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Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'.
Nature. 2020 08; 584(7821):425-429.Nat

Abstract

On 21 February 2020, a resident of the municipality of Vo', a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection1. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo' at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1-3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8-1.8%). Notably, 42.5% (95% CI: 31.5-54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9-9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon-Mann-Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures.

Authors+Show Affiliations

Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Mathematics "Tullio Levi-Civita", University of Padova, Padua, Italy. CRIBI Biotech Center, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Azienda Ospedale Padova, Padua, Italy.Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Mathematics "Tullio Levi-Civita", University of Padova, Padua, Italy. CRIBI Biotech Center, University of Padova, Padua, Italy.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.School of Medicine, University of Padova, Padua, Italy.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.No affiliation info availableDepartment of Statistical Sciences, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy. CRIBI Biotech Center, University of Padova, Padua, Italy.Department of Molecular Medicine, University of Padova, Padua, Italy.Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK. Department of Statistics, University of Oxford, Oxford, UK.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK. i.dorigatti@imperial.ac.uk.Department of Molecular Medicine, University of Padova, Padua, Italy. andrea.crisanti@unipd.it. Department of Life Sciences, Imperial College London, London, UK. andrea.crisanti@unipd.it.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32604404

Citation

Lavezzo, Enrico, et al. "Suppression of a SARS-CoV-2 Outbreak in the Italian Municipality of Vo'." Nature, vol. 584, no. 7821, 2020, pp. 425-429.
Lavezzo E, Franchin E, Ciavarella C, et al. Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'. Nature. 2020;584(7821):425-429.
Lavezzo, E., Franchin, E., Ciavarella, C., Cuomo-Dannenburg, G., Barzon, L., Del Vecchio, C., Rossi, L., Manganelli, R., Loregian, A., Navarin, N., Abate, D., Sciro, M., Merigliano, S., De Canale, E., Vanuzzo, M. C., Besutti, V., Saluzzo, F., Onelia, F., Pacenti, M., ... Crisanti, A. (2020). Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'. Nature, 584(7821), 425-429. https://doi.org/10.1038/s41586-020-2488-1
Lavezzo E, et al. Suppression of a SARS-CoV-2 Outbreak in the Italian Municipality of Vo'. Nature. 2020;584(7821):425-429. PubMed PMID: 32604404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo'. AU - Lavezzo,Enrico, AU - Franchin,Elisa, AU - Ciavarella,Constanze, AU - Cuomo-Dannenburg,Gina, AU - Barzon,Luisa, AU - Del Vecchio,Claudia, AU - Rossi,Lucia, AU - Manganelli,Riccardo, AU - Loregian,Arianna, AU - Navarin,Nicolò, AU - Abate,Davide, AU - Sciro,Manuela, AU - Merigliano,Stefano, AU - De Canale,Ettore, AU - Vanuzzo,Maria Cristina, AU - Besutti,Valeria, AU - Saluzzo,Francesca, AU - Onelia,Francesco, AU - Pacenti,Monia, AU - Parisi,Saverio G, AU - Carretta,Giovanni, AU - Donato,Daniele, AU - Flor,Luciano, AU - Cocchio,Silvia, AU - Masi,Giulia, AU - Sperduti,Alessandro, AU - Cattarino,Lorenzo, AU - Salvador,Renato, AU - Nicoletti,Michele, AU - Caldart,Federico, AU - Castelli,Gioele, AU - Nieddu,Eleonora, AU - Labella,Beatrice, AU - Fava,Ludovico, AU - Drigo,Matteo, AU - Gaythorpe,Katy A M, AU - ,, AU - Brazzale,Alessandra R, AU - Toppo,Stefano, AU - Trevisan,Marta, AU - Baldo,Vincenzo, AU - Donnelly,Christl A, AU - Ferguson,Neil M, AU - Dorigatti,Ilaria, AU - Crisanti,Andrea, AU - ,, Y1 - 2020/06/30/ PY - 2020/04/02/received PY - 2020/06/23/accepted PY - 2020/7/1/pubmed PY - 2020/8/28/medline PY - 2020/7/1/entrez SP - 425 EP - 429 JF - Nature JO - Nature VL - 584 IS - 7821 N2 - On 21 February 2020, a resident of the municipality of Vo', a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection1. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo' at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1-3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8-1.8%). Notably, 42.5% (95% CI: 31.5-54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9-9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon-Mann-Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures. SN - 1476-4687 UR - https://www.unboundmedicine.com/medline/citation/32604404/Suppression_of_a_SARS_CoV_2_outbreak_in_the_Italian_municipality_of_Vo'_ L2 - https://doi.org/10.1038/s41586-020-2488-1 DB - PRIME DP - Unbound Medicine ER -