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1.
Euro Surveill ; 27(15)2022 04.
Article in English | MEDLINE | ID: covidwho-1869325

ABSTRACT

BackgroundHouseholds appear to be the highest risk setting for COVID-19 transmission. Large household transmission studies in the early stages of the pandemic in Asia reported secondary attack rates ranging from 5 to 30%.AimWe aimed to investigate the transmission dynamics of COVID-19 in household and community settings in the UK.MethodsA prospective case-ascertained study design based on the World Health Organization FFX protocol was undertaken in the UK following the detection of the first case in late January 2020. Household contacts of cases were followed using enhanced surveillance forms to establish whether they developed symptoms of COVID-19, became confirmed cases and their outcomes. We estimated household secondary attack rates (SAR), serial intervals and individual and household basic reproduction numbers. The incubation period was estimated using known point source exposures that resulted in secondary cases.ResultsWe included 233 households with two or more people with 472 contacts. The overall household SAR was 37% (95% CI: 31-43%) with a mean serial interval of 4.67 days, an R0 of 1.85 and a household reproduction number of 2.33. SAR were lower in larger households and highest when the primary case was younger than 18 years. We estimated a mean incubation period of around 4.5 days.ConclusionsRates of COVID-19 household transmission were high in the UK for ages above and under 18 years, emphasising the need for preventative measures in this setting. This study highlights the importance of the FFX protocol in providing early insights on transmission dynamics.


Subject(s)
COVID-19 , Adolescent , Family Characteristics , Humans , Pandemics , SARS-CoV-2 , United Kingdom/epidemiology
2.
Bull World Health Organ ; 99(3): 178-189, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1256313

ABSTRACT

OBJECTIVE: To describe the clinical presentation, course of disease and health-care seeking behaviour of the first few hundred cases of coronavirus disease 2019 (COVID-19) in the United Kingdom of Great Britain and Northern Ireland. METHODS: We implemented the World Health Organization's First Few X cases and contacts investigation protocol for COVID-19. Trained public health professionals collected information on 381 virologically confirmed COVID-19 cases from 31 January 2020 to 9 April 2020. We actively followed up cases to identify exposure to infection, symptoms and outcomes. We also collected limited data on 752 symptomatic people testing negative for COVID-19, as a control group for analyses of the sensitivity, specificity and predictive value of symptoms. FINDINGS: Approximately half of the COVID-19 cases were imported (196 cases; 51.4%), of whom the majority had recent travel to Italy (140 cases; 71.4%). Of the 94 (24.7%) secondary cases, almost all reported close contact with a confirmed case (93 cases; 98.9%), many through household contact (37 cases; 39.8%). By age, a lower proportion of children had COVID-19. Most cases presented with cough, fever and fatigue. The sensitivity and specificity of symptoms varied by age, with nonlinear relationships with age. Although the proportion of COVID-19 cases with fever increased with age, for those with other respiratory infections the occurrence of fever decreased with age. The occurrence of shortness of breath also increased with age in a greater proportion of COVID-19 cases. CONCLUSION: The study has provided useful evidence for generating case definitions and has informed modelling studies of the likely burden of COVID-19.


Subject(s)
COVID-19/epidemiology , COVID-19/physiopathology , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Dyspnea/epidemiology , Female , Humans , Infant , Male , Middle Aged , Respiratory Tract Infections/epidemiology , SARS-CoV-2 , Travel , United Kingdom/epidemiology , Young Adult
3.
Exp Clin Transplant ; 19(11): 1117-1123, 2021 11.
Article in English | MEDLINE | ID: covidwho-1067949

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 pandemic has dramatically changed medical practices worldwide. These changes have been aimed both to reallocate resources toward fighting the novel coronavirus and to prevent its transmission during nonurgent medical and surgical interventions. Heart and lung transplantation could not be an exception, as most transplant centers have either restricted their activity to only urgent, lifesaving procedures or stopped these surgical procedures for various periods of time depending on the local virus epidemiology. The effect of this infection on the immunosuppressed heart and lung transplant recipient is still questionable; however, there are limited reports suggesting that there is no increased risk of transmission or more severe disease course compared with that shown in the general population. Transplant organizations have disseminated early recommendations as a guidance in a yet evolving situation. Finally, data suggest that lung transplant could potentially serve as an ultimate, lifesaving procedure for COVID-19-related end-stage respiratory failure in carefully selected patients.


Subject(s)
COVID-19/transmission , Heart Transplantation , Lung Transplantation , COVID-19/immunology , COVID-19/mortality , COVID-19/surgery , Delivery of Health Care, Integrated , Health Services Needs and Demand , Heart Transplantation/adverse effects , Heart Transplantation/mortality , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Lung Transplantation/adverse effects , Lung Transplantation/mortality , Needs Assessment , Patient Safety , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome
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