Georgia Department of Public Health, Atlanta, Georgia, USA.
COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2022 Jan 29;74(2):319-326. doi: 10.1093/cid/ciab332.
To inform prevention strategies, we assessed the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and settings in which transmission occurred in a Georgia public school district.
During 1 December 2020-22 January 2021, SARS-CoV-2-infected index cases and their close contacts in schools were identified by school and public health officials. For in-school contacts, we assessed symptoms and offered SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) testing; performed epidemiologic investigations and whole-genome sequencing to identify in-school transmission; and calculated secondary attack rate (SAR) by school setting (eg, sports, elementary school classroom), index case role (ie, staff, student), and index case symptomatic status.
We identified 86 index cases and 1119 contacts, 688 (61.5%) of whom received testing. Fifty-nine of 679 (8.7%) contacts tested positive; 15 of 86 (17.4%) index cases resulted in ≥2 positive contacts. Among 55 persons testing positive with available symptom data, 31 (56.4%) were asymptomatic. Highest SARs were in indoor, high-contact sports settings (23.8% [95% confidence interval {CI}, 12.7%-33.3%]), staff meetings/lunches (18.2% [95% CI, 4.5%-31.8%]), and elementary school classrooms (9.5% [95% CI, 6.5%-12.5%]). The SAR was higher for staff (13.1% [95% CI, 9.0%-17.2%]) vs student index cases (5.8% [95% CI, 3.6%-8.0%]) and for symptomatic (10.9% [95% CI, 8.1%-13.9%]) vs asymptomatic index cases (3.0% [95% CI, 1.0%-5.5%]).
Indoor sports may pose a risk to the safe operation of in-person learning. Preventing infection in staff members, through measures that include coronavirus disease 2019 vaccination, is critical to reducing in-school transmission. Because many positive contacts were asymptomatic, contact tracing should be paired with testing, regardless of symptoms.
为了制定防控策略，我们评估了佐治亚州一个公立学区内严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）传播的范围和发生传播的场所。
在 2020 年 12 月 1 日至 2021 年 1 月 22 日期间，由学校和公共卫生官员确定学校中感染 SARS-CoV-2 的感染源病例及其密切接触者。对于校内接触者，我们评估了症状并提供了 SARS-CoV-2 逆转录聚合酶链反应（RT-PCR）检测；开展了流行病学调查和全基因组测序，以确定校内传播；并根据学校环境（例如，体育、小学教室）、感染源病例角色（即教职员工、学生）和感染源病例症状状态计算二级发病率（SAR）。
我们确定了 86 名感染源病例和 1119 名接触者，其中 688 名（61.5%）接受了检测。679 名接触者中有 59 名（8.7%）检测结果呈阳性；86 名感染源病例中有 15 名（17.4%）导致 2 名及以上接触者呈阳性。在 55 名可提供症状数据的检测结果呈阳性者中，31 名（56.4%）为无症状。发病率最高的是室内、高接触的体育活动场所（23.8%[95%置信区间{CI}，12.7%33.3%]）、教职员工会议/午餐（18.2%[95% CI，4.5%31.8%]）和小学教室（9.5%[95% CI，6.5%12.5%]）。教职员工（13.1%[95% CI，9.0%17.2%]）感染源病例的 SAR 高于学生（5.8%[95% CI，3.6%8.0%]），而症状性（10.9%[95% CI，8.1%13.9%]）感染源病例的 SAR 低于无症状（3.0%[95% CI，1.0%~5.5%]）。
室内运动可能会对面对面学习的安全运营构成风险。通过包括 2019 冠状病毒病疫苗接种在内的措施，防止教职员工感染对于减少校内传播至关重要。由于许多阳性接触者无症状，因此无论有无症状，都应将接触者追踪与检测相结合。
