Increased Secondary Attack Rate among Unvaccinated Household Contacts of Coronavirus Disease 2019 Patients with Delta Variant in Japan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Setting
2.3. Index COVID-19 Cases
2.4. Participant Household Contacts
2.5. Variant Type of SARS-CoV-2 Strains of Participant Contacts
2.6. Outcome, Data Collection, and Variables
2.7. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- World Health Organization. Statement on the Second Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Outbreak of Novel Coronavirus (2019-nCoV). Available online: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov) (accessed on 6 February 2022).
- Campbell, F.; Archer, B.; Laurenson-Schafer, H.; Jinnai, Y.; Konings, F.; Batra, N.; Pavlin, B.; Vandemaele, K.; Van Kerkhove, M.D.; Jombart, T.; et al. Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021. Eurosurveillance 2021, 26, 2100509. [Google Scholar] [CrossRef] [PubMed]
- Deng, X.; Garcia-Knight, M.A.; Khalid, M.M.; Servellita, V.; Wang, C.; Morris, M.K.; Sotomayor-González, A.; Glasner, D.R.; Reyes, K.R.; Gliwa, A.S.; et al. Transmission, infectivity, and neutralization of a spike L452R SARS-CoV-2 variant. Cell 2021, 184, 3426–3437e8. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Weekly Epidemiological Update on COVID-19–13. Available online: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---13-october-2021 (accessed on 15 November 2020).
- National Institute of Infectious Diseases. Current Situation of Infection. Available online: https://www.niid.go.jp/niid/en/2019-ncov-e/10415-covid19-ab36th-en.html (accessed on 6 February 2022).
- COVID-19 Advisory Board of the Ministry of Health, Labor and Welfare. Current Situation of Infection and Others. (In Japanese). Available online: https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000121431_00294.html (accessed on 6 February 2022).
- Ministry of Health, Labor and Welfare. Visualizing the Data: Information on COVID-19 Infections. Available online: https://covid19.mhlw.go.jp/en/ (accessed on 6 February 2022).
- Madewell, Z.J.; Yang, Y.; Longini, I.M.; Halloran, M.E.; Dean, N.E. Household transmission of SARS-CoV-2: A systematic review and meta-analysis. JAMA Netw. Open 2020, 3, e2031756. [Google Scholar] [CrossRef]
- Madewell, Z.J.; Yang, Y.; Longini, I.M., Jr.; Halloran, M.E.; Dean, N.E. Factors associated with household transmission of SARS-CoV-2: An updated systematic review and meta-analysis. JAMA Netw. Open 2021, 4, e2122240. [Google Scholar] [CrossRef]
- Ng, O.T.; Koh, V.; Chiew, C.J.; Marimuthu, K.; Thevasagayam, N.M.; Mak, T.M.; Chua, J.K.; Ong, S.S.; Lim, Y.K.; Ferdous, Z.; et al. Impact of Delta variant and vaccination on SARS-CoV-2 secondary attack rate among household close contacts. Lancet Reg. Health-West Pac. 2021, 17, 100299. [Google Scholar] [CrossRef]
- Watanapokasin, N.; Siripongboonsitti, T.; Ungtrakul, T.; Muadchimkaew, M.; Wongpatcharawarakul, S.; Auewarakul, C.; Mahanonda, N. Transmissibility of SARS-CoV-2 variants as a secondary attack in Thai households: A retrospective study. IJID Reg. 2021, 1, 1–2. [Google Scholar] [CrossRef]
- Yi, S.; Kim, J.M.; Choe, Y.J.; Hong, S.; Choi, S.; Ahn, S.B.; Kim, M.; Park, Y.J. SARS-CoV-2 Delta Variant Breakthrough Infection and Onward Secondary Transmission in Household. J. Korean Med. Sci. 2022, 37, e12. [Google Scholar] [CrossRef]
- Hwang, H.; Lim, J.S.; Song, S.A.; Achangwa, C.; Sim, W.; Kim, G.; Ryu, S. Transmission dynamics of the Delta variant of SARS-CoV-2 infections in South Korea. J. Infect. Dis. 2022, 225, 793–799. [Google Scholar] [CrossRef]
- Dougherty, K.; Mannell, M.; Naqvi, O.; Matson, D.; Stone, J. SARS-CoV-2 B. 1.617. 2 (Delta) variant COVID-19 outbreak associated with a gymnastics facility—Oklahoma, April–May 2021. Morb. Mortal. Wkly. Rep. 2021, 70, 1004–1007. [Google Scholar] [CrossRef]
- de Gier, B.; Andeweg, S.; Backer, J.A.; RIVM COVID-19 Surveillance and Epidemiology Team; Hahné, S.J.; van den Hof, S.; de Melker, H.E.; Knol, M.J. Vaccine effectiveness against SARS-CoV-2 transmission to household contacts during dominance of Delta variant (B.1.617.2), The Netherlands, August to September 2021. Eurosurveillance 2021, 26, 2100977. [Google Scholar] [CrossRef]
- Lyngse, F.P.; Mølbak, K.; Skov, R.L.; Christiansen, L.E.; Mortensen, L.H.; Albertsen, M.; Møller, C.H.; Krause, T.G.; Rasmussen, M.; Michaelsen, T.Y.; et al. Increased transmissibility of SARS-CoV-2 lineage B.1.1.7 by age and viral load. Nat. Commun. 2021, 12, 7251. [Google Scholar] [CrossRef] [PubMed]
- Allen, H.; Vusirikala, A.; Flannagan, J.; Twohig, K.A.; Zaidi, A.; Chudasama, D.; Lamagni, T.; Groves, N.; Turner, C.; Rawlinson, C.; et al. Household transmission of COVID-19 cases associated with SARS-CoV-2 Delta variant (B.1.617.2): National case-control study. Lancet Reg. Health Eur. 2021, 12, 100252. [Google Scholar] [CrossRef] [PubMed]
- Shah, K.; Saxena, D.; Mavalankar, D. Secondary attack rate of COVID-19 in household contacts: A systematic review. QJM Int. J. Med. 2020, 113, 841–850. [Google Scholar] [CrossRef]
- Li, W.; Zhang, B.; Lu, J.; Liu, S.; Chang, Z.; Peng, C.; Liu, X.; Zhang, P.; Ling, Y.; Tao, K.; et al. Characteristics of Household Transmission of COVID-19. Clin. Infect. Dis. 2020, 71, 1943–1946. [Google Scholar] [CrossRef]
- Wu, J.; Huang, Y.; Tu, C.; Bi, C.; Chen, Z.; Luo, L.; Huang, M.; Chen, M.; Tan, C.; Wang, Z. Household transmission of SARS-CoV-2, Zhuhai, China, 2020. Clin. Infect. Dis. 2020, 71, 2099–2108. [Google Scholar] [CrossRef]
- Liu, T.; Liang, W.; Zhong, H.; He, J.; Chen, Z.; He, G.; Song, T.; Chen, S.; Wang, P.; Li, J.; et al. Risk factors associated with COVID-19 infection: A retrospective cohort study based on contacts tracing. Emerg. Microbes Infect. 2020, 9, 1546–1553. [Google Scholar] [CrossRef]
- Chaw, L.; Koh, W.C.; Jamaludin, S.A.; Naing, L.; Alikhan, M.F.; Wong, J. SARS-CoV-2 transmission in different settings: Analysis of cases and close contacts from the Tablighi cluster in Brunei Darussalam. Emerg. Infect. Dis. 2020, 26, 2598–2606. [Google Scholar] [CrossRef]
- Ogata, T.; Irie, F.; Ogawa, E.; Ujiie, S.; Seki, A.; Wada, K.; Tanaka, H. Secondary attack rate among non-spousal household contacts of coronavirus disease 2019 in Tsuchiura, Japan, August 2020–February 2021. Int. J. Environ. Res. Public Health 2021, 18, 8921. [Google Scholar] [CrossRef]
- Miyahara, R.; Tsuchiya, N.; Yasuda, I.; Ko, Y.K.; Furuse, Y.; Sando, E.; Nagata, S.; Imamura, T.; Saito, M.; Morimoto, K.; et al. Familial clusters of coronavirus disease in 10 prefectures, Japan, February–May 2020. Emerg. Infect. Dis. 2021, 27, 915–918. [Google Scholar] [CrossRef]
- National Institute of Infectious Diseases, Infectious Disease Epidemiology Center. Manual Conducting for Active Epidemiological Surveillance of Patients with Novel Coronavirus Infection (Provisional Version on May 29). May 2020. Available online: https://www.niid.go.jp/niid/ja/diseases/ka/corona-virus/2019-ncov/2484-idsc/9357-2019-ncov-02.html (accessed on 6 February 2022). (In Japanese).
- Institute of Health of Ibaraki Prefectural Government. Situation of Tests on Variant Virus of SARS-CoV-2. Available online: https://www.pref.ibaraki.jp/hokenfukushi/eiken/kikaku/covid-19_ibarakieiken_kensa.html (accessed on 6 February 2022). (In Japanese).
- Hellewell, J.; Abbott, S.; Gimma, A.; Bosse, N.I.; Jarvis, C.I.; Russell, T.W.; Munday, J.D.; Kucharski, A.J.; Edmunds, W.J.; Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group; et al. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. Lancet Glob. Health 2020, 8, e488–e496. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Period | 28 March–30 November 2020 | 1 December–19 March 2021 | 20 March–14 April 2021 | 15 April–20 June 2021 | 21 June–30 November 2021 | Total |
---|---|---|---|---|---|---|
Pandemic wave in Japan | The 1st and 2nd | The 3rd | The 4th | The 5th | ||
No. of all index patients | 92 | 179 | 28 | 171 | 1168 | |
Enrolled as wild strain | All | |||||
Number of index patient | 179 | 179 | ||||
Unvaccinated household | 459 | 459 | ||||
Enrolled as Alpha variant | N501Y (+) | L452R (−) | ||||
Number of index patient | 60 | 63 | 123 | |||
Unvaccinated household | 176 | 119 | 295 | |||
Enrolled as Delta variant | L452R (+) | |||||
Number of index patient | 278 | 278 | ||||
Unvaccinated household | 503 | 503 | ||||
Number of total enrolled index patients | 0 | 179 | 0 | 60 | 341 | 580 |
Test for confirmation | ||||||
PCR | 149 | 51 | 238 | 438 | ||
Antigen test | 23 | 8 | 85 | 116 | ||
LAMP | 7 | 1 | 14 | 22 | ||
NEAR | 2 | 2 | ||||
Unknown | 2 | 2 |
Variables | Index COVID-19 Cases | Household Contacts |
---|---|---|
N | 580 | 1257 |
Relationship to index patient | ||
Spouse | 168 (13.3%) | |
Other | 1089 (86.6%) | |
Diagnostic delay from onset | ||
≤2 days | 390 (67.2%) | |
≥3 days | 173 (29.8%) | |
Asymptomatic | 17 (2.9%) | |
Sex | ||
Male | 322 (55.5%) | 607 (48.3%) |
Female | 258 (44.5%) | 650 (51.7%) |
Age | ||
≤19 | 112 (19.3%) | 471 (37.4%) |
20–59 | 406 (70.0%) | 601 (47.8%) |
≥60 | 62 (10.7%) | 185 (14.7%) |
Variables | Household Contacts | Infected Contacts | Secondary Attack Rate | Multivariate Analysis |
---|---|---|---|---|
% (95% CI) | aOR (p-Value) | |||
N | 1257 | 390 | 31.0% (28.5–33.6) | |
Risk factors in household contacts | ||||
Relationship to index patient | ||||
Spouse | 168 | 79 | 47.0% (39.6–54.6) | 1.49 (0.022) |
Other | 1089 | 311 | 28.6% (26.0–31.3) | 1 |
Sex | ||||
Male | 607 | 179 | 29.5% (26.0–33.2) | 0.85 (0.095) |
Female | 650 | 211 | 32.5% (29.0–36.2) | 1 |
Age | ||||
≤19 | 471 | 150 | 31.8% (27.6–36.2) | 0.93 (0.56) |
20–59 | 601 | 186 | 30.9% (27.4–43.5) | 1 |
≥60 | 185 | 54 | 29.2% (23.1–36.1) | 1.14 (0.40) |
Risk factors in index COVID-19 cases | ||||
Diagnostic delay from onset | ||||
≤2 days | 825 | 244 | 29.6% (26.6–32.8) | 1 |
≥3 days | 410 | 144 | 35.1% (30.7–39.9) | 1.41 (0.051) |
Asymptomatic | 22 | 2 | 9.1% (1.5–29.3) | 0.15 (0.074) |
Sex | ||||
Male | 702 | 220 | 31.3% (28.0–34.9) | 0.99 (0.96) |
Female | 555 | 170 | 30.6% (26.9–34.6) | 1 |
Age | ||||
≤19 | 208 | 56 | 26.9% (21.4–33.4) | 0.51 (0.006) |
20–59 | 949 | 306 | 32.2% (29.3–35.3) | 1 |
≥60 | 100 | 28 | 28.0% (20.1–37.6) | 1.11 (0.72) |
Viral type | ||||
Wild type | 459 | 82 | 17.9% (14.6–21.7) | 0.80 (0.37) |
Alpha | 295 | 64 | 21.7% (17.4–26.8) | 1 |
Delta- | 503 | 244 | 48.5% (44.2–52.9) | 3.339 (0.000) |
Variables | Household Contacts | Infected Contacts | Secondary Attack Rate | Multivariate Analysis |
---|---|---|---|---|
% (95% CI) | aOR (p-Value) | |||
N | 503 | 244 | 48.5% (44.2–52.9) | |
Risk factors in household contacts | ||||
Relationship to index patient | ||||
Spouse | 85 | 54 | 63.4% (52.9–73.0) | 1.94 (0.026) |
Other | 418 | 190 | 45.5% (40.7–50.2) | 1 |
Sex | ||||
Male | 242 | 110 | 45.5% (39.3–51.8) | 0.71 (0.55) |
Female | 261 | 134 | 51.3% (45.3–57.3) | 1 |
Age | ||||
≤19 | 239 | 115 | 48.1% (41.9–54.4) | 1.33 (0.19) |
20–59 | 230 | 109 | 47.4% (41.0–53.8) | 1 |
≥60 | 34 | 20 | 58.8% (42.2–73.6) | 1.65 (0.19) |
Risk factors in index COVID-19 cases | ||||
Diagnostic delay from onset | ||||
≤2 days | 337 | 152 | 45.1% (39.9–50.4) | 1 |
≥3 days | 155 | 90 | 58.1% (50.2–65.5) | 1.66 (0.051) |
Asymptomatic | 11 | 2 | 18.2% (4.3–49.0) | 0.23 (0.18) |
Sex | ||||
Male | 267 | 129 | 48.3% (42.4–54.3) | 0.98 (0.92) |
Female | 236 | 115 | 48.7% (42.4–55.1) | 1 |
Age | ||||
≤19 | 121 | 40 | 33.1% (25.3–41.9) | 0.50 (0.027) |
20–59 | 365 | 192 | 52.6% (47.5–57.7) | 1 |
≥60 | 17 | 12 | 70.6% (46.5–86.8) | 1.87(0.22) |
Week of collecting sample | ||||
25–31 | 165 | 80 | 48.5% (41.0–56.1) | 1 |
32–34 | 251 | 128 | 50.1% (44.8–57.1) | 1.36 (0.25) |
35– | 87 | 36 | 41.4% (31.6–51.9) | 0.86 (0.70) |
Vaccination | ||||
None | 452 | 214 | 47.3% (42.8–52.0) | 1 |
1–2 | 51 | 30 | 58.8% (45.1–71.2) | 1.30 (0.49) |
Variables | Household Contacts | Infected Contacts | Secondary Attack Rate |
---|---|---|---|
% (95% CI) | |||
N | 1104 | 354 | 32.1% (29.4–34.9) |
Total | |||
Wild type | 345 | 51 | 14.8% (11.4–19.0) |
Alpha | 258 | 61 | 23.6% (18.9–29.2) |
Delta | 501 | 242 | 48.3% (44.0–52.7) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ogata, T.; Tanaka, H.; Nozawa, Y.; Mukouyama, K.; Tanaka, E.; Osaki, N.; Noguchi, E.; Seo, K.; Wada, K. Increased Secondary Attack Rate among Unvaccinated Household Contacts of Coronavirus Disease 2019 Patients with Delta Variant in Japan. Int. J. Environ. Res. Public Health 2022, 19, 3889. https://doi.org/10.3390/ijerph19073889
Ogata T, Tanaka H, Nozawa Y, Mukouyama K, Tanaka E, Osaki N, Noguchi E, Seo K, Wada K. Increased Secondary Attack Rate among Unvaccinated Household Contacts of Coronavirus Disease 2019 Patients with Delta Variant in Japan. International Journal of Environmental Research and Public Health. 2022; 19(7):3889. https://doi.org/10.3390/ijerph19073889
Chicago/Turabian StyleOgata, Tsuyoshi, Hideo Tanaka, Yumiko Nozawa, Kazue Mukouyama, Emiko Tanaka, Natsumi Osaki, Etsuko Noguchi, Kayoko Seo, and Koji Wada. 2022. "Increased Secondary Attack Rate among Unvaccinated Household Contacts of Coronavirus Disease 2019 Patients with Delta Variant in Japan" International Journal of Environmental Research and Public Health 19, no. 7: 3889. https://doi.org/10.3390/ijerph19073889