Lin Guo-Tian, Zhang Yue-Hua, Xiao Mei-Fang, Wei Yong, Chen Jin-Ni, Lin Dao-Jiong, Wang Jia-Chong, Lin Qiu-Yu, Lei Zhi-Xian, Zeng Zhen-Qiong, Li Ling, Li Hong-Ai, Zheng Ying, Li Qiu-Qiong, Zhen Huang-Zhen, Jin Yu-Ming, Wu Qing-Xia, Zhang Fan, Xiang Wei
Laboratory of Tropical Enviroment and Health, School of Public Health, Hainan Medical University, No. 3, Chengxi Xue yuan Road, Longhua District, Haikou, 571199 China.
Department of Child Infectious Diseases, Haikou People's Hospital, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570203 China.
Health Inf Sci Syst. 2021 Jan 18;9(1):6. doi: 10.1007/s13755-020-00136-2. eCollection 2021 Dec.
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.
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).
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.
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.
调查由一名3个月大的确诊阳性婴儿传播导致的家庭聚集性疫情中2019冠状病毒病（COVID-19）的临床特征、流行病学特征及传播性。
采用现场流行病学方法对病例及其密切接触者进行调查。对所有采集的标本使用实时荧光逆转录聚合酶链反应（RT-PCR）检测严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。通过化学发光法和金免疫层析法（GICA）检测血清SARS-CoV-2 IgM和IgG抗体。
此次疫情为家庭聚集性疫情，罹患率为80%（4/5）。该家庭首例病例为一名3个月大的婴儿。传播链为从婴儿传播至成人（其父亲、母亲和祖母）。婴儿出院后37天，粪便SARS-CoV-2 RNA检测仍呈阳性。婴儿出院2天后其祖母被确诊为阳性。患者A（3个月大女性）、B（患者A的父亲）、C（患者A的祖母）和D（患者A的母亲）血清IgG阳性、IgM阴性，但患者A的祖父血清IgG和IgM均为阴性。
SARS-CoV-2在家庭环境中具有较强的传播性，粪便中存在病毒RNA引发了对可能的粪口传播的担忧。对确诊COVID-19的患者进行医院随访和密切接触者追踪是必要的。
