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The evidence of indirect transmission of SARS-CoV-2 reported in Guangzhou, China.
BMC Public Health. 2020 Aug 05; 20(1):1202.BP

Abstract

BACKGROUND

More than 2 months have passed since the novel coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China. With the migration of people, the epidemic has rapidly spread within China and throughout the world. Due to the severity of the epidemic, undiscovered transmission of COVID-19 deserves further investigation. The aim of our study hypothesized possible modes of SARS-CoV-2 transmission and how the virus may have spread between two family clusters within a residential building in Guangzhou, China.

METHODS

In a cross-sectional study, we monitored and traced confirmed patients and their close contacts from January 11 to February 5, 2020 in Guangzhou, China, including 2 family cluster cases and 61 residents within one residential building. The environmental samples of the building and the throat swabs from the patients and from their related individuals were collected for SARS-CoV-2 and tested with real-time reverse transcriptase polymerase chain reaction (RT-PCR). The relevant information was collected and reported using big data tools.

RESULTS

There were two notable family cluster cases in Guangzhou, which included 3 confirmed patients (family No.1: patient A, B, C) and 2 confirmed patients (family No.2: patient D, E), respectively. None of patients had contact with other confirmed patients before the onset of symptoms, and only patient A and patient B made a short stop in Wuhan by train. Home environment inspection results showed that the door handle of family No.1 was positive of SARS-CoV-2. The close contacts of the 5 patients all tested negative of SARS-CoV-2 and in good health, and therefore were released after the official medical observation period of 14-days. Finally, according to the traceability investigation through applying big data analysis, we found an epidemiological association between family No.1 and family No.2, in which patient D (family No.2) was infected through touching an elevator button contaminated by snot with virus from patient A (family No.1) on the same day.

CONCLUSIONS

Contaminants with virus from confirmed patients can pollute the environment of public places, and the virus can survive on the surface of objects for a short period of time. Therefore, in addition to the conventional droplet transmission, there is also indirect contact transmission such as snot-oral transmission that plays a crucial role in community spread of the virus.

Authors+Show Affiliations

The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. State Key Lab of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.Department of English and American Studies, Faculty of Languages and Literatures, Ludwig Maximilian University (LMU), Munich, Germany.Baiyun District Center for Disease Control and Prevention, Guangzhou, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.Baiyun District Center for Disease Control and Prevention, Guangzhou, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. 378563318@qq.com. Guangzhou Center for Disease Control and Prevention, 1Qide Road, Guangzhou, 510440, PR China. 378563318@qq.com.The Institute for Public Health, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. jclu@gzhmu.edu.cn. State Key Lab of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, 195 Dongfengxi Road, Guangzhou, 510182, PR China. jclu@gzhmu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32758198

Citation

Xie, Chaojun, et al. "The Evidence of Indirect Transmission of SARS-CoV-2 Reported in Guangzhou, China." BMC Public Health, vol. 20, no. 1, 2020, p. 1202.
Xie C, Zhao H, Li K, et al. The evidence of indirect transmission of SARS-CoV-2 reported in Guangzhou, China. BMC Public Health. 2020;20(1):1202.
Xie, C., Zhao, H., Li, K., Zhang, Z., Lu, X., Peng, H., Wang, D., Chen, J., Zhang, X., Wu, D., Gu, Y., Yuan, J., Zhang, L., & Lu, J. (2020). The evidence of indirect transmission of SARS-CoV-2 reported in Guangzhou, China. BMC Public Health, 20(1), 1202. https://doi.org/10.1186/s12889-020-09296-y
Xie C, et al. The Evidence of Indirect Transmission of SARS-CoV-2 Reported in Guangzhou, China. BMC Public Health. 2020 Aug 5;20(1):1202. PubMed PMID: 32758198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The evidence of indirect transmission of SARS-CoV-2 reported in Guangzhou, China. AU - Xie,Chaojun, AU - Zhao,Hongjun, AU - Li,Kuibiao, AU - Zhang,Zhoubin, AU - Lu,Xiaoxiao, AU - Peng,Huide, AU - Wang,Dahu, AU - Chen,Jin, AU - Zhang,Xiao, AU - Wu,Di, AU - Gu,Yuzhou, AU - Yuan,Jun, AU - Zhang,Lin, AU - Lu,Jiachun, Y1 - 2020/08/05/ PY - 2020/03/14/received PY - 2020/07/26/accepted PY - 2020/8/8/entrez PY - 2020/8/8/pubmed PY - 2020/8/11/medline KW - Indirect transmission KW - Novel coronavirus disease KW - Severe acute respiratory syndrome coronavirus 2 KW - Snot-oral transmission SP - 1202 EP - 1202 JF - BMC public health JO - BMC Public Health VL - 20 IS - 1 N2 - BACKGROUND: More than 2 months have passed since the novel coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China. With the migration of people, the epidemic has rapidly spread within China and throughout the world. Due to the severity of the epidemic, undiscovered transmission of COVID-19 deserves further investigation. The aim of our study hypothesized possible modes of SARS-CoV-2 transmission and how the virus may have spread between two family clusters within a residential building in Guangzhou, China. METHODS: In a cross-sectional study, we monitored and traced confirmed patients and their close contacts from January 11 to February 5, 2020 in Guangzhou, China, including 2 family cluster cases and 61 residents within one residential building. The environmental samples of the building and the throat swabs from the patients and from their related individuals were collected for SARS-CoV-2 and tested with real-time reverse transcriptase polymerase chain reaction (RT-PCR). The relevant information was collected and reported using big data tools. RESULTS: There were two notable family cluster cases in Guangzhou, which included 3 confirmed patients (family No.1: patient A, B, C) and 2 confirmed patients (family No.2: patient D, E), respectively. None of patients had contact with other confirmed patients before the onset of symptoms, and only patient A and patient B made a short stop in Wuhan by train. Home environment inspection results showed that the door handle of family No.1 was positive of SARS-CoV-2. The close contacts of the 5 patients all tested negative of SARS-CoV-2 and in good health, and therefore were released after the official medical observation period of 14-days. Finally, according to the traceability investigation through applying big data analysis, we found an epidemiological association between family No.1 and family No.2, in which patient D (family No.2) was infected through touching an elevator button contaminated by snot with virus from patient A (family No.1) on the same day. CONCLUSIONS: Contaminants with virus from confirmed patients can pollute the environment of public places, and the virus can survive on the surface of objects for a short period of time. Therefore, in addition to the conventional droplet transmission, there is also indirect contact transmission such as snot-oral transmission that plays a crucial role in community spread of the virus. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/32758198/The_evidence_of_indirect_transmission_of_SARS_CoV_2_reported_in_Guangzhou_China_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09296-y DB - PRIME DP - Unbound Medicine ER -