Investigation of a family cluster outbreak of COVID-19 indicates the necessity of CT screening for asymptomatic family members in close contact with confirmed patients

We report a family cluster of cases of coronavirus disease 2019 (COVID-19), in which three members of the family were exposed to SARS-CoV-2 at the same time, but the disease manifested differently among the three family members. We describe the clinical manifestations, disease progression, and treatment of wife and husband. We also analyze the daughter who was in close contact with patients with COVID-19 but was not infected.

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Intrafamilial Transmission and Family-Specific Spectra of Cutaneous Betapapillomaviruses

Journal of Virology ◽

10.1128/jvi.01338-08 ◽

2008 ◽

Vol 83 (2) ◽

pp. 811-816 ◽

Cited By ~ 48

Author(s):

S. J. Weissenborn ◽

M. N. C. De Koning ◽

U. Wieland ◽

W. G. V. Quint ◽

H. J. Pfister

Keyword(s):

Skin Cancer ◽

General Population ◽

Persistent Infection ◽

Close Contact ◽

Family Members ◽

Hpv Dna ◽

Parents And Children ◽

Type Spectrum ◽

Hpv Types ◽

The Impact

ABSTRACT Cutaneous human betapapillomaviruses (beta-HPVs) are widespread in the general population and have been associated with skin cancer. To evaluate the impact of continuous person-to-person contact within families on an individual's beta-HPV type spectrum, we collected serial skin swab samples from parents and children from 10 families. All participants were found to be beta-HPV DNA positive, with 1 to 13 types at study entry (median, 4.0 types). Initial and cumulative (2 to 16 types) HPV type multiplicities varied widely between different families but only a little between family members. The high intrafamilial correlation of HPV multiplicity is already obvious for babies aged 10 days to 10 months. Family members typically displayed similar spectra of HPV types. More than 75% of the HPV types in babies were also detected in their parents. This indicates that HPV transmission mainly results from close contact between family members. Type-specific persistence for at least 9 months was more prevalent in parents (92%) than in children (66%). Of the types detected throughout the study, 24% turned out to persist in the parents and only 11% in the children. Interestingly, about one-half of the HPV types found to persist in one of the parents occurred less frequently or even only sporadically in the spouse. Similarly, only one-third of the persisting parental types also persisted in their children. This indicates that even regular exposure to cutaneous HPV does not necessarily lead to the establishment of a persistent infection, which may point to type-specific susceptibilities of different individuals.

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Effects of Isolation Among Older Adults Due to Coronavirus Restrictions

Innovation in Aging ◽

10.1093/geroni/igab046.1860 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 483-484

Author(s):

Cynthia Thomas

Keyword(s):

Older Adults ◽

Close Contact ◽

Family Members ◽

Daily Activities ◽

New Disease ◽

Structured Interviews ◽

Daily Lives ◽

Social Distancing ◽

The Past ◽

The Us

Abstract Semi-structured interviews were conducted with 35 residents in a Maryland condominium, four to six months after the presence of the epidemic in the US was recognized in mid-March. The objective was to determine to what extent the restrictions resulting from the presence of a new disease was affecting older adults in their daily lives, and in their plans for the future. All respondents were over the age of 60 and half were more than 80 years old. Two-thirds lived by themselves; most others lived with a husband or wife. Respondents for the most part were following guidelines to wear masks, practice social distancing and avoid close contact with persons outside their homes, including other family members. Over half had already made dramatic changes in their daily activities. Some found an opportunity to develop new skills, had connected with people from the past, or had become more introspective. Others, while exhibiting some of the same characteristics, were more focused on the restrictions they faced, and were more aware than ever of the limited amount of time left in their lives. Differences between respondents in the emphasis of their perspectives are explored, by age, gender, and other characteristics.

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Family Associations in Communally Roosting Black Vultures

The Auk ◽

10.1093/auk/103.1.32 ◽

1986 ◽

Vol 103 (1) ◽

pp. 32-41 ◽

Cited By ~ 26

Author(s):

Patricia Parker Rabenold

Keyword(s):

Close Contact ◽

Family Members ◽

Breeding Dispersal ◽

Nest Sites ◽

Related Individuals ◽

Family Associations

Abstract Observations of marked individuals in a partially marked population of Black Vultures (Coragyps atratus) show that immediate family members maintain close contact throughout the year. Associations between mates and between parents and offspring are primarily responsible for this. Mutual allopreening, feedings, and intercessions in fights occur almost exclusively within families. Adults known to breed within the study area (neighbors) associate more strongly than nonneighbors, although not as strongly as mates. Certain families associate preferentially with certain other families. Strength of interfamily associations is not related to distance between nest sites within the study area. I argue, therefore, that birds actively seek particular individuals as associates. Further knowledge of breeding dispersal of young of known parentage will provide clues to relatedness of highly associated neighbors. Strong associations among related individuals can help explain the use of avian communal roosts as information centers.

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Person-to-Person Transmission of Avian Influenza A (H7N9) Among Family Members in Eastern China, 2016

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.6 ◽

2020 ◽

pp. 1-6

Author(s):

Chao Shi ◽

Ping Shi ◽

Xu Yang ◽

Jing Bao ◽

Yanhua Qian ◽

...

Keyword(s):

Avian Influenza ◽

Influenza A ◽

Early Stage ◽

Close Contact ◽

Eastern China ◽

Family Members ◽

Index Patient ◽

H7n9 Virus ◽

Viral Shedding ◽

Live Poultry

ABSTRACT Objective: Human infections with avian influenza A (H7N9) virus are associated with exposure to poultry and live poultry markets, but the evidence of person-to-person transmission remains limited. This study reports a suspected person-to-person transmission of H7N9 virus, and explores what factors influenced this transmission. Methods: We interviewed 2 patients with H7N9 infection and their family members as well as health-care workers. Samples from the patients and environments were tested by real-time reverse transcription-polymerase chain reaction. Results: The index patient became ill 5 to 6 days after his last exposure to the poultry bought in the market of Weimiao town. The second patient, the sister of the index patient, who had sustained intensive and unprotected close contact with the index patient, had no exposure to poultry. This study documents that the H7N9 virus was transmitted directly from the index patient to his sister. Conclusions: Our findings suggest that person-to-person transmission may be associated with sustained close contact with the patient during his onset of early stage, when the H7N9 viral shedding increases sharply.

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A Single Case Outbreak of Nipah Encephalitis From India in May–June 2019

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.607 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s104-s104

Author(s):

Anup Warrier ◽

Arun Wilson

Keyword(s):

Respiratory Symptoms ◽

Throat Swab ◽

Close Contact ◽

Single Case ◽

Nipah Virus ◽

Family Members ◽

Contact Tracing ◽

Surveillance Period ◽

Standard Precautions ◽

Close Family

Background: Nipah encephalitis outbreaks mostly involve multiple patients. We report a case of Nipah virus encephalitis (NVE), which had no documented secondary cases in spite of many having prolonged and close contact with the patient. Methods: A 21-year-old male was admitted with NVE on May 30, 2019. Before the confirmatory report, there was close contact with multiple healthcare workers (HCWs), defined as exposure for >1 hour to the patient or his immediate environment and/or exposure to body fluids. We conducted extensive contact tracing of all HCWs who had come into close contact with the proven NVE case from the time of admission to the time of discharge. This contact tracing included those who had nursed him before the diagnosis with usual standard precautions and those who had nursed him after the diagnosis with full PPE. These HCWs were reviewed daily for fever and respiratory symptoms. All those who developed these symptoms within the 3 weeks of exposure where tested for NEV with a throat swab using RT-PCR. This testing was conducted twice over 3 days to confirm negative results. For the close family contacts that were asymptomatic, both throat swab and serum for Nipah IgM were tested. Results: In total, 169 HCW contacts were identified at our hospital. Of these, 94 were at high risk according the predetermined criteria and others were low-risk contacts. Moreover, 7 HCWs developed fever and respiratory symptoms within the defined surveillance period; 5 had symptoms before the diagnosis (using only standard precautions) and 2 were in contact with full PPE after the diagnosis. All of these symptomatic contacts were tested for NEV (throat swab and serology), and all were negative. The family members of the patient (his mother and aunt) who had cared for him throughout his illness period of 12 days before the diagnosis were also tested and were seronegative for NEV. Conclusions: This NEV case had very low transmission capability; even close family members who cared for him for 12 days without any precautions and had exposure to urine (which was positive for NEV) did not contract the disease. The absence of overt respiratory involvement and young age of the affected patient could have contributed to low transmissibility both prior to hospitalization and during the hospitalization.Funding: NoneDisclosures: None

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Attitude and Practices of Health Care Professionals and Their Family Members toward Health Care Professionals Dealing with Covid-19 Patients in New Delhi, India

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/460 ◽

2021 ◽

Vol 10 (30) ◽

pp. 2249-2254

Author(s):

Shruti Chopra ◽

Sabreen Gujral ◽

Shweta Sood ◽

Naresh Sharma ◽

Akshara Singh

Keyword(s):

Health Care ◽

Family Member ◽

Health Care Professionals ◽

Positive Attitude ◽

Close Contact ◽

Family Members ◽

World Health ◽

Initial Reaction ◽

Preventive Practices ◽

First Case

BACKGROUND Coronavirus was noticed in the mid-1930’s and the first case of infection in humans was reported as a cold in 1960. In December 2019, clusters of pneumonia cases caused havoc in China. In order to eliminate the infection in the current pandemic, World Health Organisation (WHO) has furnished several recommendations, online courses, and training sessions to increase knowledge, prevention, and control among the health care workers (HCWs). It is crucial to guarantee the safety of not only the health care professionals but also the people who are in close contact with them. We wanted to assess the attitude and safety practices of family members of health care professionals dealing with Covid-19 patients and if the increasing number of cases in India have altered their reaction. METHODS A cross-sectional survey-based study was conducted from July - August 2020 on HCWs dealing with Covid-19 patients and any close contact personnel such as family members of HCWs in order to avoid the spread of Covid-19 among individuals aged 14 - 60 years. RESULTS A total of 368 respondents participated in the study. Majority of the respondents had a positive attitude. In terms of relation, children had a negative attitude towards having their family member deal with Covid-19 patients (46.2 %; N = 46) whereas, 51.5 % (N = 35) spouses had a more positive outlook and 49.2 % (N = 181) respondents reported that the increasing cases in India had altered their initial reaction. CONCLUSIONS Majority of the participants from our study reported a positive attitude towards a family member working in close contact with a Covid-19 patient. More than 50 % of the participants had undertaken various precautions to restrict the spread of the disease. KEY WORDS Health Personnel, Infectious Disease Transmission, Pandemic, Preventive Practices, Relatives

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Tuberculosis in Healthcare Workers Caring for a Congenitally Infected Infant

Infection Control and Hospital Epidemiology ◽

10.1086/502344 ◽

2004 ◽

Vol 25 (12) ◽

pp. 1062-1066 ◽

Cited By ~ 14

Author(s):

Françoise Mouchet ◽

Valérie Hansen ◽

Inge Van Herreweghe ◽

Olivier Vandenberg ◽

Régine Van Hesse ◽

...

Keyword(s):

Healthcare Workers ◽

Neonatal Intensive Care ◽

Close Contact ◽

Family Members ◽

Delayed Diagnosis ◽

Nosocomial Transmission ◽

Skin Tests ◽

Urban Hospital ◽

Infected Infant ◽

Congenital Tuberculosis

AbstractObjective:To assess the extent of nosocomial transmission of tuberculosis among infants, family members, and healthcare workers (HCWs) who were exposed to a 29-week-old premature infant with congenital tuberculosis, diagnosed at 102 days of age.Design:A prospective exposure investigation using tuberculin skin test (TST) conversion was conducted. Contacts underwent two skin tests 10 to 12 weeks apart. Clinical examination and chest radiographs were performed to rule out disease. Isoniazid prophylaxis was administered to exposed infants at higher risk.Setting:A neonatal intensive care unit in an urban hospital in Brussels, Belgium.Participants:Ninety-seven infants, 139 HCWs, and 180 visitors.Results:Newly positive TST results occurred in HCWs who had been in close contact with the infant. Six (19%) of 32 primary care nurses and physicians had TST conversions and received treatment. Among the 97 exposed infants, 85 were screened and 34 were identified as at higher risk of infection. Of these, 27 received preventive isoniazid. None of the infants and none of the 93 other infants' family members evaluated were infected.Conclusions:Congenital tuberculosis in an infant poses a risk for nosocomial transmission to HCWs. Delayed diagnosis of this rare disease and close proximity are the most important factors related to transmission.

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

Health Information Science and Systems ◽

10.1007/s13755-020-00136-2 ◽

2021 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Guo-tian Lin ◽

Yue-hua Zhang ◽

Mei-fang Xiao ◽

Yong Wei ◽

Jin-ni Chen ◽

...

Keyword(s):

Close Contact ◽

Contact Tracing ◽

Epidemiological Methods ◽

Oral Transmission ◽

Family Cluster ◽

Serum Igg ◽

First Case ◽

Hospital Patients ◽

Fecal Tests ◽

Epidemiological Characteristics

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.

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Clinical Characteristics of SARS-CoV-2 Infection in Haikou: a study of a family cluster

10.21203/rs.3.rs-23245/v1 ◽

2020 ◽

Author(s):

Hui Juan Chen ◽

Jie Qiu ◽

Biao Wu ◽

Zhen Ping Wang ◽

Yang Chen ◽

...

Keyword(s):

Clinical Laboratory ◽

White Blood Cells ◽

Family Members ◽

C Reactive Protein ◽

Reactive Protein ◽

The Third ◽

Family Cluster ◽

The Family ◽

Family Setting ◽

Acid Test

Abstract Background: The outbreak of sever acute respiratory syndrome coronavirus 2(SARS-CoV-2) has become a great threat to the world. No study has been done on the mild or asymptomatic SARS-CoV-2 in a family cluster.Methods: We report the epidemiological, clinical, laboratory, radiological, and clinical outcomes of five patients in a family cluster.Results: We enrolled a family of five patients who was confirmed with SARS-CoV-2 infection. One of them worked in Wuhan and returned to Danzhou, Hainan on January 22,2020. The other four family members, who did not travel to Wuhan, became infected with the virus after several days of contact with the family member. Five family members (aged 33–57years) presented with fever, cough or no symptom onset. Three of them had negative nucleic test on first swab sampling. One of them was not confirmed until the third nucleic acid test. Two of them had radiological ground-glass lung opacities. Two patients presenting with fever had lymphopenia or decreased white blood cells. No one had increased C-reactive protein or lactate dehydrogenase levels. After treatment, they were discharged.Conclusions: Person-to-person transmission of SARS-CoV-2 was confirmed in family setting. Concerns should be raised for the asymptomatic persons in a family cluster.

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