Infectivity, susceptibility, and risk factors associated with SARS-CoV-2 transmission under intensive contact tracing in Hunan, China

Shixiong Hu, Wei Wang, Yan Wang, Maria Litvinova, Kaiwei Luo, Lingshuang Ren, Qianlai Sun, Xinghui Chen, Ge Zeng, Jing Li, Lu Liang, Zhihong Deng, Wen Zheng, Mei Li, Hao Yang, Jinxin Guo, Kai Wang, Xinhua Chen, Ziyan Liu, Han Yan, Huilin Shi, Zhiyuan Chen, Yonghong Zhou, Kaiyuan Sun, Alessandro Vespignani, Cécile Viboud, Lidong Gao (), Marco Ajelli () and Hongjie Yu ()
Additional contact information
Shixiong Hu: Hunan Provincial Center for Disease Control and Prevention
Wei Wang: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Yan Wang: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Maria Litvinova: Indiana University School of Public Health
Kaiwei Luo: Hunan Provincial Center for Disease Control and Prevention
Lingshuang Ren: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Qianlai Sun: Hunan Provincial Center for Disease Control and Prevention
Xinghui Chen: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Ge Zeng: Hunan Provincial Center for Disease Control and Prevention
Jing Li: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Lu Liang: Sichuan University
Zhihong Deng: Hunan Provincial Center for Disease Control and Prevention
Wen Zheng: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Mei Li: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Hao Yang: Hunan Provincial Center for Disease Control and Prevention
Jinxin Guo: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Kai Wang: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Xinhua Chen: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Ziyan Liu: Hunan Provincial Center for Disease Control and Prevention
Han Yan: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Huilin Shi: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Zhiyuan Chen: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Yonghong Zhou: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education
Kaiyuan Sun: Fogarty International Center, National Institutes of Health
Alessandro Vespignani: ISI Foundation
Cécile Viboud: Fogarty International Center, National Institutes of Health
Lidong Gao: Hunan Provincial Center for Disease Control and Prevention
Marco Ajelli: Indiana University School of Public Health
Hongjie Yu: Fudan University, Key Laboratory of Public Health Safety, Ministry of Education

Nature Communications, 2021, vol. 12, issue 1, 1-11

Abstract: Abstract Several mechanisms driving SARS-CoV-2 transmission remain unclear. Based on individual records of 1178 potential SARS-CoV-2 infectors and their 15,648 contacts in Hunan, China, we estimated key transmission parameters. The mean generation time was estimated to be 5.7 (median: 5.5, IQR: 4.5, 6.8) days, with infectiousness peaking 1.8 days before symptom onset, with 95% of transmission events occurring between 8.8 days before and 9.5 days after symptom onset. Most transmission events occurred during the pre-symptomatic phase (59.2%). SARS-CoV-2 susceptibility to infection increases with age, while transmissibility is not significantly different between age groups and between symptomatic and asymptomatic individuals. Contacts in households and exposure to first-generation cases are associated with higher odds of transmission. Our findings support the hypothesis that children can effectively transmit SARS-CoV-2 and highlight how pre-symptomatic and asymptomatic transmission can hinder control efforts.

Date: 2021
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DOI: 10.1038/s41467-021-21710-6

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