Lancet reports first person-person transmission of coronavirus in the USA

USA: In January 2020, a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the causative agent for a cluster of pneumonia cases initially detected in Wuhan City, Hubei province, China. As of February 29, 2020, more than 85,000 cases of coronavirus disease 2019 (COVID-19) have been reported from China and 53 other countries with 2,924 deaths. Phylogenetic data implicate a zoonotic origin, and the rapid spread suggests ongoing person-to-person transmission.

New research published in The Lancet has mentioned that on Jan 23, 2020, Illinois, USA, reported the state's first laboratory-confirmed case (index case) of COVID-19 in a traveler who returned from Wuhan in mid-January, 2020. Subsequently, the first evidence of secondary transmission in the USA was reported on Jan 30, when the husband of the index patient, who had not traveled outside the USA, tested positive for SARS-CoV-2. Public health authorities did an intensive epidemiological investigation of the two confirmed cases.

In total, 372 individuals were identified as potential contacts--347 of these people were actively monitored after confirmation of exposure to the woman or her husband on or after the day of symptom onset (including 152 community contacts and 195 healthcare professionals). There were 25 people that had insufficient contact information to complete active monitoring. A convenience sample of 32 asymptomatic healthcare personnel contacts were also tested.

These 347 contacts underwent active symptom monitoring for 14 days following their last exposure. Of these, 43 contacts who developed fever, cough, or shortness of breath were isolated and tested for SARS-CoV-2, as well as asymptomatic healthcare professionals. All 75 individuals tested negative for SARS-CoV-2.

On December 25, 2019, the female patient who had traveled to Wuhan, on her return to the USA on January 13, 2020, she experienced six days of mild fever, fatigue, and cough before being hospitalized with pneumonia and testing positive for SARS-CoV-2. Prior to hospitalization, she was living with her husband who has chronic obstructive pulmonary disease (COPD) and chronic cough. Eight days after his wife was admitted to hospital, the husband was also hospitalized with worsening shortness of breath and coughing up blood, and also tested positive for SARS-CoV-2.

Both patients recovered and were discharged to home isolation, which was lifted 33 days after the woman returned from Wuhan, following two negative tests for SARS-CoV-2 taken 24 hours apart.

"This report suggests that person-to-person transmission of SARS-CoV-2 might be most likely to occur through unprotected, prolonged exposure to an individual with symptomatic COVID-19", stated Dr. Jennifer Layden, Chief Medical Officer of the Chicago Department of Public Health, USA, who co-led the research.

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https://doi.org/10.1016/S0140-6736(20)30607-3