Characteristics and Timing of Initial Virus Shedding in Severe Acute Respiratory Syndrome Coronavirus 2, Utah, USA #MMPMID33275874
Lewis NM; Duca LM; Marcenac P; Dietrich EA; Gregory CJ; Fields VL; Banks MM; Rispens JR; Hall A; Harcourt JL; Tamin A; Willardson S; Kiphibane T; Christensen K; Dunn AC; Tate JE; Nabity S; Matanock AM; Kirking HL
Emerg Infect Dis 2021[Feb]; 27 (2): 352-359 PMID33275874show ga
Virus shedding in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur before onset of symptoms; less is known about symptom progression or infectiousness associated with initiation of viral shedding. We investigated household transmission in 5 households with daily specimen collection for 5 consecutive days starting a median of 4 days after symptom onset in index patients. Seven contacts across 2 households implementing no precautionary measures were infected. Of these 7, 2 tested positive for SARS-CoV-2 by reverse transcription PCR on day 3 of 5. Both had mild, nonspecific symptoms for 1-3 days preceding the first positive test. SARS-CoV-2 was cultured from the fourth-day specimen in 1 patient and from the fourth- and fifth-day specimens in the other. We also describe infection control measures taken in the households that had no transmission. Persons exposed to SARS-CoV-2 should self-isolate, including from household contacts, wear a mask, practice hand hygiene, and seek testing promptly.