WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Nat Med. 2020 Nov;26(11):1714-1719. doi: 10.1038/s41591-020-1092-0. Epub 2020 Sep 17.
Superspreading events (SSEs) have characterized previous epidemics of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infections. For SARS-CoV-2, the degree to which SSEs are involved in transmission remains unclear, but there is growing evidence that SSEs might be a typical feature of COVID-19. Using contact tracing data from 1,038 SARS-CoV-2 cases confirmed between 23 January and 28 April 2020 in Hong Kong, we identified and characterized all local clusters of infection. We identified 4-7 SSEs across 51 clusters (n = 309 cases) and estimated that 19% (95% confidence interval, 15-24%) of cases seeded 80% of all local transmission. Transmission in social settings was associated with more secondary cases than households when controlling for age (P = 0.002). Decreasing the delay between symptom onset and case confirmation did not result in fewer secondary cases (P = 0.98), although the odds that an individual being quarantined as a contact interrupted transmission was 14.4 (95% CI, 1.9-107.2). Public health authorities should focus on rapidly tracing and quarantining contacts, along with implementing restrictions targeting social settings to reduce the risk of SSEs and suppress SARS-CoV-2 transmission.
超级传播事件(SSEs)是严重急性呼吸综合征冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)感染以往流行疫情的特征。对于 SARS-CoV-2,超级传播事件在传播中所起的作用程度尚不清楚,但越来越多的证据表明,超级传播事件可能是 COVID-19 的一个典型特征。我们利用 2020 年 1 月 23 日至 4 月 28 日期间在香港确诊的 1038 例 SARS-CoV-2 病例的接触者追踪数据,确定并描述了所有本地感染集群。我们在 51 个集群(n=309 例)中发现了 4-7 次超级传播事件,估计 19%(95%置信区间,15-24%)的病例引发了 80%的本地传播。在控制年龄因素的情况下,与家庭相比,社交环境中的传播与更多的继发病例相关(P=0.002)。减少从症状出现到病例确诊之间的时间延迟并不会导致继发病例减少(P=0.98),尽管作为接触者被隔离的个体中断传播的可能性为 14.4(95%置信区间,1.9-107.2)。公共卫生当局应重点迅速追踪和隔离接触者,并实施针对社交环境的限制措施,以降低超级传播事件的风险并抑制 SARS-CoV-2 的传播。