, Pan JR , Grubelnik V Two reviewers (K.S. Updating the diagnostic criteria of COVID-19 “suspected case” and “confirmed case” is necessary, © The Author(s) 2020. , Holshue M , Aggarwal N No public clipboards found for this slide. , et al. Browse other articles of this reference work: The full text of this article hosted at iucr.org is unavailable due to technical difficulties. Right from the initial outbreak of the COVID-19, epidemiologists and public health experts undoubtedly recommended quarantining and isolation of the positive cases as one of the most effective preventive strategy.37,38,39 Findings of this review showed that SARs in case of quarantining of index cases immediately after onset of symptoms were significantly low in case of non-quarantined index cases.22 It reduced SAR to as low as to 0%. Air Force Head Quarters, Near Lekawada Bus Stop, Gandhinagar-Chiloda Road, Gandhinagar, Gujarat 382042, India. , Zuliani G , Dobrescu AI Guan WJ , Liu DP Transmission of an infection requires three conditions: An effective contact is defined as any kind of contact between two individuals such that, if one individual is infectious and the other susceptible, then the first individual infects the second. Enter multiple addresses on separate lines or separate them with commas. Cheng HY If the 18 households included 86 persons, calculate the secondary attack rate. (ii) Asymptomatic cases have lesser chances of spreading the disease (low SAR); however, immediate quarantining of the cases upon development of the symptoms reduces the risk of SAR drastically. , Gillies CL , Garg S The secondary attack rate is defined as the probability that infection occurs among susceptible persons within a reasonable incubation period following known contact with an infectious person or an infectious source. If you wish to opt out, please close your SlideShare account. In developed countries for serious diseases such as AIDS or tuberculosis, contact tracing is often carried out when a patient is diagnosed (the patient and medical authorities try to inform every possible contact the patient may have made since infection). See our User Agreement and Privacy Policy. , Rigatelli G. Singh AK In our study, the secondary attack rate in households was 27%, which is similar to rates in studies by Komiya et al. , et al. , Cao P It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. • Developed to measure the spread of the infection within the family, household or any closed aggregate of persons who have had contact with a case or disease. , Jordan A Secondary attack rates are useful for comparisons between vaccinated and unvaccinated groups and hence assessing the efficacy of vaccinations against the disease under inspection. , Banerjee T Laboratory surveillance for SARS-CoV-2 in India: performance of testing and descriptive epidemiology of detected COVID-19, 22 January to 30 April 2020, Symptomatic suspected cases and certain asymptomatic groups (high risk), (1) 200 006 (19.6%) asymptomatic family contacts(2) 48 852 (4.8%) asymptomatic healthcare workers, Active monitoring of persons exposed to patients with confirmed COVID-19—USA, January–February 2020, (1) All contacts: 0.45% (95% CI, 0.12–1.6%), Contact-tracing assessment of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods before and after symptom onset, Contact with household, family, and health care, Overall, 0.7% (95% CI, 0.4–1.0%); household contact, 4.6% (95% CI, 2.3–9.3%); non-household family contact, 5.3% (95% CI, 2.1–12.8%); healthcare contact, 0.9% (95% CI, 0.4–1.9%); others, 0.1% (95% CI, 0–0.3%), Korea Centers for Disease Control and Prevention, Cheongju, Korea, Coronavirus disease-19: summary of 2370 contact investigations of the first 30 cases in the Republic of Korea, Household contact, 7.56% (95% CI, 3.7–14.26%); overall, 0.55% (95% CI, 0.31–0.96%), Household secondary attack rate of COVID-19 and associated determinants, Household contacts, 13.8% (95% CI, 11.1–17.0%); non-household contacts, 3.1% (95% CI, 4.7–10.6%), Epidemiological characteristics of the first 53 laboratory confirmed cases of COVID-19 epidemic in Hong Kong, 13 February 2020, Coronavirus disease outbreak in call center, South Korea, Household contacts, 16.2% (95% CI, 11.6–22.0%), Symptomatic index and asymptomatic confirmed cases, (1) After sensitivity analysis addressing mission data SAR changed from 6 to 3.9%, (2) After correction, secondary attack rate was highest in Chandigarh (11.5%) and Maharashtra (10.6%), (3) 95% of secondary cases were expected to develop symptoms within 14.3 days (95% CI, 11.1–17.6%) of their infector, (1) Household contacts and those traveling with a case were at higher risk of infection (odds ratio 6.27 [95% CI, 1.49–26.33%] for household contacts and 7.06 [1.43–34.91%] for those traveling with a case) than other close contacts, (2) At the time of the first clinical assessment, 25 (29%) of 87 cases in the contact-based surveillance group did not have fever, and 17 (20%) of 87 had no symptoms, Five household contact who continued exposure to COVID-19 during quarantine phase did not developed infection, (1) The attack rate was higher among contacts whose exposure to the index case started within 5 days of symptom onset than those who were exposed later, (2) The attack rate was higher among household (4.6% [95% CI, 2.3–9.3%]) and non-household (5.3% [95% CI, 2.1–12.8%]) family contacts than that in health care or other settings, (3) The attack rates were higher among those aged 40–59 years (1.1% [95% CI, 0.6–2.1%]) and those aged 60 years and older (0.9% [95% CI, 0.3–2.6%]), (4) Odds of SAR is higher in contacts of cases with severe symptoms as compared to cases with mild symptoms, (1) Odds of SAR is higher in household contacts as compared other contacts (healthcare workers and co-workers), (1) The secondary attack rate in close contacts with shortest incubation period of 1–3 days was 17.12–18.99%, the secondary attack rate in family members was 46.11–49.56%(2) The median number of subsequent infections caused by an index case in a cluster epidemic was 3, (1) The attack rate for household contacts from index cases was 12.6% while it was 3.1% for non-household contacts, (2) The household attack rate was lower among contacts <20 years (5.3%, 95% CI, 2.4–9.8%) compared to older age groups (13.7% among 20–59-year olds [95% CI, 10.7–17.2%] and 17.7% among those 60 years or older [95% CI, 11.9–24.8%]), (3) Mean incubation period of 4 days and maximum infection period of 13 days, (1) Within households, the non-primary attack rate was much lower in contacts <20 years group, 5.26% (95% CI, 2.43–9.76%), as compared to 13.72% (95% CI, 10.68–17.24%) and 17.69% (95% CI, 11.89–24.83%) in 20–59-year olds and ≥60-year olds, respectively (, (2) Estimated the household SAR to be 13.8% (95% CI, 11.1–17.0%) if household contacts are defined as all close relatives and 19.3% (95% CI, 15.5–23.9%) if household contacts only include those at the same residential address as the cases.

What is a Secondary Attack Rate?

, Li YM Working off-campus? All rights reserved. Out of these three, two studies were from China and were showing SAR of 49.56 and 31% and third was from UK (35%).18,24 Potential explanation for this higher rate could be the fact that the data were compiled till 10 and 18 February, respectively, and that time the country was experiencing peak of the transmission with ∼15 000 newly diagnosed cases in a day. , Cai J , Wong VW I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. Pitzer VE , Lu J 3. Age-dependent effects in the transmission and control of COVID-19 epidemics, COVID-19: the gendered impacts of the outbreak, Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. Household Secondary Attack Rate of COVID-19 and Associated Determinants, Endocrinology (including Diabetes Mellitus and Metabolic Disease), Intensive Care and Critical Care Medicine, Rehabilitation Medicine and Physical Therapy. The effective contact rate (denoted β) in a given population for a given infectious disease is measured in effective contacts per unit time. Marhl M , et al. , Singh R Google scholar search was also under taken to identify relevant gray literature using the same search terms. A more direct assessment of transmission risks can be provided by a contact study, which is often carried out because of an outbreak (such a study was carried out during the SARS outbreak of 2002–3). Household transmission of Pandemic (H1N1) 2009 Virus, Taiwan. , Brown R By continuing you agree to the use of cookies. The first (or primary) case within a defined group (such as a school or family) is identified and people infected by this individual (called secondary cases) are documented. Gupta N

I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Liu T Use the link below to share a full-text version of this article with your friends and colleagues. Diagrammatic representation of SAR in household contact is presented as Figure 2. , Wang W This could be possibly due to their active involvement in the care taking activities of the cases that may have resulted into prolonged very close physical contact with the index cases and hence longer exposure to the virus.25,26 It is known that old age and comorbid conditions are independent risk factors of COVID-19 infections and hence it explains higher transmission rate in elderly in household SAR as well.27–30 This resulted in higher fatality rate in elderly as well.8,31–35 It was found that SARs in asymptomatic contacts were significantly lower than the household contacts of the symptomatic cases, where time for symptom onset in index case did not alter the rate of secondary transmission in contacts.23 Li et al.22 showed that the median time from symptom onset in index cases to symptom onset in household contacts was 6 days, though it varied somewhat from study to study. Conclusion: SARS-CoV-2 is more transmissible in households than SARS-CoV and MERS-CoV, and the elderly ≥60 years old are the most vulnerable to household transmission. , et al.

, Cao TZ

The household transmission rate (secondary attack rate) was defined as the percentage of household members who had laboratory-confirmed pandemic (H1N1) 2009 infection 1-7 days after the onset of symptoms in the index patient. , et al. After initial screening of 326 articles, 13 eligible studies were included in the final evidence synthesis. Martins-Filho PR

, Zhang ZB , Li Q Indian Institute of Public Health Gandhinagar. Studies not reporting quantitative statistics regarding SARs, providing SARs in close contacts but not in household contacts, were excluded from evidence synthesis. Diagrammatical presentation of household transmission of COVID-19. This meta-analysis was published as a preprint and thus, had not yet undergone peer review. , et al. email: Search for other works by this author on: Persistent vegetative state after brain damage: a syndrome in search of a name, The scientific literature on Coronaviruses, COVID-19 and its associated safety-related research dimensions: a scientometric analysis and scoping review, A review of modern technologies for tackling COVID-19 pandemic, Active case finding with case management: the key to tackling the COVID-19 pandemic, COVID-19: learning from lessons to guide treatment and prevention interventions, CMMID COVID-19 working group.

Studies acknowledged the higher rate of family renewal rate of cluster contacts (higher than all contacts) and clearly stated that in the early stage of epidemic prevention and control in many areas of the country, non-single/single room isolation measures were taken for close contacts, which cannot effectively cut off the transmission route within the family. See our Privacy Policy and User Agreement for details. Hamner et al. , Chapman A • Secondary attack rates are defined as the number of exposed persons developing the disease within the range of the incubation period following exposure to a primary case. , Bodenhamer C , Davidson JR , Lin HH. We use cookies to help provide and enhance our service and tailor content and ads. , Coles B , Liu SL , Lloyd SM , Chang Z

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