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1.
BMC Infect Dis ; 22(1): 296, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1765439

ABSTRACT

BACKGROUND: The global pandemic of coronavirus disease 2019 (COVID-19) has attracted great public health efforts across the world. Few studies, however, have described the potential impact of these measures on other important infectious diseases. METHODS: The incidence of 19 major infectious diseases in Zhejiang Province was collected from the National Notifiable Infectious Disease Surveillance System from January 2017 to October 2020. The entire epidemic control phase was divided into three stages. The government deployed the first level response from 24 January to 2 March (the most rigorous measures). When the outbreak of COVID-19 was under control, the response level changed to the second level from 3 to 23 March, and then the third level response was implemented after 24 March. We compared the epidemiological characteristics of 19 major infectious diseases during different periods of the COVID-19 epidemic and previous years. RESULTS: A total of 1,814,881 cases of 19 infectious diseases were reported in Zhejiang from January 2017 to October 2020, resulting in an incidence rate of 8088.30 cases per 1,000,000 person-years. After the non-pharmaceutical intervention, the incidence of 19 infectious diseases dropped by 70.84%, from 9436.32 cases per 1,000,000 person-years to 2751.51 cases per 1,000,000 person-years, with the large decrease in the first response period of influenza. However, we observed that the daily incidence of severe fever with thrombocytopenia syndrome (SFTS) and leptospirosis increased slightly (from 1.11 cases per 1,000,000 person-years to 1.82 cases per 1,000,000 person-years for SFTS and 0.30 cases per 1,000,000 person-years to 1.24 cases per 1,000,000 person-years for leptospirosis). There was no significant difference in the distribution of epidemiological characteristic of most infectious diseases before and during the implementation of COVID-19 control measures. CONCLUSION: Our study summarizes the epidemiological characteristics of 19 infectious diseases and indicates that the rigorous control measures for COVID-19 are also effective for majority of infectious diseases.


Subject(s)
COVID-19 , Communicable Diseases , Epidemics , COVID-19/epidemiology , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Epidemics/prevention & control , Humans , Incidence
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324176

ABSTRACT

An outbreak of novel coronavirus (SARS-CoV-2) was identified in China in December 2019, and has spread rapidly to more than 200 countries and areas in four months. A few studies have reported that transmissibility exists during the late incubation period based on one single infection cluster caused by SARS-CoV-2. Here based on 178 SARS-CoV-2 clusters confirmed in Zhejiang Province, we analyzed the epidemic link between all 212 secondary cases with their previous cases, and found 49 secondary cases (from 26 clusters), which were 23.11% (49/212) of the total secondary cases infected from previous cases during the latter’s incubation period. The median days from the last exposure of secondary cases to the onset of previous cases was 2.0 days (IQR: 1.00~5.00 days, 90th percentile: 9.00 days) .This study has shown transmission of the SARS-CoV-2 during the incubation period and indicated that some cases might be infectious soon after they were exposed to a prior transmitter. The results highlight the importance of extending the contact group for medical observation and isolation to those in contact with the index case nine (90th percentile) or more days before the latter’s illness onset, when medical resources were sufficient.

3.
JAMA Intern Med ; 181(10): 1343-1350, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1368408

ABSTRACT

Importance: Much remains unknown about the transmission dynamics of COVID-19. How the severity of the index case and timing of exposure is associated with disease in close contacts of index patients with COVID-19 and clinical presentation in those developing disease is not well elucidated. Objectives: To investigate the association between the timing of exposure and development of disease among close contacts of index patients with COVID-19 and to evaluate whether the severity of the index case is associated with clinical presentation in close contacts who develop COVID-19. Design, Setting, and Participants: This study used a large, population-based cohort of 730 individuals (index patients) who received a diagnosis of COVID-19 in Zhejiang Province, China, from January 8 to July 30, 2020, along with a contact tracing surveillance program. Field workers visited 8852 close contacts of the index patients and evaluated them for COVID-19 through August 2020. A timeline was constructed to characterize different exposure periods between index patients and their contacts. Main Outcomes and Measures: The primary outcome was the attack rate of COVID-19, defined as the total number of new COVID-19 cases diagnosed among contacts of index patients divided by the total number of exposed contacts. A secondary outcome was asymptomatic clinical presentation among infected contacts. Relative risks were calculated to investigate risk factors for COVID-19 among contacts and asymptomatic clinical presentation among infected contacts. Results: Among 8852 close contacts (4679 male contacts [52.9%]; median age, 41 years [interquartile range, 28-54 years]) of 730 index patients (374 male patients [51.2%]; median age, 46 years [interquartile range, 36-56 years]), contacts were at highest risk of COVID-19 if they were exposed between 2 days before and 3 days after the index patient's symptom onset, peaking at day 0 (adjusted relative risk [ARR], 1.3; 95% CI, 1.2-1.5). Compared with being exposed to an asymptomatic index patient, the risk of COVID-19 among contacts was higher when they were exposed to index patients with mild (ARR, 4.0; 95% CI, 1.8-9.1) and moderate (ARR, 4.3; 95% CI, 1.9-9.7) cases of COVID-19. As index case severity increased, infected contacts were less likely to be asymptomatic (exposed to patient with mild COVID-19: ARR, 0.3; 95% CI, 0.1-0.9; exposed to patient with moderate COVID-19: ARR, 0.3; 95% CI, 0.1-0.8). Conclusions and Relevance: This cohort study found that individuals with COVID-19 were most infectious a few days before and after symptom onset. Infected contacts of asymptomatic index patients were less likely to present with COVID-19 symptoms, suggesting that quantity of exposure may be associated with clinical presentation in close contacts.


Subject(s)
COVID-19/transmission , Contact Tracing , SARS-CoV-2/pathogenicity , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , China , Cohort Studies , Female , Humans , Male , Middle Aged , Risk Factors , Symptom Assessment , Time Factors , Young Adult
4.
Biosci Trends ; 15(3): 188-191, 2021 Jul 06.
Article in English | MEDLINE | ID: covidwho-1271034

ABSTRACT

The COVID-19 pandemic continues to ravage the world. As many countries have entered the postpandemic period, current efforts to prevent and control COVID-19 have gradually been normalized in many countries. Although the focus is on vaccines to achieve herd immunity, conventional physical containment strategies should be reassessed as part of efforts to prevent and control infectious diseases. Continued respiratory protective measures such as social distancing and the wearing of masks have been extensively accepted by the public in most countries. A point worth noticing is that the activities of influenza and other respiratory diseases have decreased as these strategies have been implemented. Public mobilization and large-scale campaigns to promote health are also important to interrupting the transmission of pathogens. A good example can be found in the achievements of China's Patriotic Public Health Campaign. These practices underscore the importance of enhancing physical containment strategies and public mobilization and management, with support from the legal system, to respond to any potential emerging infectious diseases.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Public Health , SARS-CoV-2/physiology , COVID-19/virology , Humans , Influenza, Human/epidemiology
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