• Clin. Infect. Dis. · Oct 2021

    Household Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 in the United States.

    • Nathaniel M Lewis, Victoria T Chu, Dongni Ye, Erin E Conners, Radhika Gharpure, Rebecca L Laws, Hannah E Reses, Brandi D Freeman, Mark Fajans, Elizabeth M Rabold, Patrick Dawson, Sean Buono, Sherry Yin, Daniel Owusu, Ashutosh Wadhwa, Mary Pomeroy, Anna Yousaf, Eric Pevzner, Henry Njuguna, Katherine A Battey, Cuc H Tran, Victoria L Fields, Phillip Salvatore, Michelle O'Hegarty, Jeni Vuong, Rebecca Chancey, Christopher Gregory, Michelle Banks, Jared R Rispens, Elizabeth Dietrich, Perrine Marcenac, Almea M Matanock, Lindsey Duca, Allison Binder, Garrett Fox, Sandra Lester, Lisa Mills, Susan I Gerber, John Watson, Amy Schumacher, Lucia Pawloski, Natalie J Thornburg, Aron J Hall, Tair Kiphibane, Sarah Willardson, Kim Christensen, Lindsey Page, Sanjib Bhattacharyya, Trivikram Dasu, Ann Christiansen, Ian W Pray, Ryan P Westergaard, Angela C Dunn, Jacqueline E Tate, Scott A Nabity, and Hannah L Kirking.
    • COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
    • Clin. Infect. Dis. 2021 Oct 5; 73 (7): 1805-1813.

    BackgroundThe evidence base for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is nascent. We sought to characterize SARS-CoV-2 transmission within US households and estimate the household secondary infection rate (SIR) to inform strategies to reduce transmission.MethodsWe recruited patients with laboratory-confirmed SARS-CoV-2 infection and their household contacts in Utah and Wisconsin during 22 March 2020-25 April 2020. We interviewed patients and all household contacts to obtain demographics and medical histories. At the initial household visit, 14 days later, and when a household contact became newly symptomatic, we collected respiratory swabs from patients and household contacts for testing by SARS-CoV-2 real-time reverse-transcription polymerase chain reaction (rRT-PCR) and sera for SARS-CoV-2 antibodies testing by enzyme-linked immunosorbent assay (ELISA). We estimated SIR and odds ratios (ORs) to assess risk factors for secondary infection, defined by a positive rRT-PCR or ELISA test.ResultsThirty-two (55%) of 58 households secondary infection among household contacts. The SIR was 29% (n = 55/188; 95% confidence interval [CI], 23%-36%) overall, 42% among children (aged <18 years) of the COVID-19 patient and 33% among spouses/partners. Household contacts to COVID-19 patients with immunocompromised conditions and household contacts who themselves had diabetes mellitus had increased odds of infection with ORs 15.9 (95% CI, 2.4-106.9) and 7.1 (95% CI: 1.2-42.5), respectively.ConclusionsWe found substantial evidence of secondary infections among household contacts. People with COVID-19, particularly those with immunocompromising conditions or those with household contacts with diabetes, should take care to promptly self-isolate to prevent household transmission.Published by Oxford University Press for the Infectious Diseases Society of America 2020.

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