The communication is from Gulou Hospital Affiliated to Medical College of Nanjing University and Zhongda Hospital Affiliated to Southeast University of Nanjing, China. The corresponding author is Wu Chao, vice president and director of infection department of Gulou Hospital Affiliated to Medical College of Nanjing University, China.
In this case, it is worth noting that the source of the cluster infection in this family is an asymptomatic infector. Since then, other asymptomatic infectors have developed follow-up infection. It is suggested that asymptomatic infection is also a potential source of new coronavirus infection. The communication shows in detail the sequence of infection and the course of disease in these 11 patients.
On January 21, 2020, an indictive case traveled from Xiaogan, Hubei Province to Nanjing, Jiangsu Province, where he changed trains.
Indicator case refers to the first case found and reported in an epidemic. Indicator case is one of the most important indicators in the investigation of epidemic outbreak, which provides the most direct and critical clues and hints for tracking the epidemic transmission chain, analyzing the causes of the outbreak and proposing control measures.
After the instruction case arrived in Nanjing, she lived with her two sisters (patient 1 and patient 2) and her mother (patient 3). On the evening of January 21, the patient was instructed to have dinner with his mother, two sisters and younger brother (patient 4).
On the evening of January 23, the patient was instructed to have dinner with 8 relatives again.
On January 24, the patients were instructed to go to Zhejiang Province. On January 28, the symptoms of fever and cough began to appear. On January 29, she was tested positive for the new coronavirus.
With the exception of indicator disease, other family members had not been to Wuhan, Hubei Province for two weeks before the onset of the disease. However, since January 21, three relatives living with the indicated case (her two sisters are patient 1, patient 2, and her mother is patient 3) and three relatives in a dinner on January 23 (her brother is patient 4 and patient 6, and patient 6s wife is patient 7) were later diagnosed as positive for the new coronavirus nucleic acid.
Patient 5 (the wife of patient 4, who had no direct contact with the indicator case) living with patient 4 (the brother of the indicator case) also showed positive for the new coronavirus nucleic acid on January 30.
Two patients who had participated in the dinner on January 23 but had no symptoms at that time (the brother of the indicator case is patient 6, the wife of patient 6 is patient 7), and another family dinner with 13 other relatives on January 24. Three relatives (patient 7s brother is patient 8, patient 7s sister is patient 9, patient 9s husband patient 10) who participated in the dinner were successively diagnosed as positive for new coronavirus nucleic acid within two weeks. Close contact can cause the new coronavirus to spread from person to person.
This case of familial aggregation suggests that asymptomatic infections may be a potential source of infection for the new coronavirus, the team said.
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