key: cord-0976188-r8yybx55
authors: Chen, Yi-Ching; Yang, Hsin-Ping; Li, Hsin-Chieh; Huang, Po-Yen; Chen, Chyi-Liang; Chiu, Cheng-Hsun
title: Features and transmission dynamics of SARS-CoV-2 superspreading events in Taiwan: Implications for effective and sustainable community-centered control
date: 2021-05-29
journal: Pediatr Neonatol
DOI: 10.1016/j.pedneo.2021.05.012
sha: 9e52277da9776fc633e1f61ab6def7953238922d
doc_id: 976188
cord_uid: r8yybx55

nan

March, when the world was in the early pandemic phase and the curve remained flat after then 57 ( Figure 1A ). Among all confirmed cases with traceable contact source, four SSEs with another 58 four possible SSEs were recorded with two identified super spreaders ( Figure 1B ). Two SSEs 59 developed in the household setting, and three developed in the household-like environment (e.g., 60 tour groups). The largest cluster was found in a tour group traveling to Turkey, including 14 61

persons. All of them were diagnosed in the quarantine period by RT-PCR test, and only one 62 secondary offspring infection was recorded. The largest SSE in the local setting is a nosocomial 63 cluster in a medical center, including nine patients with one identified superspreader, who is a 64 57-year-old woman with an underlying congestive heart failure. The crude SAR among 14 65 clusters was 1.0% (34/3303), and only three clusters showed a secondary offspring infection 66 ( Figure 1B ). In total, 24 confirmed cases were of children; all of them were adolescents (10-18 67 years old), except two who were at pre-school age (0-4 years old). Most of the pediatric cases 68 were imported cases, except four were local infection. Among the local cases, two were 69 household transmission and the other two belonged to the same school cluster. Only one patient 70 had an epidemiological link to a SSE. 71

As for the transmission dynamics, the mean serial interval among 42 infector-infectee pairs 72 was 6.2 days (95% confidence interval: −5.07 to 17.9) ( Figure 1C ). By the negative binomial

We found in this study that the transmission dynamics of SSEs in Taiwan April 2020. Effective quarantine and contact-tracing policy that can early detect the potential 106 viral spreaders in the community was also implemented. 17 The early and universal facial masking 107 policy will prevent pre-symptomatic transmission if any infected cases already encountered other 108 people. In this way, the risk of the development of SSE can be reduced to the minimum in the 109 public environment. 18 110 Although SSEs were still recorded, with the deployment of abovementioned bundle-111 enhanced, multi-strategic policies, Taiwan has sustained a good disease control without any large 112 community outbreak since early 2020. With a low community disease burden, health care 113 facilities could be protected with a less risk for a nosocomial outbreak while ensuring continued 114 medical service to patients. According to this study's results, we anticipate that Taiwan will 115 sustain a good control if these mandatory policies can be properly and continuously executed. 116 

Secondary attack rate and superspreading events for

Clustering and 137 superspreading potential of SARS-CoV-2 infections in Hong Kong

Comparing methods for estimating R 0 from the size 140 distribution of subcritical transmission chains

Superspreading and the effect of 142 individual variation on disease emergence

control of Severe Acute Respiratory Syndrome Coronavirus 2

Epidemiology and transmission of

COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a 148 retrospective cohort study

High SARS-CoV-2 Attack 150 rate following exposure at a choir practice -Skagit County

Estimating the reproductive number

R 0 of SARS-CoV-2 in the United States and eight European countries and implications for 154 vaccination

Clinical characteristics of novel coronavirus 156 disease 2019 (COVID-19) in newborns, infants and children

SARS-CoV-2 infection in children: Transmission 159 dynamics and clinical characteristics

Innovations in 161 practice: Adaptation of developmental and behavioral pediatric service in a tertiary center

Clinical course and molecular viral 166 shedding among asymptomatic and symptomatic patients with SARS-CoV-2 infection in a 167 community treatment center in the Republic of Korea

Transmission of SARS-CoV-2: A 169 review of viral, host, and environmental factors

Who wears a mask? Gender differences in risk behaviors in the

COVID-19 early days in Taiwan

Contact tracing assessment 173 of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods 174 before and after symptom onset

CoV-2 transmission from people without COVID-19 symptoms