Chen Stein-Zamir , Ora Sinai-Zaken , Eti Zvulun , Ghada Najajra , Rinat Pinto , Shahar Koren , Hanna Shoob , Nitza Abramson
{"title":"大型高中新冠肺炎爆发和家庭二次传播中学生和教职员工的SARS-CoV-2感染特征","authors":"Chen Stein-Zamir , Ora Sinai-Zaken , Eti Zvulun , Ghada Najajra , Rinat Pinto , Shahar Koren , Hanna Shoob , Nitza Abramson","doi":"10.1016/j.imj.2023.02.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>SARS-CoV-2 clinical presentation is associated with the patients’ age group. Overall, young individuals present higher proportions of asymptomatic or mild COVID-19 infection, compared to adults. Data on secondary COVID-19 transmission in households, according to the cases’ age group, are accumulating.</p></div><div><h3>Methods</h3><p>We performed a follow-up cohort study including all COVID-19 real-time polymerase chain reaction (RT-PCR)-confirmed cases (adolescent students and school staff) diagnosed in an epidemiological investigation of a large high school outbreak. We compared the adolescent and adult groups regarding clinical symptoms, time to negative COVID-19 RT-PCR tests, and infection transmission in households.</p></div><div><h3>Results</h3><p>The study population included 817 persons. The confirmed COVID-19 RT-PCR outbreak cases (<em>n</em> = 178) were followed (students aged 12–19 years, median age 14 years, <em>n</em> = 153, school staff aged 24–67 years, median age 39 years, <em>n</em> = 25) and the cases’ household close contacts (<em>n</em> = 639) were tested. The adolescents had lower symptomatic infection rates, shorter time to negative COVID-19 RT-PCR tests, and lower transmission rates to household members, compared to the adults. The general transmission rate among household contacts was 13.5%, (86/639) ranging from 8.6% in asymptomatic students’ contacts to 27.3% in symptomatic staff contacts. COVID-19 transmission rates were significantly higher in contacts of symptomatic cases compared to asymptomatic cases (odds ratio: 2.06, 95% CI 1.26–3.4) and higher in adults compared to adolescents (odds ratio: 2.69, 95% CI 1.43–4.89).</p></div><div><h3>Conclusions</h3><p>Adolescents and adults diagnosed in an outbreak investigation differ as to COVID-19 clinical presentation and transmission. As adolescents may show mild or no symptoms, COVID-19 prevention in school settings is challenging. Implementing nonpharmaceutical measures and promoting vaccination programs in eligible staff and students should be considered.</p></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"2 1","pages":"Pages 36-43"},"PeriodicalIF":0.0000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"SARS-CoV-2 infection characteristics among students and staff in a large high school COVID-19 outbreak and secondary transmission in households\",\"authors\":\"Chen Stein-Zamir , Ora Sinai-Zaken , Eti Zvulun , Ghada Najajra , Rinat Pinto , Shahar Koren , Hanna Shoob , Nitza Abramson\",\"doi\":\"10.1016/j.imj.2023.02.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>SARS-CoV-2 clinical presentation is associated with the patients’ age group. Overall, young individuals present higher proportions of asymptomatic or mild COVID-19 infection, compared to adults. Data on secondary COVID-19 transmission in households, according to the cases’ age group, are accumulating.</p></div><div><h3>Methods</h3><p>We performed a follow-up cohort study including all COVID-19 real-time polymerase chain reaction (RT-PCR)-confirmed cases (adolescent students and school staff) diagnosed in an epidemiological investigation of a large high school outbreak. We compared the adolescent and adult groups regarding clinical symptoms, time to negative COVID-19 RT-PCR tests, and infection transmission in households.</p></div><div><h3>Results</h3><p>The study population included 817 persons. The confirmed COVID-19 RT-PCR outbreak cases (<em>n</em> = 178) were followed (students aged 12–19 years, median age 14 years, <em>n</em> = 153, school staff aged 24–67 years, median age 39 years, <em>n</em> = 25) and the cases’ household close contacts (<em>n</em> = 639) were tested. The adolescents had lower symptomatic infection rates, shorter time to negative COVID-19 RT-PCR tests, and lower transmission rates to household members, compared to the adults. The general transmission rate among household contacts was 13.5%, (86/639) ranging from 8.6% in asymptomatic students’ contacts to 27.3% in symptomatic staff contacts. COVID-19 transmission rates were significantly higher in contacts of symptomatic cases compared to asymptomatic cases (odds ratio: 2.06, 95% CI 1.26–3.4) and higher in adults compared to adolescents (odds ratio: 2.69, 95% CI 1.43–4.89).</p></div><div><h3>Conclusions</h3><p>Adolescents and adults diagnosed in an outbreak investigation differ as to COVID-19 clinical presentation and transmission. As adolescents may show mild or no symptoms, COVID-19 prevention in school settings is challenging. Implementing nonpharmaceutical measures and promoting vaccination programs in eligible staff and students should be considered.</p></div>\",\"PeriodicalId\":100667,\"journal\":{\"name\":\"Infectious Medicine\",\"volume\":\"2 1\",\"pages\":\"Pages 36-43\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infectious Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772431X23000084\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772431X23000084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
SARS-CoV-2 infection characteristics among students and staff in a large high school COVID-19 outbreak and secondary transmission in households
Background
SARS-CoV-2 clinical presentation is associated with the patients’ age group. Overall, young individuals present higher proportions of asymptomatic or mild COVID-19 infection, compared to adults. Data on secondary COVID-19 transmission in households, according to the cases’ age group, are accumulating.
Methods
We performed a follow-up cohort study including all COVID-19 real-time polymerase chain reaction (RT-PCR)-confirmed cases (adolescent students and school staff) diagnosed in an epidemiological investigation of a large high school outbreak. We compared the adolescent and adult groups regarding clinical symptoms, time to negative COVID-19 RT-PCR tests, and infection transmission in households.
Results
The study population included 817 persons. The confirmed COVID-19 RT-PCR outbreak cases (n = 178) were followed (students aged 12–19 years, median age 14 years, n = 153, school staff aged 24–67 years, median age 39 years, n = 25) and the cases’ household close contacts (n = 639) were tested. The adolescents had lower symptomatic infection rates, shorter time to negative COVID-19 RT-PCR tests, and lower transmission rates to household members, compared to the adults. The general transmission rate among household contacts was 13.5%, (86/639) ranging from 8.6% in asymptomatic students’ contacts to 27.3% in symptomatic staff contacts. COVID-19 transmission rates were significantly higher in contacts of symptomatic cases compared to asymptomatic cases (odds ratio: 2.06, 95% CI 1.26–3.4) and higher in adults compared to adolescents (odds ratio: 2.69, 95% CI 1.43–4.89).
Conclusions
Adolescents and adults diagnosed in an outbreak investigation differ as to COVID-19 clinical presentation and transmission. As adolescents may show mild or no symptoms, COVID-19 prevention in school settings is challenging. Implementing nonpharmaceutical measures and promoting vaccination programs in eligible staff and students should be considered.
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