First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020
Abstract Background Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, nonhospitalized COVID-19 case who traveled to...
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| Veröffentlicht in: | Clinical infectious diseases 2020-07, Vol.71 (15), p.807-812 |
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| creator | Scott, Sarah E Zabel, Karen Collins, Jennifer Hobbs, Katherine C Kretschmer, Melissa J Lach, Mitchell Turnbow, Katie Speck, Lindsay White, Jessica R Maldonado, Keila Howard, Brandon Fowler, Jeanene Singh, Sonia Robinson, Susan Pompa, Alexandra Peterson Chatham-Stephens, Kevin Xie, Amy Cates, Jordan Lindstrom, Stephen Lu, Xiaoyan Rolfes, Melissa A Flanagan, Marcy Sunenshine, Rebecca |
| description | Abstract
Background
Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, nonhospitalized COVID-19 case who traveled to China.
Methods
The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–positive specimens collected on 22 January 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥ 10 minutes within 2 m). Medium-risk contacts wore all US Centers for Disease Control and Prevention–recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2.
Results
Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥ 1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative.
Conclusions
This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.
We describe the public health investigation of the first mildly ill, nonhospitalized US COVID-19 case. Despite specimens testing positive 18 days after diagnosis, no severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurred among 10 high-risk contacts, including 1 intimate contact, based on serial SARS-CoV-2 testing. |
| doi_str_mv | 10.1093/cid/ciaa374 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2386280223</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/cid/ciaa374</oup_id><sourcerecordid>2386280223</sourcerecordid><originalsourceid>FETCH-LOGICAL-c357t-45cbb09ef861a0f972010392b3c72c902cce1f2e57dddd21f4b32197e6ba35b63</originalsourceid><addsrcrecordid>eNp9kctKxDAUhoMo3lfuJStRnGouTdsspd4GvCy8LUuapkwk09QkFcaVD-Hah_NJjMzo0kDIIXx854cfgB2MjjDi9FjqJl4haJ4ugXXMaJ5kjOPlOCNWJGlBizWw4f0zQhgXiK2CNUpIikjB1sHnuXY-wGttGjODY2NG8MZ2E-t7HYTRb6qBpfAK2haW1tlOvGo3eHiqvfr5JghzuF_ePo5PE8wP4JMOEzsE-KidMPDeic5PtffadlB3MEwUfOh0iNK7IILyX-8f18JpaXsR9UMXZiN44vRb3DOKboK2wEorjFfbi3cTPJyf3ZeXydXtxbg8uUokZXlIUibrGnHVFhkWqOV5zIUoJzWVOZEcESkVbolieRMPwW1aU4J5rrJaUFZndBPsz729sy-D8qGKsaUyRnTKDr4itMhIgQihET2co9JZ751qq97pqXCzCqPqp5AqFlItCon07kI81FPV_LG_DURgbw7Yof_X9A1nM5SE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2386280223</pqid></control><display><type>article</type><title>First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Scott, Sarah E ; Zabel, Karen ; Collins, Jennifer ; Hobbs, Katherine C ; Kretschmer, Melissa J ; Lach, Mitchell ; Turnbow, Katie ; Speck, Lindsay ; White, Jessica R ; Maldonado, Keila ; Howard, Brandon ; Fowler, Jeanene ; Singh, Sonia ; Robinson, Susan ; Pompa, Alexandra Peterson ; Chatham-Stephens, Kevin ; Xie, Amy ; Cates, Jordan ; Lindstrom, Stephen ; Lu, Xiaoyan ; Rolfes, Melissa A ; Flanagan, Marcy ; Sunenshine, Rebecca</creator><creatorcontrib>Scott, Sarah E ; Zabel, Karen ; Collins, Jennifer ; Hobbs, Katherine C ; Kretschmer, Melissa J ; Lach, Mitchell ; Turnbow, Katie ; Speck, Lindsay ; White, Jessica R ; Maldonado, Keila ; Howard, Brandon ; Fowler, Jeanene ; Singh, Sonia ; Robinson, Susan ; Pompa, Alexandra Peterson ; Chatham-Stephens, Kevin ; Xie, Amy ; Cates, Jordan ; Lindstrom, Stephen ; Lu, Xiaoyan ; Rolfes, Melissa A ; Flanagan, Marcy ; Sunenshine, Rebecca ; Maricopa County COVID-19 Case Investigation Team ; for the Maricopa County COVID-19 Case Investigation Team</creatorcontrib><description>Abstract
Background
Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, nonhospitalized COVID-19 case who traveled to China.
Methods
The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–positive specimens collected on 22 January 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥ 10 minutes within 2 m). Medium-risk contacts wore all US Centers for Disease Control and Prevention–recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2.
Results
Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥ 1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative.
Conclusions
This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.
We describe the public health investigation of the first mildly ill, nonhospitalized US COVID-19 case. Despite specimens testing positive 18 days after diagnosis, no severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurred among 10 high-risk contacts, including 1 intimate contact, based on serial SARS-CoV-2 testing.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciaa374</identifier><identifier>PMID: 32240285</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adult ; Arizona ; Betacoronavirus - pathogenicity ; China ; Clinical Laboratory Techniques ; Contact Tracing - methods ; Coronavirus Infections - diagnosis ; Coronavirus Infections - transmission ; Coronavirus Infections - virology ; COVID-19 ; COVID-19 Testing ; Humans ; Male ; Pandemics ; Pneumonia, Viral - diagnosis ; Pneumonia, Viral - transmission ; Pneumonia, Viral - virology ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome - diagnosis ; Severe Acute Respiratory Syndrome - virology ; Specimen Handling - methods ; Travel</subject><ispartof>Clinical infectious diseases, 2020-07, Vol.71 (15), p.807-812</ispartof><rights>Published by Oxford University Press for the Infectious Diseases Society of America 2020. 2020</rights><rights>Published by Oxford University Press for the Infectious Diseases Society of America 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-45cbb09ef861a0f972010392b3c72c902cce1f2e57dddd21f4b32197e6ba35b63</citedby><cites>FETCH-LOGICAL-c357t-45cbb09ef861a0f972010392b3c72c902cce1f2e57dddd21f4b32197e6ba35b63</cites><orcidid>0000-0002-3325-8169</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32240285$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scott, Sarah E</creatorcontrib><creatorcontrib>Zabel, Karen</creatorcontrib><creatorcontrib>Collins, Jennifer</creatorcontrib><creatorcontrib>Hobbs, Katherine C</creatorcontrib><creatorcontrib>Kretschmer, Melissa J</creatorcontrib><creatorcontrib>Lach, Mitchell</creatorcontrib><creatorcontrib>Turnbow, Katie</creatorcontrib><creatorcontrib>Speck, Lindsay</creatorcontrib><creatorcontrib>White, Jessica R</creatorcontrib><creatorcontrib>Maldonado, Keila</creatorcontrib><creatorcontrib>Howard, Brandon</creatorcontrib><creatorcontrib>Fowler, Jeanene</creatorcontrib><creatorcontrib>Singh, Sonia</creatorcontrib><creatorcontrib>Robinson, Susan</creatorcontrib><creatorcontrib>Pompa, Alexandra Peterson</creatorcontrib><creatorcontrib>Chatham-Stephens, Kevin</creatorcontrib><creatorcontrib>Xie, Amy</creatorcontrib><creatorcontrib>Cates, Jordan</creatorcontrib><creatorcontrib>Lindstrom, Stephen</creatorcontrib><creatorcontrib>Lu, Xiaoyan</creatorcontrib><creatorcontrib>Rolfes, Melissa A</creatorcontrib><creatorcontrib>Flanagan, Marcy</creatorcontrib><creatorcontrib>Sunenshine, Rebecca</creatorcontrib><creatorcontrib>Maricopa County COVID-19 Case Investigation Team</creatorcontrib><creatorcontrib>for the Maricopa County COVID-19 Case Investigation Team</creatorcontrib><title>First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Abstract
Background
Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, nonhospitalized COVID-19 case who traveled to China.
Methods
The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–positive specimens collected on 22 January 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥ 10 minutes within 2 m). Medium-risk contacts wore all US Centers for Disease Control and Prevention–recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2.
Results
Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥ 1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative.
Conclusions
This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.
We describe the public health investigation of the first mildly ill, nonhospitalized US COVID-19 case. Despite specimens testing positive 18 days after diagnosis, no severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurred among 10 high-risk contacts, including 1 intimate contact, based on serial SARS-CoV-2 testing.</description><subject>Adult</subject><subject>Arizona</subject><subject>Betacoronavirus - pathogenicity</subject><subject>China</subject><subject>Clinical Laboratory Techniques</subject><subject>Contact Tracing - methods</subject><subject>Coronavirus Infections - diagnosis</subject><subject>Coronavirus Infections - transmission</subject><subject>Coronavirus Infections - virology</subject><subject>COVID-19</subject><subject>COVID-19 Testing</subject><subject>Humans</subject><subject>Male</subject><subject>Pandemics</subject><subject>Pneumonia, Viral - diagnosis</subject><subject>Pneumonia, Viral - transmission</subject><subject>Pneumonia, Viral - virology</subject><subject>SARS-CoV-2</subject><subject>Severe Acute Respiratory Syndrome - diagnosis</subject><subject>Severe Acute Respiratory Syndrome - virology</subject><subject>Specimen Handling - methods</subject><subject>Travel</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctKxDAUhoMo3lfuJStRnGouTdsspd4GvCy8LUuapkwk09QkFcaVD-Hah_NJjMzo0kDIIXx854cfgB2MjjDi9FjqJl4haJ4ugXXMaJ5kjOPlOCNWJGlBizWw4f0zQhgXiK2CNUpIikjB1sHnuXY-wGttGjODY2NG8MZ2E-t7HYTRb6qBpfAK2haW1tlOvGo3eHiqvfr5JghzuF_ePo5PE8wP4JMOEzsE-KidMPDeic5PtffadlB3MEwUfOh0iNK7IILyX-8f18JpaXsR9UMXZiN44vRb3DOKboK2wEorjFfbi3cTPJyf3ZeXydXtxbg8uUokZXlIUibrGnHVFhkWqOV5zIUoJzWVOZEcESkVbolieRMPwW1aU4J5rrJaUFZndBPsz729sy-D8qGKsaUyRnTKDr4itMhIgQihET2co9JZ751qq97pqXCzCqPqp5AqFlItCon07kI81FPV_LG_DURgbw7Yof_X9A1nM5SE</recordid><startdate>20200728</startdate><enddate>20200728</enddate><creator>Scott, Sarah E</creator><creator>Zabel, Karen</creator><creator>Collins, Jennifer</creator><creator>Hobbs, Katherine C</creator><creator>Kretschmer, Melissa J</creator><creator>Lach, Mitchell</creator><creator>Turnbow, Katie</creator><creator>Speck, Lindsay</creator><creator>White, Jessica R</creator><creator>Maldonado, Keila</creator><creator>Howard, Brandon</creator><creator>Fowler, Jeanene</creator><creator>Singh, Sonia</creator><creator>Robinson, Susan</creator><creator>Pompa, Alexandra Peterson</creator><creator>Chatham-Stephens, Kevin</creator><creator>Xie, Amy</creator><creator>Cates, Jordan</creator><creator>Lindstrom, Stephen</creator><creator>Lu, Xiaoyan</creator><creator>Rolfes, Melissa A</creator><creator>Flanagan, Marcy</creator><creator>Sunenshine, Rebecca</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3325-8169</orcidid></search><sort><creationdate>20200728</creationdate><title>First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020</title><author>Scott, Sarah E ; Zabel, Karen ; Collins, Jennifer ; Hobbs, Katherine C ; Kretschmer, Melissa J ; Lach, Mitchell ; Turnbow, Katie ; Speck, Lindsay ; White, Jessica R ; Maldonado, Keila ; Howard, Brandon ; Fowler, Jeanene ; Singh, Sonia ; Robinson, Susan ; Pompa, Alexandra Peterson ; Chatham-Stephens, Kevin ; Xie, Amy ; Cates, Jordan ; Lindstrom, Stephen ; Lu, Xiaoyan ; Rolfes, Melissa A ; Flanagan, Marcy ; Sunenshine, Rebecca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-45cbb09ef861a0f972010392b3c72c902cce1f2e57dddd21f4b32197e6ba35b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Arizona</topic><topic>Betacoronavirus - pathogenicity</topic><topic>China</topic><topic>Clinical Laboratory Techniques</topic><topic>Contact Tracing - methods</topic><topic>Coronavirus Infections - diagnosis</topic><topic>Coronavirus Infections - transmission</topic><topic>Coronavirus Infections - virology</topic><topic>COVID-19</topic><topic>COVID-19 Testing</topic><topic>Humans</topic><topic>Male</topic><topic>Pandemics</topic><topic>Pneumonia, Viral - diagnosis</topic><topic>Pneumonia, Viral - transmission</topic><topic>Pneumonia, Viral - virology</topic><topic>SARS-CoV-2</topic><topic>Severe Acute Respiratory Syndrome - diagnosis</topic><topic>Severe Acute Respiratory Syndrome - virology</topic><topic>Specimen Handling - methods</topic><topic>Travel</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scott, Sarah E</creatorcontrib><creatorcontrib>Zabel, Karen</creatorcontrib><creatorcontrib>Collins, Jennifer</creatorcontrib><creatorcontrib>Hobbs, Katherine C</creatorcontrib><creatorcontrib>Kretschmer, Melissa J</creatorcontrib><creatorcontrib>Lach, Mitchell</creatorcontrib><creatorcontrib>Turnbow, Katie</creatorcontrib><creatorcontrib>Speck, Lindsay</creatorcontrib><creatorcontrib>White, Jessica R</creatorcontrib><creatorcontrib>Maldonado, Keila</creatorcontrib><creatorcontrib>Howard, Brandon</creatorcontrib><creatorcontrib>Fowler, Jeanene</creatorcontrib><creatorcontrib>Singh, Sonia</creatorcontrib><creatorcontrib>Robinson, Susan</creatorcontrib><creatorcontrib>Pompa, Alexandra Peterson</creatorcontrib><creatorcontrib>Chatham-Stephens, Kevin</creatorcontrib><creatorcontrib>Xie, Amy</creatorcontrib><creatorcontrib>Cates, Jordan</creatorcontrib><creatorcontrib>Lindstrom, Stephen</creatorcontrib><creatorcontrib>Lu, Xiaoyan</creatorcontrib><creatorcontrib>Rolfes, Melissa A</creatorcontrib><creatorcontrib>Flanagan, Marcy</creatorcontrib><creatorcontrib>Sunenshine, Rebecca</creatorcontrib><creatorcontrib>Maricopa County COVID-19 Case Investigation Team</creatorcontrib><creatorcontrib>for the Maricopa County COVID-19 Case Investigation Team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scott, Sarah E</au><au>Zabel, Karen</au><au>Collins, Jennifer</au><au>Hobbs, Katherine C</au><au>Kretschmer, Melissa J</au><au>Lach, Mitchell</au><au>Turnbow, Katie</au><au>Speck, Lindsay</au><au>White, Jessica R</au><au>Maldonado, Keila</au><au>Howard, Brandon</au><au>Fowler, Jeanene</au><au>Singh, Sonia</au><au>Robinson, Susan</au><au>Pompa, Alexandra Peterson</au><au>Chatham-Stephens, Kevin</au><au>Xie, Amy</au><au>Cates, Jordan</au><au>Lindstrom, Stephen</au><au>Lu, Xiaoyan</au><au>Rolfes, Melissa A</au><au>Flanagan, Marcy</au><au>Sunenshine, Rebecca</au><aucorp>Maricopa County COVID-19 Case Investigation Team</aucorp><aucorp>for the Maricopa County COVID-19 Case Investigation Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2020-07-28</date><risdate>2020</risdate><volume>71</volume><issue>15</issue><spage>807</spage><epage>812</epage><pages>807-812</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Abstract
Background
Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, nonhospitalized COVID-19 case who traveled to China.
Methods
The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–positive specimens collected on 22 January 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥ 10 minutes within 2 m). Medium-risk contacts wore all US Centers for Disease Control and Prevention–recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2.
Results
Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥ 1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative.
Conclusions
This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.
We describe the public health investigation of the first mildly ill, nonhospitalized US COVID-19 case. Despite specimens testing positive 18 days after diagnosis, no severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurred among 10 high-risk contacts, including 1 intimate contact, based on serial SARS-CoV-2 testing.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>32240285</pmid><doi>10.1093/cid/ciaa374</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3325-8169</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical infectious diseases, 2020-07, Vol.71 (15), p.807-812 |
| issn | 1058-4838 1537-6591 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2386280223 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Arizona Betacoronavirus - pathogenicity China Clinical Laboratory Techniques Contact Tracing - methods Coronavirus Infections - diagnosis Coronavirus Infections - transmission Coronavirus Infections - virology COVID-19 COVID-19 Testing Humans Male Pandemics Pneumonia, Viral - diagnosis Pneumonia, Viral - transmission Pneumonia, Viral - virology SARS-CoV-2 Severe Acute Respiratory Syndrome - diagnosis Severe Acute Respiratory Syndrome - virology Specimen Handling - methods Travel |
| title | First Mildly Ill, Nonhospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States—Maricopa County, Arizona, 2020 |
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