Superspreading of SARS-CoV-2: a systematic review and meta-analysis of event attack rates and individual transmission patterns.

IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Epidemiology and Infection Pub Date : 2024-10-08 DOI:10.1017/S0950268824000955
Clifton D McKee, Emma X Yu, Andrés Garcia, Jules Jackson, Aybüke Koyuncu, Sophie Rose, Andrew S Azman, Katie Lobner, Emma Sacks, Maria D Van Kerkhove, Emily S Gurley
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Abstract

SARS-CoV-2 superspreading occurs when transmission is highly efficient and/or an individual infects many others, contributing to rapid spread. To better quantify heterogeneity in SARS-CoV-2 transmission, particularly superspreading, we performed a systematic review of transmission events with data on secondary attack rates or contact tracing of individual index cases published before September 2021 prior to the emergence of variants of concern and widespread vaccination. We reviewed 592 distinct events and 9,883 index cases from 491 papers. A meta-analysis of secondary attack rates identified substantial heterogeneity across 12 chosen event types/settings, with the highest transmission (25-35%) in co-living situations including households, nursing homes, and other congregate housing. Among index cases, 67% reported zero secondary cases and only 3% (287) infected >5 secondary cases ("superspreaders"). Index case demographic data were limited, with only 55% of individuals reporting age, sex, symptoms, real-time polymerase chain reaction (PCR) cycle threshold values, or total contacts. With the data available, we identified a higher percentage of superspreaders among symptomatic individuals, individuals aged 49-64 years, and individuals with over 100 total contacts. Addressing gaps in the literature regarding transmission events and contact tracing is needed to properly explain the heterogeneity in transmission and facilitate control efforts for SARS-CoV-2 and other infections.

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SARS-CoV-2 的超级传播:事件发作率和个体传播模式的系统回顾和荟萃分析。
SARS-CoV-2 超级传播发生在传播效率很高和/或一个人感染了许多其他人,从而导致快速传播的情况下。为了更好地量化 SARS-CoV-2 传播中的异质性,尤其是超级传播,我们对 2021 年 9 月之前发表的传播事件进行了系统性回顾,这些事件中包含了二次发病率数据或个别指数病例的接触追踪数据,当时还没有出现值得关注的变种和广泛的疫苗接种。我们审查了 491 篇论文中的 592 个不同事件和 9883 个指数病例。对二次发病率进行的荟萃分析发现,在 12 种选定的事件类型/环境中存在很大的异质性,在家庭、养老院和其他聚居地等共同生活环境中的传播率最高(25%-35%)。在指数病例中,67%报告的继发病例为零,只有3%(287例)感染了超过5个继发病例("超级传播者")。指数病例的人口统计学数据有限,只有 55% 的人报告了年龄、性别、症状、实时聚合酶链反应 (PCR) 周期阈值或总接触者。根据现有数据,我们发现有症状者、49-64 岁者和总接触次数超过 100 次者中超级传播者的比例较高。要正确解释传播的异质性并促进 SARS-CoV-2 和其他感染的控制工作,就必须填补传播事件和接触者追踪方面的文献空白。
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来源期刊
Epidemiology and Infection
Epidemiology and Infection 医学-传染病学
CiteScore
4.10
自引率
2.40%
发文量
366
审稿时长
3-6 weeks
期刊介绍: Epidemiology & Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The scope covers the zoonoses, outbreaks, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease, as well as some tropical infections. It has become the key international periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections are of particular value.
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