Magnitude and Determinants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Household Transmission: A Longitudinal Cohort Study.

Autor:	Kelly JD; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA.; F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA.; San Francisco Veterans Affairs Medical Center, San Francisco, California, USA., Lu S; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Anglin K; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Garcia-Knight M; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA., Pineda-Ramirez J; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Goldberg SA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA., Tassetto M; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA., Zhang A; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA., Donohue K; School of Medicine, University of California, San Francisco, San Francisco, California, USA., Davidson MC; School of Medicine, University of California, San Francisco, San Francisco, California, USA., Romero M; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Diaz Sanchez R; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Djomaleu M; School of Medicine, University of California, San Francisco, San Francisco, California, USA., Mathur S; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA., Chen JY; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Forman CA; School of Medicine, Drexel University, Philadelphia, Pennsylvania, USA., Servellita V; Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA., Montejano RD; School of Medicine, University of California, San Francisco, San Francisco, California, USA., Shak JR; San Francisco Veterans Affairs Medical Center, San Francisco, California, USA., Rutherford GW; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.; Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA., Deeks SG; Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Abedi GR; Respiratory Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Rolfes MA; Respiratory Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Saydah S; Respiratory Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Briggs-Hagen M; Respiratory Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Peluso MJ; Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA., Chiu C; Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA., Midgley CM; Respiratory Viruses Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Andino R; Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA., Martin JN; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2022 Oct 03; Vol. 75 (Suppl 2), pp. S193-S204.
DOI:	10.1093/cid/ciac545
Abstrakt:	Background: Households have emerged as important venues for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Little is known, however, regarding the magnitude and determinants of household transmission in increasingly vaccinated populations. Methods: From September 2020 to January 2022, symptomatic nonhospitalized individuals with SARS-CoV-2 infection by RNA detection were identified within 5 days of symptom onset; all individuals resided with at least 1 other SARS-CoV-2-uninfected household member. These infected persons (cases) and their household members (contacts) were subsequently followed with questionnaire-based measurement and serial nasal specimen collection. The primary outcome was SARS-CoV-2 infection among contacts. Results: We evaluated 42 cases and their 74 household contacts. Among the contacts, 32 (43%) became infected, of whom 5 (16%) were asymptomatic; 81% of transmissions occurred by 5 days after the case's symptom onset. From 21 unvaccinated cases, 14-day cumulative incidence of SARS-CoV-2 infection among contacts was 18/40 (45% [95% confidence interval {CI}, 29%-62%]), most of whom were unvaccinated. From 21 vaccinated cases, 14-day cumulative incidence of SARS-CoV-2 infection was 14/34 (41% [95% CI, 25%-59%]) among all contacts and 12/29 (41% [95% CI, 24%-61%]) among vaccinated contacts. At least 1 comorbid condition among cases and 10 or more days of RNA detection in cases were associated with increased risk of infection among contacts. Conclusions: Among households including individuals with symptomatic SARS-CoV-2 infection, both vaccinated-to-vaccinated and unvaccinated-to-unvaccinated transmission of SARS-CoV-2 to household contacts was common. Because vaccination alone did not notably reduce risk of infection, household contacts will need to employ additional interventions to avoid infection. Competing Interests: Potential conflicts of interest. M. B. H. reports funding support from the CDC. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.)
Databáze:	MEDLINE
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