Factors Associated With Transmission Across Three Waves of SARS-CoV-2 in a Prospective Community-Based Study of Households With School-Aged Children—Dane County, Wisconsin, 2020–2022

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES Influenza and Other Respiratory Viruses Pub Date : 2024-10-30 DOI:10.1111/irv.70031

Ajay K. Sethi, Cristalyne Bell, Derek Norton, Maureen D. Goss, Shari Barlow, Guanhua Chen, Amra Uzicanin, Jonathan L. Temte

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Abstract

Background

Household transmission of SARS-CoV-2 is a driver of the ongoing COVID-19 pandemic. Understanding factors that contribute to secondary infection risks (SIRs) can define changing trends and inform public health policies.

Methods

The ORegon CHild Absenteeism due to Respiratory Disease Study (ORCHARDS) prospectively monitors respiratory viruses within the Oregon School District (OSD) in southcentral Wisconsin. Households with students who had ≥ 2 respiratory symptoms were eligible and opted to participate in ORCHARDS. Between October 28, 2020, and May 16, 2022, all household members provided self-collected nasal specimens on days 0, 7, and 14 for SARS-CoV-2 detection using real-time reverse-transcription-polymerase chain reaction. We used logistic regression to investigate individual- and household-level characteristics associated with SARS-CoV-2 transmission.

Results

Overall, 127 households comprising 572 individuals (48% female; 52% male; 0.4% nonbinary; 77% ≥ 18 years) had at least one detection of SARS-CoV-2. The overall SIR was 47% and decreased over time (pre-Delta = 72% [95% CI: 58%–83%]; Delta = 51% [40%–63%]; and Omicron = 41% [36%–47%]). Odds of household transmission were 63% lower during the Omicron period compared with the pre-Delta period (OR = 0.36 [95% CI: 0.13–0.94] p = 0.037). Greater household density (members/bedroom) was significantly associated with household transmission during the Omicron period (OR = 6.8, [2.19–21.37] p = 0.001). Index case age, illness severity, and individual symptoms were not significantly associated with odds of household transmission.

Conclusions

Greater household density was associated with a higher risk of SARS-CoV-2 transmission, but the risk declined over time with subsequent variants. Interplay between variants, prior infection, and individual/household factors may identify modifiable factors (e.g., behavior and vaccination) to reduce future transmission risk.

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2020-2022 年威斯康星州戴恩县以社区为基础对有学龄儿童的家庭进行的前瞻性研究中与 SARS-CoV-2 的三次传播相关的因素。

背景：SARS-CoV-2 的家庭传播是目前 COVID-19 大流行的驱动因素。了解导致二次感染风险（SIRs）的因素可以确定不断变化的趋势并为公共卫生政策提供信息：奥勒冈呼吸道疾病儿童缺勤研究（ORCHARDS）对威斯康星州中南部奥勒冈学区（OSD）的呼吸道病毒进行了前瞻性监测。有学生出现≥2次呼吸道症状的家庭符合条件并选择参加 ORCHARDS。在 2020 年 10 月 28 日至 2022 年 5 月 16 日期间，所有家庭成员在第 0、7 和 14 天提供自采的鼻腔标本，使用实时反转录聚合酶链反应检测 SARS-CoV-2。我们使用逻辑回归法研究了与 SARS-CoV-2 传播相关的个人和家庭特征：总体而言，127 个家庭的 572 名成员（48% 为女性；52% 为男性；0.4% 为非二元性别；77% ≥ 18 岁）中至少有一人检测到了 SARS-CoV-2。总体 SIR 为 47%，并随时间推移而下降（德尔塔前 = 72% [95% CI：58%-83%]；德尔塔 = 51% [40%-63%]；奥米克隆 = 41% [36%-47%]）。与德尔塔前相比，Omicron 阶段的家庭传播几率降低了 63% （OR = 0.36 [95% CI: 0.13-0.94] p = 0.037）。在奥米克隆时期，家庭密度（成员/卧室）的增加与家庭传播显著相关（OR = 6.8，[2.19-21.37] p = 0.001）。指标病例年龄、病情严重程度和个人症状与家庭传播几率无明显关联：结论：家庭密度越大，SARS-CoV-2 传播的风险越高，但随着时间的推移，风险随着变异株的增加而降低。变种、先前感染和个人/家庭因素之间的相互作用可能会确定可改变的因素（如行为和疫苗接种），从而降低未来的传播风险。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.