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Close contact management, and market investigation initiated, technical protocols for Wuhan released; NHC notified World Health Organization and relevant countries and regions; gene sequencing completed by China CDC

Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia.

NEW ENGLAND JOURNAL OF MEDICINE, no. 13 (2020): 1199-1207

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摘要

BackgroundThe initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. MethodsWe collected information on demographic characteristic...更多

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简介
  • The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020.
  • The authors analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP
重点内容
  • The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020
  • In response to the identification of pneumonia cases and in an effort to increase the sensitivity for early detection, we developed a tailored surveillance protocol to identify potential cases on January 3, 2020, using the case definitions described below.[1]
  • Linked to Huanan market Not linked to Huanan market
  • A novel coronavirus was officially announced as the causative pathogen of the outbreak by China CDC
  • Case investigation, close contact management, and market investigation initiated, technical protocols for Wuhan released; NHC notified World Health Organization and relevant countries and regions; gene sequencing completed by China CDC
  • Interval [CI], 4.1 to 7.0); the 95th percentile of the distribution was 12.5 days (95% CI, 9.2 to 18) (Fig. 2A)
  • The majority of the earliest cases were linked to the Huanan Seafood Wholesale Market and the patients could have been infected through zoonotic or environmental exposures, it is clear that human-tohuman transmission has been occurring and that the epidemic has been gradually growing in recent weeks
方法
  • The authors collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020.
  • Investigators interviewed each patient with infection and their relatives, where necessary, to determine exposure histories during the 2 weeks before the illness onset, including the dates, times, frequency, and patterns of exposures to any wild animals, especially those purportedly available in the Huanan Seafood Wholesale Market in Wuhan, or exposures to any relevant environments such as that specific market or other wet markets.
  • All epidemiologic information collected during field investigations, including exposure history, timelines of events, and close contact identification, was cross-checked with information from multiple sources.
  • Data were entered into a central database, in duplicate, and were verified with EpiData software (EpiData Association)
结果
  • Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male.
  • The development of the epidemic follows an exponential growth in cases, and a decline in the most recent days is likely to be due to underascertainment of cases with recent onset and delayed identification and reporting rather than a true turning point in incidence (Fig. 1).
  • China CDC Level 2 emergency response activated.
  • Case investigation, close contact management, and market investigation initiated, technical protocols for Wuhan released; NHC notified WHO and relevant countries and regions; gene sequencing completed by China CDC.
  • China CDC publicly shared the gene sequence of the novel coronavirus; completed PCR diagnostic reagent development and testing.
结论
  • The authors provide an initial assessment of the transmission dynamics and epidemiologic characteristics of NCIP.
  • The majority of the earliest cases were linked to the Huanan Seafood Wholesale Market and the patients could have been infected through zoonotic or environmental exposures, it is clear that human-tohuman transmission has been occurring and that the epidemic has been gradually growing in recent weeks.
  • The authors' findings provide important parameters for further analyses, including evaluations of the impact of control measures and predictions of the future spread of infection.
  • Days from Illness Onset to First Medical VisitOn the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019.
表格
  • Table1: Characteristics of Patients with Novel Coronavirus–Infected Pneumonia in Wuhan as of January 22, 2020.*
Download tables as Excel
基金
  • Interval [CI], 4.1 to 7.0); the 95th percentile of the distribution was 12.5 days (95% CI, 9.2 to 18) (Fig. 2A)
  • On the basis of the dates of illness onset of 6 pairs of cases in these clusters, we estimated that the serial interval distribution had a mean (±SD) of 7.5±3.4 days (95% CI, 5.3 to 19) (Fig. 2B)
  • In the epidemic curve up to January 4, 2020, the epidemic growth rate was 0.10 per day (95% CI, 0.050 to 0.16) and the doubling time was 7.4 days (95% CI, 4.2 to 14)
  • Using the serial interval distribution above, we estimated that R0 was 2.2 (95% CI, 1.4 to 3.9)
  • The duration from illness onset to first medical visit for 45 patients with illness onset before January 1 was estimated to have a mean of 5.8 days (95% CI, 4.3 to 7.5), which was similar to that for 207 patients with illness onset between January 1 and January 11, with a mean of 4.6 days (95% CI, 4.1 to 5.1) (Fig. 2C)
  • The mean duration from onset to hospital admission was estimated to be 12.5 days (95% CI, 10.3 to 14.8) among 44 cases with illness onset before January 1, which was longer than that among 189 patients with illness onset between January
研究对象与分析
confirmed cases: 425
BACKGROUND The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. METHODS We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020

facilities: 2
RNA was extracted and tested by real-time RT-PCR with 2019-nCoV–specific primers and probes. Tests were carried out in biosafety level 2 facilities at the Hubei (provincial) CDC and then at the National Institute for Viral Disease Control at China CDC. If two targets (open reading frame 1a or 1b, nucleocapsid protein) tested positive by specific real-time RT-PCR, the case would be considered to be laboratory-confirmed

facilities: 3
The genome was identified in samples of bronchoalveolar-lavage fluid from the patient by one of three methods: Sanger sequencing, Illumina sequencing, or nanopore sequencing. Respiratory specimens were inoculated in cells for viral isolation in enhanced biosafety laboratory 3 facilities at the China CDC.[3]. The epidemic curve was constructed by date of illness onset, and key dates relating to epidemic identification and control measures were overlaid to aid interpretation

people: 11000000
No other uses without permission. Since December 2019, an increasing number of cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) have been identified in Wuhan, a large city of 11 million people in central China.1-3. On December 29, 2019, the first 4 cases reported, all linked to the Huanan (Southern China) Seafood Wholesale Market, were identified by local hospitals using a surveillance mechanism for “pneumonia of unknown etiology” that was established in the wake of the 2003 severe acute respiratory syndrome (SARS) outbreak with the aim of allowing timely identification of novel pathogens such as 2019nCoV.[4]

cases: 4
Since December 2019, an increasing number of cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) have been identified in Wuhan, a large city of 11 million people in central China.1-3. On December 29, 2019, the first 4 cases reported, all linked to the Huanan (Southern China) Seafood Wholesale Market, were identified by local hospitals using a surveillance mechanism for “pneumonia of unknown etiology” that was established in the wake of the 2003 severe acute respiratory syndrome (SARS) outbreak with the aim of allowing timely identification of novel pathogens such as 2019nCoV.4. In recent days, infections have been identified in other Chinese cities and in more than a dozen countries around the world.[5]

laboratory-confirmed cases: 425
In recent days, infections have been identified in other Chinese cities and in more than a dozen countries around the world.5. Here, we provide an analysis of data on the first 425 laboratory-confirmed cases in Wuhan to describe the epidemiologic characteristics and transmission dynamics of NCIP. Sources of Data

facilities: 3
The genome was identified in samples of bronchoalveolar-lavage fluid from the patient by one of three methods: Sanger sequencing, Illumina sequencing, or nanopore sequencing. Respiratory specimens were inoculated in cells for viral isolation in enhanced biosafety laboratory 3 facilities at the China CDC.3. The epidemic curve was constructed by date of illness onset, and key dates relating to epidemic identification and control measures were overlaid to aid interpretation

data: 47
Wholesale Market Contact with another person with respiratory symptoms No exposure to either market or person with respiratory symptoms Health care worker — no./total no. (%). Before January 1 (N = 47). January 1 –January 11 (N = 248) 60 (21–89)

data: 248
Before January 1 (N = 47). January 1 –January 11 (N = 248) 60 (21–89). January 12 –January 22 (N = 130) 61 (15–89)

data: 130
January 1 –January 11 (N = 248) 60 (21–89). January 12 –January 22 (N = 130) 61 (15–89). * R educed denominators indicate missing data

clusters of cases: 5
interval [CI], 4.1 to 7.0); the 95th percentile of the distribution was 12.5 days (95% CI, 9.2 to 18) (Fig. 2A). We obtained information on 5 clusters of cases, shown in Figure 3. On the basis of the dates of illness onset of 6 pairs of cases in these clusters, we estimated that the serial interval distribution had a mean (±SD) of 7.5±3.4 days (95% CI, 5.3 to 19) (Fig. 2B)

pairs of cases: 6
We obtained information on 5 clusters of cases, shown in Figure 3. On the basis of the dates of illness onset of 6 pairs of cases in these clusters, we estimated that the serial interval distribution had a mean (±SD) of 7.5±3.4 days (95% CI, 5.3 to 19) (Fig. 2B). In the epidemic curve up to January 4, 2020, the epidemic growth rate was 0.10 per day (95% CI, 0.050 to 0.16) and the doubling time was 7.4 days (95% CI, 4.2 to 14)

patients with illness onset before January 1: 45
Using the serial interval distribution above, we estimated that R0 was 2.2 (95% CI, 1.4 to 3.9). The duration from illness onset to first medical visit for 45 patients with illness onset before January 1 was estimated to have a mean of 5.8 days (95% CI, 4.3 to 7.5), which was similar to that for 207 patients with illness onset between January 1 and January 11, with a mean of 4.6 days (95% CI, 4.1 to 5.1) (Fig. 2C). The mean duration from onset to hospital admission was estimated to be 12.5 days (95% CI, 10.3 to 14.8) among 44 cases with illness onset before January 1, which was longer than that among 189 patients with illness onset between January

cases with illness onset before January 1: 44
The duration from illness onset to first medical visit for 45 patients with illness onset before January 1 was estimated to have a mean of 5.8 days (95% CI, 4.3 to 7.5), which was similar to that for 207 patients with illness onset between January 1 and January 11, with a mean of 4.6 days (95% CI, 4.1 to 5.1) (Fig. 2C). The mean duration from onset to hospital admission was estimated to be 12.5 days (95% CI, 10.3 to 14.8) among 44 cases with illness onset before January 1, which was longer than that among 189 patients with illness onset between January. 1 and 11 (mean, 9.1 days; 95% CI, 8.6 to 9.7) (Fig. 2D)

cases: 425
Although the population quarantine of Wuhan and neighboring cities since January 23 should reduce the exportation of cases to the rest of the country and overseas, it is now a priority to determine whether local transmission at a similar intensity is occurring in other locations. It is notable that few of the early cases occurred in children, and almost half the 425 cases were in adults 60 years of age or older, although our case definition specified severe enough illness to require medical attention, which may vary according to the presence of coexisting conditions. Furthermore, children might be less likely to become infected or, if infected, may show milder symptoms, and either of these situations n engl j med  nejm.org

secondary cases: 5
Numbers in boxes are calendar dates in December 2019 and January 2020. Data from the 5 secondary cases (patients who had clear exposure to only one index case and had no other potential source of infection) were used to estimate the serial interval distribution. The first four clusters were identified in Wuhan, and the fifth cluster was identified in Huanggang

cases: 10
No other uses without permission. was based on information from 10 cases and is somewhat imprecise; it would be important for further studies to provide more information on this distribution. When more data become available on epidemiologic characteristics of NCIP, a detailed comparison with the corresponding characteristics of SARS and MERS, as well as the four coronaviruses endemic in humans, would be informative

coronaviruses endemic in humans: 4
was based on information from 10 cases and is somewhat imprecise; it would be important for further studies to provide more information on this distribution. When more data become available on epidemiologic characteristics of NCIP, a detailed comparison with the corresponding characteristics of SARS and MERS, as well as the four coronaviruses endemic in humans, would be informative. Our study suffers from the usual limitations of initial investigations of infections with an emerging novel pathogen, particularly during the earliest phase, when little is known about any aspect of the outbreak and there is a lack of diagnostic reagents

引用论文
  • The 2019-nCoV Outbreak Joint Field case definition for reporting to WHO. Epidemiology Investigation Team, Li Q. 2017 (https://www.who.int/csr/disease/
    Findings
  • Tan WJ, Zhao X, Ma XJ, et al. A novel mission of MERS coronavirus. N Engl J
    Google ScholarLocate open access versionFindings
  • Zhu N, Zhang D, Wang W, et al. A 2020 (http://www.nhc.gov.cn/jkj/s3577/
    Locate open access versionFindings
  • 10. Laboratory diagnostics for novel coro-
    Google ScholarFindings
  • 4. Xiang N, Havers F, Chen T, et al. Use navirus. WHO 2020 (https://www.who.int/
    Locate open access versionFindings
  • 5. Munster VJ, Koopmans M, van severe acute respiratory syndrome. Sci-Doremalen N, van Riel D, de Wit E. A novel ence 2003; 300: 1966-70.
    Google ScholarFindings
  • Middle East respiratory syndrome (Epub ahead of print).
    Google ScholarFindings
  • 14. Perlman S. Another decade, another coronavirus. N Engl J Med. DOI: 10.1056/ NEJMe2001126.
    Google ScholarLocate open access versionFindings
  • 15. de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol 2016; 14: 523-34.
    Google ScholarLocate open access versionFindings
  • 16. Wong G, Liu W, Liu Y, Zhou B, Bi Y, Gao GF. MERS, SARS, and Ebola: the role of super-spreaders in infectious disease. Cell Host Microbe 2015; 18: 398-401.
    Google ScholarLocate open access versionFindings
  • 17. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020 January 24 (Epub ahead of print).
    Google ScholarLocate open access versionFindings
  • 18. Wu P, Hao X, Lau EHY, et al. Realtime tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China, as at January 2020. Eurosurveillance 2020; 25(3):pii=2000044.
    Google ScholarLocate open access versionFindings
  • 19. Lipsitch M, Hayden FG, Cowling BJ, Leung GM. How to maintain surveillance for novel influenza A H1N1 when there are too many cases to count. Lancet 2009; 374: 1209-11.
    Google ScholarLocate open access versionFindings
作者
Xuhua Guan
Xuhua Guan
Xiaoye Wang
Xiaoye Wang
Lei Zhou
Lei Zhou
Yeqing Tong
Yeqing Tong
Ruiqi Ren
Ruiqi Ren
Kathy S M Leung
Kathy S M Leung
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