Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020 - Volume 26, Number 6—June 2020 - Emerging Infectious Diseases journal - CDC

Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020 - Volume 26, Number 6—June 2020 - Emerging Infectious Diseases journal - CDC

Volume 26, Number 6—June 2020

Research Letter

Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020

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Jing Cai1, Wenjie Sun1, Jianping Huang1, Michelle Gamber, Jing Wu , and Guiqing He 

Author affiliations: Wenzhou Sixth People’s Hospital, Wenzhou Central Hospital Medical Group, Wenzhou, China (J. Cai, J. Huang, G. He); The Second Affiliated Hospital of Fujian Traditional Chinese Medical University, Fuzhou, China (W. Sun); Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA (W. Sun); Shenandoah University, Winchester, Virginia, USA (M. Gamber); Huashan Hospital, Fudan University, Shanghai, China (J. Wu)

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Abstract

To determine possible modes of virus transmission, we investigated a cluster of coronavirus disease cases associated with a shopping mall in Wenzhou, China. Data indicated that indirect transmission of the causative virus occurred, perhaps resulting from virus contamination of common objects, virus aerosolization in a confined space, or spread from asymptomatic infected persons.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease (COVID-19), is presumed to spread primarily via respiratory droplets and close contact. However, these transmission modes do not explain all cases. To determine how the virus may have spread among a cluster of COVID-19 cases associated with a shopping mall in Wenzhou (a city with 8 million residents), China, we monitored and traced close contacts and hypothesized possible transmission modes. We analyzed clinical and laboratory data for cases by using real-time reverse transcription PCR (1). The study was approved with written consent from the Ethics Committee of Wenzhou Central Hospital and written informed consent from all case-patients.