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

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First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA.
The Lancet ( IF 168.9 ) Pub Date : 2020-03-13 , DOI: 10.1016/s0140-6736(20)30607-3
Isaac Ghinai ₁ , Tristan D McPherson ₂ , Jennifer C Hunter ₃ , Hannah L Kirking ₄ , Demian Christiansen ₅ , Kiran Joshi ₅ , Rachel Rubin ₅ , Shirley Morales-Estrada ₅ , Stephanie R Black ₆ , Massimo Pacilli ₆ , Marielle J Fricchione ₆ , Rashmi K Chugh ₇ , Kelly A Walblay ₆ , N Seema Ahmed ₈ , William C Stoecker ₈ , Nausheen F Hasan ₉ , Deborah P Burdsall ₁₀ , Heather E Reese ₁₁ , Megan Wallace ₁₂ , Chen Wang ₁₃ , Darcie Moeller ₁₃ , Jacqueline Korpics ₁₃ , Shannon A Novosad ₃ , Isaac Benowitz ₃ , Max W Jacobs ₁₄ , Vishal S Dasari ₁₅ , Megan T Patel ₁₀ , Judy Kauerauf ₁₀ , E Matt Charles ₁₀ , Ngozi O Ezike ₁₀ , Victoria Chu ₁₂ , Claire M Midgley ₄ , Melissa A Rolfes ₁₆ , Susan I Gerber ₄ , Xiaoyan Lu ₄ , Stephen Lindstrom ₄ , Jennifer R Verani ₁₇ , Jennifer E Layden ₆ ,

Affiliation

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Illinois Department of Public Health, Springfield, IL, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Chicago Department of Public Health, Chicago, IL, USA.
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Cook County Department of Public Health, Oak Forest, IL, USA.
Chicago Department of Public Health, Chicago, IL, USA.
DuPage County Health Department, Wheaton, IL, USA.
Metro Infectious Disease Consultants, Burr Ridge, IL, USA.
Premier Primary Care Physicians, Carol Stream, IL, USA.
Illinois Department of Public Health, Springfield, IL, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Cook County Health, Chicago, IL, USA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
One Health Office, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.

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.

更新日期：2020-04-03

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