Factors Associated With Transmission Across Three Waves of SARS-CoV-2 in a Prospective Community-Based Study of Households With School-Aged Children-Dane County, Wisconsin, 2020-2022

Overview

Journal Influenza Other Respir Viruses

Publisher Wiley

Specialty Microbiology

Date 2024 Oct 31

PMID 39478308

Authors

Ajay K Sethi

Cristalyne Bell

Derek Norton

Maureen D Goss

Shari Barlow

Guanhua Chen

Amra Uzicanin

Jonathan L Temte

Affiliations

Soon will be listed here.

Abstract

Background: Household transmission of SARS-CoV-2 is a driver of the ongoing COVID-19 pandemic. Understanding factors that contribute to secondary infection risks (SIRs) can define changing trends and inform public health policies.

Methods: The ORegon CHild Absenteeism due to Respiratory Disease Study (ORCHARDS) prospectively monitors respiratory viruses within the Oregon School District (OSD) in southcentral Wisconsin. Households with students who had ≥ 2 respiratory symptoms were eligible and opted to participate in ORCHARDS. Between October 28, 2020, and May 16, 2022, all household members provided self-collected nasal specimens on days 0, 7, and 14 for SARS-CoV-2 detection using real-time reverse-transcription-polymerase chain reaction. We used logistic regression to investigate individual- and household-level characteristics associated with SARS-CoV-2 transmission.

Results: Overall, 127 households comprising 572 individuals (48% female; 52% male; 0.4% nonbinary; 77% ≥ 18 years) had at least one detection of SARS-CoV-2. The overall SIR was 47% and decreased over time (pre-Delta = 72% [95% CI: 58%-83%]; Delta = 51% [40%-63%]; and Omicron = 41% [36%-47%]). Odds of household transmission were 63% lower during the Omicron period compared with the pre-Delta period (OR = 0.36 [95% CI: 0.13-0.94] p = 0.037). Greater household density (members/bedroom) was significantly associated with household transmission during the Omicron period (OR = 6.8, [2.19-21.37] p = 0.001). Index case age, illness severity, and individual symptoms were not significantly associated with odds of household transmission.

Conclusions: Greater household density was associated with a higher risk of SARS-CoV-2 transmission, but the risk declined over time with subsequent variants. Interplay between variants, prior infection, and individual/household factors may identify modifiable factors (e.g., behavior and vaccination) to reduce future transmission risk.

References

Katzourakis A . COVID-19: endemic doesn't mean harmless. Nature. 2022; 601(7894):485. DOI: 10.1038/d41586-022-00155-x. View

Temte J, Barlow S, Goss M, Temte E, Bell C, He C . The Oregon Child Absenteeism Due to Respiratory Disease Study (ORCHARDS): Rationale, objectives, and design. Influenza Other Respir Viruses. 2021; 16(2):340-350. PMC: 8818813. DOI: 10.1111/irv.12920. View

Ahmad F, Cisewski J, Xu J, Anderson R . COVID-19 Mortality Update - United States, 2022. MMWR Morb Mortal Wkly Rep. 2023; 72(18):493-496. PMC: 10168601. DOI: 10.15585/mmwr.mm7218a4. View

Chen F, Tian Y, Zhang L, Shi Y . The role of children in household transmission of COVID-19: a systematic review and meta-analysis. Int J Infect Dis. 2022; 122:266-275. PMC: 9091150. DOI: 10.1016/j.ijid.2022.05.016. View

Singanayagam A, Hakki S, Dunning J, Madon K, Crone M, Koycheva A . Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study. Lancet Infect Dis. 2021; 22(2):183-195. PMC: 8554486. DOI: 10.1016/S1473-3099(21)00648-4. View

Gerhards N, Gonzales J, Vreman S, Ravesloot L, van den Brand J, Doekes H . Efficient Direct and Limited Environmental Transmission of SARS-CoV-2 Lineage B.1.22 in Domestic Cats. Microbiol Spectr. 2023; 11(3):e0255322. PMC: 10269887. DOI: 10.1128/spectrum.02553-22. View

Temte J, Barlow S, Goss M, Temte E, Schemmel A, Bell C . Cause-specific student absenteeism monitoring in K-12 schools for detection of increased influenza activity in the surrounding community-Dane County, Wisconsin, 2014-2020. PLoS One. 2022; 17(4):e0267111. PMC: 9017898. DOI: 10.1371/journal.pone.0267111. View

Sharker Y, Kenah E . Estimating and interpreting secondary attack risk: Binomial considered biased. PLoS Comput Biol. 2021; 17(1):e1008601. PMC: 7850487. DOI: 10.1371/journal.pcbi.1008601. View

Soriano-Arandes A, Gatell A, Serrano P, Biosca M, Campillo F, Capdevila R . Household Severe Acute Respiratory Syndrome Coronavirus 2 Transmission and Children: A Network Prospective Study. Clin Infect Dis. 2021; 73(6):e1261-e1269. PMC: 7989526. DOI: 10.1093/cid/ciab228. View

10.

Frutos A, Kuan G, Lopez R, Ojeda S, Shotwell A, Sanchez N . Infection-Induced Immunity Is Associated With Protection Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Decreased Infectivity. Clin Infect Dis. 2023; 76(12):2126-2133. PMC: 10273383. DOI: 10.1093/cid/ciad074. View

11.

Lei H, Xu X, Xiao S, Wu X, Shu Y . Household transmission of COVID-19-a systematic review and meta-analysis. J Infect. 2020; 81(6):979-997. PMC: 7446647. DOI: 10.1016/j.jinf.2020.08.033. View

12.

Telenti A, Arvin A, Corey L, Corti D, Diamond M, Garcia-Sastre A . After the pandemic: perspectives on the future trajectory of COVID-19. Nature. 2021; 596(7873):495-504. DOI: 10.1038/s41586-021-03792-w. View

13.

Bhatt M, Plint A, Tang K, Malley R, Huy A, McGahern C . Household transmission of SARS-CoV-2 from unvaccinated asymptomatic and symptomatic household members with confirmed SARS-CoV-2 infection: an antibody-surveillance study. CMAJ Open. 2022; 10(2):E357-E366. PMC: 9007444. DOI: 10.9778/cmajo.20220026. View

14.

Temte J, Barlow S, Temte E, Goss M, Florek K, Braun K . Evidence of Early Household Transmission of SARS-CoV-2 Involving a School-aged Child. WMJ. 2021; 120(3):233-236. PMC: 8721881. View

15.

Madewell Z, Yang Y, Longini Jr I, Halloran M, Dean N . Household Secondary Attack Rates of SARS-CoV-2 by Variant and Vaccination Status: An Updated Systematic Review and Meta-analysis. JAMA Netw Open. 2022; 5(4):e229317. PMC: 9051991. DOI: 10.1001/jamanetworkopen.2022.9317. View

16.

Ng D, Tan K, Chin L, Cheng X, Vijayakulasingam T, Liew D . Risk factors associated with household transmission of SARS-CoV-2 in Negeri Sembilan, Malaysia. J Paediatr Child Health. 2021; 58(5):769-773. PMC: 8661798. DOI: 10.1111/jpc.15821. View

17.

Cauchemez S, Donnelly C, Reed C, Ghani A, Fraser C, Kent C . Household transmission of 2009 pandemic influenza A (H1N1) virus in the United States. N Engl J Med. 2010; 361(27):2619-27. PMC: 3840270. DOI: 10.1056/NEJMoa0905498. View

18.

Shiels M, Haque A, Berrington de Gonzalez A, Freedman N . Leading Causes of Death in the US During the COVID-19 Pandemic, March 2020 to October 2021. JAMA Intern Med. 2022; 182(8):883-886. PMC: 9257676. DOI: 10.1001/jamainternmed.2022.2476. View

19.

Murray C, Piot P . The Potential Future of the COVID-19 Pandemic: Will SARS-CoV-2 Become a Recurrent Seasonal Infection?. JAMA. 2021; 325(13):1249-1250. DOI: 10.1001/jama.2021.2828. View

20.

Quick J, Grubaugh N, Pullan S, Claro I, Smith A, Gangavarapu K . Multiplex PCR method for MinION and Illumina sequencing of Zika and other virus genomes directly from clinical samples. Nat Protoc. 2017; 12(6):1261-1276. PMC: 5902022. DOI: 10.1038/nprot.2017.066. View