First Mildly Ill, Non-Hospitalized Case of Coronavirus Disease 2019 (COVID-19) Without Viral Transmission in the United States — Maricopa County, Arizona, 2020

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Scott, Sarah E ; Zabel, Karen ; Collins, Jennifer ; Hobbs, Katherine C ; Kretschmer, Melissa J ; Lach, Mitchell ; Turnbow, Katie ; Speck, Lindsay ; White, Jessica R ; Maldonado, Keila ; Howard, Brandon ; Fowler, Jeanene ; Singh, Sonia ; Robinson, Susan ; Pompa, Alexandra Peterson ; Chatham-Stephens, Kevin ; Xie, Amy ; Cates, Jordan ; Lindstrom, Stephen ; Lu, Xiaoyan ; Rolfes, Melissa A ; Flanagan, Marcy ; Sunenshine, Rebecca
• Corporate Authors:
  Maricopa County COVID-19 Case Investigation Team
• Description:
  Background
  
  Coronavirus disease 2019 (COVID-19) causes a range of illness severity. Mild illness has been reported, but whether illness severity correlates with infectivity is unknown. We describe the public health investigation of a mildly ill, non-hospitalized COVID-19 case who traveled to China.
  
  Methods
  
  The case was a Maricopa County resident with multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive specimens collected on January 22, 2020. Contacts were persons exposed to the case on or after the day before case diagnostic specimen collection. Contacts were monitored for 14 days after last known exposure. High-risk contacts had close, prolonged case contact (≥10 minutes within 2 meters). Medium-risk contacts wore all U.S. Centers for Disease Control and Prevention (CDC)-recommended personal protective equipment during interactions. Nasopharyngeal and oropharyngeal (NP/OP) specimens were collected from the case and high-risk contacts and tested for SARS-CoV-2.
  
  Results
  
  Paired case NP/OP specimens were collected for SARS-CoV-2 testing at 11 time points. In 8 pairs (73%), ≥1 specimen tested positive or indeterminate, and in 3 pairs (27%) both tested negative. Specimens collected 18 days after diagnosis tested positive. Sixteen contacts were identified; 11 (69%) had high-risk exposure, including 1 intimate contact, and 5 (31%) had medium-risk exposure. In total, 35 high-risk contact NP/OP specimens were collected for SARS-CoV-2 testing; all 35 pairs (100%) tested negative.
  
  Conclusions
  
  This report demonstrates that SARS-CoV-2 infection can cause mild illness and result in positive tests for up to 18 days after diagnosis, without evidence of transmission to close contacts. These data might inform public health strategies to manage individuals with asymptomatic infection or mild illness.
  
  
• Subjects:
  Adult Betacoronavirus Clinical Laboratory Techniques Contact Tracing Coronavirus Infections COVID-19 Humans Major Article Male Pandemics Pneumonia, Viral Severe Acute Respiratory Syndrome Specimen Handling / Methods Travel

  More +
• Source:
  Clin Infect Dis. 2020;
• Pubmed ID:
  32240285
• Pubmed Central ID:
  PMC7184399
• Document Type:
  Journal Article
• Place as Subject:
  Arizona ; China
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3267626de8cd976ea3439f7aba09c8b374922e3f7e17cf6681b3ee7ff1fd7f04
• Download URL:
  https://stacks.cdc.gov/view/cdc/88104/cdc_88104_DS1.pdf
• File Type:
  [PDF - 361.21 KB ]