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Relative risk of SARS-CoV-2 infection from potential risk factors.
Source publication
Objective: To explore the factors associated with the transmission of SARS-CoV-2 to patrons of a restaurant.
Methods: A retrospective cohort design was undertaken, with spatial examination and genomic sequencing of cases. The cohort included all patrons who attended the restaurant on Saturday 25 July 2020. A case was identified as a person who test...
Context in source publication
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Outbreaks/epidemics caused by coxsackievirus A6 (CVA6) have been reported continuously since 2008. However, outbreaks of ocular conjunctival hemorrhage caused by CVA6 in adults in a collective unit have not been reported. Methods. The epidemiological investigations were carried out according to the monitoring program, and the clinical data were col...
Citations
... Several study designs have been used to address this question. Outbreak reports have generated crucial early evidence, particularly in settings with low community transmission, allowing accurate contact tracing [2][3][4][5][6]. Other studies have aimed to screen all contacts of a series of cases and identify in which settings contacts were more likely to result in transmission [7,8]. ...
Purpose
The aim of the study was to identify settings associated with SARS-CoV-2 transmission throughout the COVID-19 pandemic in France.
Methods
Cases with recent SARS-CoV-2 infection were matched with controls (4:1 ratio) on age, sex, region, population size, and calendar week. Odds ratios for SARS-CoV-2 infection were estimated for nine periods in models adjusting for socio-demographic characteristics, health status, COVID-19 vaccine, and past infection.
Results
Between October 27, 2020 and October 2, 2022, 175,688 cases were matched with 43,922 controls. An increased risk of infection was documented throughout the study for open-space offices compared to offices without open space (OR range across the nine periods: 1.12 to 1.57) and long-distance trains (1.25 to 1.88), and during most of the study for convenience stores (OR range in the periods with increased risk: 1.15 to 1.44), take-away delivery (1.07 to 1.28), car-pooling with relatives (1.09 to 1.68), taxis (1.08 to 1.89), airplanes (1.20 to 1.78), concerts (1.31 to 2.09) and night-clubs (1.45 to 2.95). No increase in transmission was associated with short-distance shared transport, car-pooling booked over platforms, markets, supermarkets and malls, hairdressers, museums, movie theatres, outdoor sports, and swimming pools. The increased risk of infection in bars and restaurants was no longer present in restaurants after reopening in June 2021. It persisted in bars only among those aged under 40 years.
Conclusion
Closed settings in which people are less likely to wear masks were most affected by SARS-CoV-2 transmission and should be the focus of air quality improvement.
ClinicalTrials.gov (03/09/2022)
NCT04607941.
... Furthermore, an oral transmission route for SARS-CoV-2 was suggested in an outbreak report from Thailand, where individual members of a group fell ill only after sharing a cup with a SARS-CoV-2-infected individual (Mungmungpuntipantip and Wiwanitkit, 2020). Contradictory, other studies found no evidence of SARS-CoV-2 transmission via surfaces or drinking glasses in restaurant settings (Capon et al., 2021;Zhang et al., 2021). Syrian hamster model studies have shown, that oral administration of high amounts (10 5 infectious particles) of SARS-CoV-2 resulted in no clinical signs of disease, while intranasal inoculation resulted in ruffled fur, labored breathing, and loss of body weight. ...
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is primarily transmitted from human to human via droplets and aerosols. While transmission via contaminated surfaces is also considered possible, the overall risk of this transmission route is assumed to be low. Nevertheless, transmission through contaminated drinking glasses may pose an increased risk as the glass is in direct contact with the mouth and oral cavity. Using human coronavirus 229E (HCoV-229E) as surrogate for SARS-CoV-2, this study examined coronavirus stability on glass, inactivation by dishwashing detergents, and virus elimination by a manual glass scrubbing device. Infectious HCoV-229E was recovered from glass up to 7 and 21 days storage under daylight and dark conditions, respectively. Near complete inactivation of HCoV-229E (>4 log10 reduction) was observed after incubation with two common dishwashing detergents at room temperature for 15 s, whereas incubation at 43 °C for 60 s was necessary for a third detergent to achieve a similar titer reduction. The virus was efficiently removed from contaminated drinking glasses using a manual glass scrubbing device in accordance with German standard DIN 6653-3. The results confirm that coronaviruses are relatively stable on glass, but indicate that common manual dishwashing procedures can efficiently eliminate coronaviruses from drinking glasses.
... 12 Soon after, cases appeared in South Eastern Sydney and were subsequently linked to outbreaks in restaurants, gymnasiums and workplaces throughout the region. 13,14 By this stage testing capacity Note: This figure does not include overseas acquired cases after 11 April 2020 as, due to mandatory hotel quarantine implemented on March 28, these cases could not trigger community transmission. The grey 'Locally acquired -no links to known case or cluster' indicates unlinked community transmission cases. ...
Objectives: To describe local operational aspects of the coronavirus disease 2019 (COVID-19) response during the first three waves of outbreaks in New South Wales (NSW), Australia, which began in January, July and December 2020.
Type of program or service: Public health outbreak response.
Methods: Narrative with epidemiological linking and genomic testing.
Results: Epidemiological linking and genomic testing found that during the first wave of COVID-19 in NSW, a large number of community transmissions went undetected because of limited testing for the virus and limited contact tracing of cases. The second wave of COVID-19 in NSW emerged following reintroduction from the second wave in Victoria, Australia in July 2020, and the third wave followed undetected introduction from overseas. By the second and third waves, cases could be more effectively detected and isolated through an increased ability to test and contact trace, and to rapidly genomic sequence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolates, allowing most cases to be identified and epidemiologically linked. This greater certainty in understanding chains of transmission resulted in control of the outbreaks despite less stringent restrictions on the community, by using a refined strategy of targeted shutdown, restrictions on cases, their close contacts, identified hotspots and venues of concern rather than a whole of community lockdown. Risk assessments of potential transmission sites were constantly updated through our evolving experience with transmission events. However, this refined strategy did leave the potential for large point source outbreaks should any cases go undetected.
[Addendum] A fourth wave that began in Sydney in June 2021 challenged this strategy due to the more transmissible nature of the Delta variant of SARS-CoV-2.
Lessons learnt: A wave of COVID-19 infections can develop quickly from one infected person. The community needs to remain vigilant, adhering to physical distancing measures, signing in to venues they visit, and getting tested if they have any symptoms. Signing out of venues on exit allows public health resources to be used more efficiently to respond to outbreaks.
In spite of prevention measures enacted all over the world to control the COVID-19 pandemic outbreak, including mask wearing, social distancing, hand hygiene, vaccination, and other precautions, the SARS-CoV-2 virus continues to spread globally at an unabated rate of about 1 million cases per day. The specificities of superspreading events as well as evidence of human-to-human, human-to-animal and animal-to-human transmission, indoors or outdoors, raise questions about a possibly neglected viral transmission route. In addition to inhaled aerosols, which are already recognized as key contributors to transmission, the oral route represents a strong candidate, in particular when meals and drinks are shared. In this review, we intend to discuss that significant quantities of virus dispersed by large droplets during discussions at festive gatherings could explain group contamination either directly or indirectly after deposition on surfaces, food, drinks, cutlery, and several other soiled vectors. We suggest that hand hygiene and sanitary practices around objects brought to the mouth and food also need to be taken into account in order to curb transmission.
