First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2

Lancet. 2020 Apr 4;395(10230):1137-1144. doi: 10.1016/S0140-6736(20)30607-3. Epub 2020 Mar 13.

First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA.

Ghinai I1, McPherson TD2, Hunter JC3, Kirking HL4, Christiansen D5, Joshi K5, Rubin R5, Morales-Estrada S5, Black SR6, Pacilli M6, Fricchione MJ6, Chugh RK7, Walblay KA6, Ahmed NS8, Stoecker WC8, Hasan NF9, Burdsall DP10, Reese HE11, Wallace M12, Wang C13, Moeller D13, Korpics J13, Novosad SA3, Benowitz I3, Jacobs MW14, Dasari VS15, Patel MT10, Kauerauf J10, Charles EM10, Ezike NO10, Chu V12, Midgley CM4, Rolfes MA16, Gerber SI4, Lu X4, Lindstrom S4, Verani JR17, Layden JE18; Illinois COVID-19 Investigation Team.

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Abstract BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first detected in China in December, 2019. In January, 2020, state, local, and federal public health agencies investigated the first case of COVID-19 in Illinois, USA. METHODS: Patients with confirmed COVID-19 were defined as those with a positive SARS-CoV-2 test. Contacts were people with exposure to a patient with COVID-19 on or after the patient's symptom onset date. Contacts underwent active symptom monitoring for 14 days following their last exposure. Contacts who developed fever, cough, or shortness of breath became persons under investigation and were tested for SARS-CoV-2. A convenience sample of 32 asymptomatic health-care personnel contacts were also tested. FINDINGS: Patient 1-a woman in her 60s-returned from China in mid-January, 2020. One week later, she was hospitalised with pneumonia and tested positive for SARS-CoV-2. Her husband (Patient 2) did not travel but had frequent close contact with his wife. He was admitted 8 days later and tested positive for SARS-CoV-2. Overall, 372 contacts of both cases were identified; 347 underwent active symptom monitoring, including 152 community contacts and 195 health-care personnel. Of monitored contacts, 43 became persons under investigation, in addition to Patient 2. These 43 persons under investigation and all 32 asymptomatic health-care personnel tested negative for SARS-CoV-2. INTERPRETATION: Person-to-person transmission of SARS-CoV-2 occurred between two people with prolonged, unprotected exposure while Patient 1 was symptomatic. Despite active symptom monitoring and testing of symptomatic and some asymptomatic contacts, no further transmission was detected. FUNDING: None. Copyright © 2020 Elsevier Ltd. All rights reserved.

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The COVID-19 pandemic in the USA: what might we expect? [Lancet. 2020]

PMID: 32178768 DOI: 10.1016/S0140-6736(20)30607-3



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