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Outbreak investigation: transmission of COVID-19 started from a spa facility in a local community in Korea
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Taewon Han
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Epidemiol Health. 2020;42:e2020056. Published online July 29, 2020
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DOI: https://doi.org/10.4178/epih.e2020056
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Abstract
OBJECTIVES
In Korea, there have been 10,480 confirmed cases of coronavirus disease 2019 (COVID-19) as of April 11, 2020. We investigated the transmission of COVID-19 in a cluster of cases.
METHODS We analyzed the epidemiological characteristics of 10 confirmed COVID-19 patients in an outbreak that started at Spa facility A in a local community in Korea on March 28, 2020 and traced them through April 8, 2020. Epidemiological surveys and diagnostic tests were conducted for each contact, and the secondary attack rate was estimated.
RESULTS There were 3 male confirmed patients (30.0%) and 7 female confirmed patients (70.0%), and their mean age was 53.5 years (range, 2.0 to 73.0). Two patients (20.0%) were asymptomatic. The incubation period was between 3 days and 12 days. Three confirmed patients were infected at female’s Spa facility A and 7 confirmed patients were second, third, and fourth generations of transmission. Seven confirmed patients contracted COVID-19 through presymptomatic contact. In total, 192 contacts were identified, with a secondary attack rate of 3.6%. Eighty-three contacts (43.2%) were aged 40-59 years, and the secondary attack rate was the highest (12.1%) in those aged ≥60 years. Most exposures (n=156, 81.3%) involved casual contact. The number of visitors using the female’s spa facility was 58, including 3 confirmed patients, resulting in a secondary outbreak rate of 5.9%.
CONCLUSIONS This study presents a cluster of cases occurring in a setting with high temperature and humidity. The second, third, and fourth generations were transmitted through presymptomatic contact.
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Summary
Korean summary
본 연구는 목욕탕에서 시작된 지역사회로 전파된 코로나19의 유행조사를 통해 전증상전파와 그 영향에 대해서 알아보고자 하였다. 유행조절과 감염원파악을 위해 목욕탕 방문자와 각 확진자들의 접촉자에 대해서 역학조사 및 검사를 진행하였으며 이에 기반하여 이차감염률을 추정하였고, 이를 통해 전증상 전파 역시도 코로나19 유행에 큰 영향을 미친다는 것을 알 수 있었다. 이러한 전증상전파가 특징인 코로나19 유행을 조절하기 위해선 보건당국의 빠른 접촉자 파악과 격리, 검사 뿐만 아니라 국민들의 개인위생 및 사회적 거리두기가 필수적이다.
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Citations
Citations to this article as recorded by  - Assessing changes in incubation period, serial interval, and generation time of SARS-CoV-2 variants of concern: a systematic review and meta-analysis
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JAMA Network Open.2022; 5(8): e2228008. CrossRef - Relative infectiousness of asymptomatic SARS-CoV-2 infected persons compared with symptomatic individuals: a rapid scoping review
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Pratha Sah, Meagan C. Fitzpatrick, Charlotte F. Zimmer, Elaheh Abdollahi, Lyndon Juden-Kelly, Seyed M. Moghadas, Burton H. Singer, Alison P. Galvani
Proceedings of the National Academy of Sciences.2021;[Epub] CrossRef - Household Transmission of SARS-CoV-2
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JAMA Network Open.2020; 3(12): e2031756. CrossRef
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