular and inflammatory bowel and kidney diseases showed increased risk of SARS-CoV-2 infection. Similar estimates were recorded for men and women and younger and older than 65 years. Fifteen conditions significantly contributed to the SIS. As SIS value increases, risk progressively increases, being odds of SARS-CoV-2 infection among people with the highest SIS value (SIS = 4) 1.74 times higher than those unaffected by any SIS contributing conditions (SIS = 1). Conclusion Conditions and diseases making people more vulnerable to SARS-CoV-2 infection were identified by the current study. Our results support decision-makers in identifying high-risk people and adopting of preventive measures to minimize the spread of further epidemic waves.

scholarly journals Trajectories of sickness absence and disability pension in colorectal cancer: a Swedish cohort study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Chen ◽  
K Alexanderson
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Sickness Absence ◽  
Educational Level ◽  
Disability Pension ◽  
Population Based ◽  
Work Situation ◽  
Working Age ◽  
Future Work ◽  
Very High

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.

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