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Abstract

Background

Households appear to be the highest risk setting for COVID-19 transmission. Large household transmission studies in the early stages of the pandemic in Asia reported secondary attack rates ranging from 5 to 30%.

Aim

We aimed to investigate the transmission dynamics of COVID-19 in household and community settings in the UK.

Methods

A prospective case-ascertained study design based on the World Health Organization FFX protocol was undertaken in the UK following the detection of the first case in late January 2020. Household contacts of cases were followed using enhanced surveillance forms to establish whether they developed symptoms of COVID-19, became confirmed cases and their outcomes. We estimated household secondary attack rates (SAR), serial intervals and individual and household basic reproduction numbers. The incubation period was estimated using known point source exposures that resulted in secondary cases.

Results

We included 233 households with two or more people with 472 contacts. The overall household SAR was 37% (95% CI: 31–43%) with a mean serial interval of 4.67 days, an R of 1.85 and a household reproduction number of 2.33. SAR were lower in larger households and highest when the primary case was younger than 18 years. We estimated a mean incubation period of around 4.5 days.

Conclusions

Rates of COVID-19 household transmission were high in the UK for ages above and under 18 years, emphasising the need for preventative measures in this setting. This study highlights the importance of the FFX protocol in providing early insights on transmission dynamics.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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/content/10.2807/1560-7917.ES.2022.27.15.2001551
2022-04-14
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.15.2001551
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Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jamie+Lopez+Bernal&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lopez Bernal Jamie</a>, <a href="/search?value1=Nikolaos+Panagiotopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Panagiotopoulos Nikolaos</a>, <a href="/search?value1=Chloe+Byers&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Byers Chloe</a>, <a href="/search?value1=Tatiana+Garcia+Vilaplana&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Garcia Vilaplana Tatiana</a>, <a href="/search?value1=Nicki+Boddington&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boddington Nicki</a>, <a href="/search?value1=Xu-Sheng+Zhang&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zhang Xu-Sheng</a>, <a href="/search?value1=Andre+Charlett&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Charlett Andre</a>, <a href="/search?value1=Suzanne+Elgohari&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Elgohari Suzanne</a>, <a href="/search?value1=Laura+Coughlan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Coughlan Laura</a>, <a href="/search?value1=Rosie+Whillock&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Whillock Rosie</a>, <a href="/search?value1=Sophie+Logan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Logan Sophie</a>, <a href="/search?value1=Hikaru+Bolt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bolt Hikaru</a>, <a href="/search?value1=Mary+Sinnathamby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sinnathamby Mary</a>, <a href="/search?value1=Louise+Letley&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Letley Louise</a>, <a href="/search?value1=Pauline+MacDonald&option1=author&noRedirect=true" class="nonDisambigAuthorLink">MacDonald Pauline</a>, <a href="/search?value1=Roberto+Vivancos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vivancos Roberto</a>, <a href="/search?value1=Obaghe+Edeghere&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Edeghere Obaghe</a>, <a href="/search?value1=Charlotte+Anderson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Anderson Charlotte</a>, <a href="/search?value1=Karthik+Paranthaman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Paranthaman Karthik</a>, <a href="/search?value1=Simon+Cottrell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cottrell Simon</a>, <a href="/search?value1=Jim+McMenamin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McMenamin Jim</a>, <a href="/search?value1=Maria+Zambon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zambon Maria</a>, <a href="/search?value1=Gavin+Dabrera&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dabrera Gavin</a>, <a href="/search?value1=Mary+Ramsay&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ramsay Mary</a>, <a href="/search?value1=Vanessa+Saliba&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saliba Vanessa</a></span>. Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(15):pii=2001551. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.15.2001551" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.15.2001551</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 15 Aug 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 20 Feb 2022 </span> </p>
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