Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England

Elizabeth Miller; Pauline A. Waight; Nick J. Andrews; Kelsey McOwat; Kevin E. Brown; Höschler Katja; Samreen Ijaz; Louise Letley; Donna Haskins; Mary Sinnathamby; Hannah Cuthbertson; Bassam Hallis; Vaishnavi Parimalanathan; Simon de Lusignan; Jamie Lopez-Bernal

doi:10.1016/j.jinf.2021.07.037

Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England

Elizabeth Miller^*, Pauline A. Waight, Nick J. Andrews, Kelsey McOwat, Kevin E. Brown, Höschler Katja, Samreen Ijaz, Louise Letley, Donna Haskins, Mary Sinnathamby, Hannah Cuthbertson, Bassam Hallis, Vaishnavi Parimalanathan, Simon de Lusignan, Jamie Lopez-Bernal

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

34 Citations (Scopus)

Abstract

Objectives: To measure secondary attack rates (SARs) in prospectively followed household contacts of paediatric and adult cases of SARS-CoV-2 infection in England.

Methods: Self-taken nasal swabs from household contacts of PCR confirmed cases of COVID-19 and blood samples on day 35 were tested for evidence of infection with SARS-CoV-2 virus.

Results: The secondary attack rate (SAR) among 431 contacts of 172 symptomatic index cases was 33% (95% confidence intervals [CI] 25–40) and was lower from primary cases without respiratory symptoms, 6% (CI 0–14) vs 37% (CI 29–45), p = 0.030. The SAR from index cases <11 years was 25% (CI 12–38). SARs ranged from 16% (4–28) in contacts <11 years old to 36% (CI 28–45) in contacts aged 19–54 years (p = 0.119). The proportion infected who developed symptoms (78%) was similar by age (p = 0.44) though <19 year olds had fewer mean number of symptoms than adults (p = 0.001) and fewer reported loss of sense of taste or smell (p = 0.0001).

Conclusions:: There are high risks of transmission of SARS-CoV-2 virus in the home, including those where infection is introduced by a child. The risk of children acquiring infection was lower than that in adults and fewer developed typical symptoms of Covid-19 infection.

Original language	English
Pages (from-to)	483-489
Number of pages	7
Journal	Journal of Infection
Volume	83
Issue number	4
Early online date	1 Aug 2021
DOIs	https://doi.org/10.1016/j.jinf.2021.07.037
Publication status	Published - Oct 2021

Bibliographical note

Funding Information: This study was funded by Public Health England (an executive agency of the Department of Health) as part of the COVID-19 response. The authors had sole responsibility for the study design, data collection, data analysis, data interpretation, and writing of the report. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication.

The authors have declared no competing interest. SdeL is the Director of the Royal College of General Practitioners Research and Surveillance, and hold a grant from AstraZeneca both funded through his university.

Open Access: No Open Access licence

Publisher Copyright: © 2021 Published by Elsevier Ltd on behalf of The British Infection Association.

Citation: Elizabeth Miller, Pauline A. Waight, Nick J. Andrews, Kelsey McOwat, Kevin E. Brown, Katja Höschler, Samreen Ijaz, Louise Letley, Donna Haskins, Mary Sinnathamby, Hannah Cuthbertson, Bassam Hallis, Vaishnavi Parimalanathan, Simon de Lusignan, Jamie Lopez-Bernal, Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England,Journal of Infection, Volume 83, Issue 4, 2021, Pages 483-489, ISSN 0163-4453,

DOI: https://doi.org/10.1016/j.jinf.2021.07.037.

Keywords

Households
SARS-CoV-2 transmission
Secondary attack rates by age

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jinf.2021.07.037

Cite this

Miller, E., Waight, P. A., Andrews, N. J., McOwat, K., Brown, K. E., Katja, H., Ijaz, S., Letley, L., Haskins, D., Sinnathamby, M., Cuthbertson, H., Hallis, B., Parimalanathan, V., de Lusignan, S., & Lopez-Bernal, J. (2021). Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England. Journal of Infection, 83(4), 483-489. https://doi.org/10.1016/j.jinf.2021.07.037

@article{6bc6af0380074cc6b3253ea9adb344f1,

title = "Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England",

abstract = "Objectives: To measure secondary attack rates (SARs) in prospectively followed household contacts of paediatric and adult cases of SARS-CoV-2 infection in England. Methods: Self-taken nasal swabs from household contacts of PCR confirmed cases of COVID-19 and blood samples on day 35 were tested for evidence of infection with SARS-CoV-2 virus. Results: The secondary attack rate (SAR) among 431 contacts of 172 symptomatic index cases was 33% (95% confidence intervals [CI] 25–40) and was lower from primary cases without respiratory symptoms, 6% (CI 0–14) vs 37% (CI 29–45), p = 0.030. The SAR from index cases <11 years was 25% (CI 12–38). SARs ranged from 16% (4–28) in contacts <11 years old to 36% (CI 28–45) in contacts aged 19–54 years (p = 0.119). The proportion infected who developed symptoms (78%) was similar by age (p = 0.44) though <19 year olds had fewer mean number of symptoms than adults (p = 0.001) and fewer reported loss of sense of taste or smell (p = 0.0001). Conclusions:: There are high risks of transmission of SARS-CoV-2 virus in the home, including those where infection is introduced by a child. The risk of children acquiring infection was lower than that in adults and fewer developed typical symptoms of Covid-19 infection.",

keywords = "Households, SARS-CoV-2 transmission, Secondary attack rates by age",

author = "Elizabeth Miller and Waight, {Pauline A.} and Andrews, {Nick J.} and Kelsey McOwat and Brown, {Kevin E.} and H{\"o}schler Katja and Samreen Ijaz and Louise Letley and Donna Haskins and Mary Sinnathamby and Hannah Cuthbertson and Bassam Hallis and Vaishnavi Parimalanathan and {de Lusignan}, Simon and Jamie Lopez-Bernal",

note = "Funding Information: This study was funded by Public Health England (an executive agency of the Department of Health) as part of the COVID-19 response. The authors had sole responsibility for the study design, data collection, data analysis, data interpretation, and writing of the report. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication. The authors have declared no competing interest. SdeL is the Director of the Royal College of General Practitioners Research and Surveillance, and hold a grant from AstraZeneca both funded through his university. Open Access: No Open Access licence Publisher Copyright: {\textcopyright} 2021 Published by Elsevier Ltd on behalf of The British Infection Association. Citation: Elizabeth Miller, Pauline A. Waight, Nick J. Andrews, Kelsey McOwat, Kevin E. Brown, Katja H{\"o}schler, Samreen Ijaz, Louise Letley, Donna Haskins, Mary Sinnathamby, Hannah Cuthbertson, Bassam Hallis, Vaishnavi Parimalanathan, Simon de Lusignan, Jamie Lopez-Bernal, Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England,Journal of Infection, Volume 83, Issue 4, 2021, Pages 483-489, ISSN 0163-4453, DOI: https://doi.org/10.1016/j.jinf.2021.07.037.",

year = "2021",

month = oct,

doi = "10.1016/j.jinf.2021.07.037",

language = "English",

volume = "83",

pages = "483--489",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W.B. Saunders Ltd",

number = "4",

}

Miller, E, Waight, PA, Andrews, NJ, McOwat, K, Brown, KE , Katja, H , Ijaz, S , Letley, L, Haskins, D, Sinnathamby, M , Cuthbertson, H , Hallis, B, Parimalanathan, V, de Lusignan, S & Lopez-Bernal, J 2021, 'Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England', Journal of Infection, vol. 83, no. 4, pp. 483-489. https://doi.org/10.1016/j.jinf.2021.07.037

TY - JOUR

T1 - Transmission of SARS-CoV-2 in the household setting

T2 - A prospective cohort study in children and adults in England

AU - Miller, Elizabeth

AU - Waight, Pauline A.

AU - Andrews, Nick J.

AU - McOwat, Kelsey

AU - Brown, Kevin E.

AU - Katja, Höschler

AU - Ijaz, Samreen

AU - Letley, Louise

AU - Haskins, Donna

AU - Sinnathamby, Mary

AU - Cuthbertson, Hannah

AU - Hallis, Bassam

AU - Parimalanathan, Vaishnavi

AU - de Lusignan, Simon

AU - Lopez-Bernal, Jamie

N1 - Funding Information: This study was funded by Public Health England (an executive agency of the Department of Health) as part of the COVID-19 response. The authors had sole responsibility for the study design, data collection, data analysis, data interpretation, and writing of the report. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication. The authors have declared no competing interest. SdeL is the Director of the Royal College of General Practitioners Research and Surveillance, and hold a grant from AstraZeneca both funded through his university. Open Access: No Open Access licence Publisher Copyright: © 2021 Published by Elsevier Ltd on behalf of The British Infection Association. Citation: Elizabeth Miller, Pauline A. Waight, Nick J. Andrews, Kelsey McOwat, Kevin E. Brown, Katja Höschler, Samreen Ijaz, Louise Letley, Donna Haskins, Mary Sinnathamby, Hannah Cuthbertson, Bassam Hallis, Vaishnavi Parimalanathan, Simon de Lusignan, Jamie Lopez-Bernal, Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England,Journal of Infection, Volume 83, Issue 4, 2021, Pages 483-489, ISSN 0163-4453, DOI: https://doi.org/10.1016/j.jinf.2021.07.037.

PY - 2021/10

Y1 - 2021/10

N2 - Objectives: To measure secondary attack rates (SARs) in prospectively followed household contacts of paediatric and adult cases of SARS-CoV-2 infection in England. Methods: Self-taken nasal swabs from household contacts of PCR confirmed cases of COVID-19 and blood samples on day 35 were tested for evidence of infection with SARS-CoV-2 virus. Results: The secondary attack rate (SAR) among 431 contacts of 172 symptomatic index cases was 33% (95% confidence intervals [CI] 25–40) and was lower from primary cases without respiratory symptoms, 6% (CI 0–14) vs 37% (CI 29–45), p = 0.030. The SAR from index cases <11 years was 25% (CI 12–38). SARs ranged from 16% (4–28) in contacts <11 years old to 36% (CI 28–45) in contacts aged 19–54 years (p = 0.119). The proportion infected who developed symptoms (78%) was similar by age (p = 0.44) though <19 year olds had fewer mean number of symptoms than adults (p = 0.001) and fewer reported loss of sense of taste or smell (p = 0.0001). Conclusions:: There are high risks of transmission of SARS-CoV-2 virus in the home, including those where infection is introduced by a child. The risk of children acquiring infection was lower than that in adults and fewer developed typical symptoms of Covid-19 infection.

AB - Objectives: To measure secondary attack rates (SARs) in prospectively followed household contacts of paediatric and adult cases of SARS-CoV-2 infection in England. Methods: Self-taken nasal swabs from household contacts of PCR confirmed cases of COVID-19 and blood samples on day 35 were tested for evidence of infection with SARS-CoV-2 virus. Results: The secondary attack rate (SAR) among 431 contacts of 172 symptomatic index cases was 33% (95% confidence intervals [CI] 25–40) and was lower from primary cases without respiratory symptoms, 6% (CI 0–14) vs 37% (CI 29–45), p = 0.030. The SAR from index cases <11 years was 25% (CI 12–38). SARs ranged from 16% (4–28) in contacts <11 years old to 36% (CI 28–45) in contacts aged 19–54 years (p = 0.119). The proportion infected who developed symptoms (78%) was similar by age (p = 0.44) though <19 year olds had fewer mean number of symptoms than adults (p = 0.001) and fewer reported loss of sense of taste or smell (p = 0.0001). Conclusions:: There are high risks of transmission of SARS-CoV-2 virus in the home, including those where infection is introduced by a child. The risk of children acquiring infection was lower than that in adults and fewer developed typical symptoms of Covid-19 infection.

KW - Households

KW - SARS-CoV-2 transmission

KW - Secondary attack rates by age

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U2 - 10.1016/j.jinf.2021.07.037

DO - 10.1016/j.jinf.2021.07.037

M3 - Article

AN - SCOPUS:85112495883

SN - 0163-4453

VL - 83

SP - 483

EP - 489

JO - Journal of Infection

JF - Journal of Infection

IS - 4

ER -

Transmission of SARS-CoV-2 in the household setting: A prospective cohort study in children and adults in England

Abstract

Bibliographical note

Keywords

UN SDGs

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