Secondary Attack Rate among the Contacts of COVID-19 Patients at the Beginning of the Pandemic in Pune City of Western Maharashtra, India

  • Ganesh R Jagdale Junior Resident III, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • Malangori A Parande MD (Community Medicine) Associate Professor, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • PS Borle MSc Statistics, DHA Statistician-cum-Assistant Professor, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • Vinay Shridhar Tapare DPH, MD (Community Medicine) - Professor and Head, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • Muralidhar P Tambe Dean and Professor and Head, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • Sanjeev Wavare Assistant Medical Officer of Health, Health Department, Pune Municipal Corporation, Pune, Maharashtra, India.
  • Minal Hatnapure Junior Resident III, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • Priyanka Salunke Junior Resident III, Please find the document attached with this mail, the modified file sent by the author after incorporating the changes sent by you. Kindly share your final decision.
  • Pradnya Shinde Assistant Professor, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
  • Apeksha Paunikar Junior Resident III, Department of Community Medicine, BJ Government Medical College, Pune, Maharashtra, India.
Keywords: COVID-19, Maharashtra, SAR, Contacts

Abstract

Introduction: The COVID-19 was the emerging disease caused by SARS-COV 2. Efficient transmission of this disease occurs through droplets and fomites. As COVID-19 has high transmission and hence susceptible household & non-household close contacts are at high risk of developing disease. Study Objectives: 1) To estimate secondary attack rate of COVID-19 among the contacts during the pandemic in Pune city; 2) To identify factors associated with transmission and development of COVID-19 disease.

Material & Methods: This was a retrospective cohort study conducted in the month of June 2020. The sample includes 741 contacts of 119 Laboratory confirmed cases for COVID-19, resides in 15 ward offices areas of Pune
Municipal Corporation after written informed consent. A confidential telephonic interview was taken by using a prestructured questionnaire which includes socio demographic data, duration of stay, family background,
outcome, type of house, development of symptoms etc.

Results: The overall Secondary Attack Rate estimated to be 32.5%, 33.7% among the high risk contacts while 13.3% among the low risk contacts. In this city, 6 wards (40%) out of 15 wards showed SAR of more than 40%.
The characteristics of primary cases associated with spread of disease were presence of symptoms and duration between onset of disease and isolation of primary case. The factors significantly affecting SAR were age, comorbidity, no. of family members, type of family, type of house, overcrowding, no. of rooms, bedroom attached with toilet, type of contact & containment zone.

Conclusion: Higher SAR was seen in the household contacts. It is necessary to adopt rigorous measures to cut the transmission chain in this area of close contact.

How to cite this article:

Jagdale GR, Parande MA, Borle PS, Tapare VS, Tambe MP, Wavare S, Hatnapure M, Salunke P, Shinde P, Paunikar A. Secondary Attack Rate among the Contacts of COVID-19 Patients at the Beginning of the Pandemic in Pune City of Western Maharashtra, India. J Commun Dis. 2021;53(3):51-59.

DOI: https://doi.org/10.24321/0019.5138.202138

References

Van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt

JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ. Aerosol and surface stability of SARSCoV-

as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-7. [PubMed] [Google Scholar]

Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, Guo Q, Sun X, Zhao D, Shen J, Zhang H, Liu H, Xia H, Tang J, Zhang

K, Gong S. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral

shedding. Nat Med. 2020 Apr;26(4):502-5. [PubMed] [Google Scholar]

Rolling updates on corona virus disease (COVID-19). Available from: https://www.who.int/emergencies/

diseases/novel-coronavirus-2019/events-as-theyhappen. Accessed on 30 May 2020.

WHO coronavirus disease (COVID-19) dashboard. Available from: https://covid19.who.int/. Accessed

on 4 June 2020.

Shah K, Saxena D, Mavalankar D. Secondary attack rate of COVID-19 in household contacts: a systematic

review QJM. 2020 Dec;113(12):841-50. [PubMed] [Google Scholar]

Madewell ZJ, Yang Y, Longini IM, Halloran ME, Dean NE. Household transmission of SARS-CoV-2: a systematic

review and meta-analysis. JAMA Netw Open. 2020 Dec;3(12):e2031756. [PubMed] [Google Scholar]

Coronavirus update (Live): Worldometer. Available from: https://www.worldometers.info/coronavirus/.

Accessed on 4 June 2020.

Ministry of health and family welfare, Government of India. COVID-19 state wise status. Available from:

https://www.mohfw.gov.in/. Accessed on 20 June 2020.

Maharashtra Covid-19 dashboard. Available from: https://arogya.maharashtra.gov.in/. Accessed on 4

June 2020.

Time of India news article. Available from: http://timesofindia.indiatimes.com/articleshow/75364064.

cms?utm_source=contentofinterest and utm_medium=text and utm_campaign=cppst. Accessed

on 10 October 2020.

Integrated Disease Surveillance Programme Media alert. COVID 19 updates. Accessed on 22 February 2021.

Jing QL, Liu MJ, Zhang ZB, Fang LQ, Yuan J, Zhang AR, Dean NE, Luo L, Ma MM, Longini I, Kenah E, Lu Y,

Ma Y, Jalali N, Yang ZC, Yang Y. Household secondary attack rate of COVID-19 and associated determinants

in Guangzhou, China: a retrospective cohort study. Lancet Infect Dis. 2020 Oct;20(10):1141-50. [PubMed]

[Google Scholar]

Ministry of health and family welfare - Government of India. COVID-19 guidelines for home quarantine.

Available from: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf. Accessed on 01

June 2020.

Ministry of health and family welfare - Government of India. COVID-19 SOP for contact tracing for COVID-19

cases. Available from: https://www.mohfw.gov.in.Accessed on 04 June 2020.

Park K. Park’s textbook of preventive and social medicine. 25th edition. Dynamics of disease

transmission. Banarsidas Bhanot Publisher, Jabalpur. Feb 2019, p. 102-108.

Liu T, Liang W, Zhong H, He J, Chen Z, He G, Song T, Chen S, Wang P, Li J, Lan Y, Cheng M, Huang J, Niu J,

Xia L, Xiao J, Hu J, Lin L, Huang Q, Rong Z, Deng A, Zeng W, Li J, Li X, Tan X, Kang M, Guo L, Zhu Z, Gong

D, Chen G, Dong M, Ma W. Risk factors associated with COVID-19 infection: a retrospective cohort study

based on contacts tracing. Emerg Microbes Infect. 2020 Dec;9(1):1546-53. [PubMed] [Google Scholar]

Laxminarayan R, Wahl B, Dudala SR, Gopal K, Mohan BC, Neelima S, Jawahar Reddy KS, Radhakrishnan J,

Lewnard JA. Epidemiology and transmission dynamics of COVID-19 in two Indian states. Science. 2020

Nov;370(6517):691-7. [PubMed] [Google Scholar]

ICMR COVID Study Group, COVID Epidemiology & Data Management Team, COVID Laboratory Team, VRDLN

Team, Abraham P, Aggarwal N, Babu GR, Barani S, Bhargava B, Bhatnagar T, Dhama AS, Gangakhedkar RR,

Giri S, Gupta N, Kurup KK, Manickam P, Murhekar M, Potdar V, Praharaj I, Rade K, Reddy DCS, Saravanakumar

V, Shah N, Singh H, Thangaraj JWV, Yadav N. Laboratory surveillance for SARS-CoV-2 in India: Performance

of testing & descriptive epidemiology of detected COVID-19, January 22 - April 30, 2020. Indian J Med Res.

May;151(5):424-37. [PubMed] [Google Scholar]

Sharma P, Solanki N, Ninama R. Secondary attack rate and epidemiological determinants of secondary

high- risk contacts of SARS COV-2; lessons to learn: a study from North Gujarat. Natl J Community Med.

;11(8):376-9. [Google Scholar]

Saraswathy AS, Sanya R, Kumaran JA. Secondary attack rate of COVID-19; analysis of contacts of COVID-19 cases admitted in a tertiary care centre, Northern District of Kerala: a cross-sectional study. Int J Community Med

Public Health. 2020;7:5111-4. [Google Scholar]

Sinclair JE, Tong ZEM, Steele LE, Noye EC, Lu J, Chew KY, Pickering J, Gilks C, Bowen AC, Short KR. Children

are unlikely to have been the primary source of household SARS-CoV-2 infections. medRxiv. 2020:

03.26.20044826. [Google Scholar]

Cevik M, Tate M, Lloyd O, Maraolo AE, Schafers J,Ho A. SARS-CoV-2, SARS-CoV546 1 and MERS-CoV

viral load dynamics, duration of viral shedding and infectiousness: 547 a living systematic review and

meta-analysis. Lancet Microbe. 2021 Jan;2(1):e13-22. [PubMed] [Google Scholar]

Park YJ, Choe YJ, Park O, Park SY, Kim YM, Kim J, Kweon S, Woo Y, Gwack J, Kim SS, Lee J, Hyun J, Ryu B, Jang

YS, Kim H, Shin SH, Yi S, Lee S, Kim HK, Lee H, Jin Y, Park E, Choi SW, Kim M, Song J, Choi SW, Kim D, Jeon

BH, Yoo H, Jeong EK; COVID-19 National Emergency Response Center, Epidemiology and Case Management

Team. Contact tracing during coronavirus disease outbreak, South Korea, 2020. Emerg Infect Dis. 2020

Oct;26(10):2465-8. [PubMed] [Google Scholar]

Luo L, Liu D, Liao X-L, Wu X-B, Jing Q-L, Zheng J-Z, Liu F-H, Yang S-G, Bi B, Li Z-H, Liu J-P, Song W-Q, Zhu W,

Wang Z-H, Zhang X-R, Chen P-L, Liu H-M, Cheng X, Cai M-C, Huang Q-M, Yang P, Yang, X-F, Han Z-G, Tang J, Ma

Y, Mao C. Modes of contact and risk of transmission in COVID-19: a prospective cohort study 4950 close

contact persons in Guangzhou of China. 2020. Available at SSRN: https://ssrn.com/abstract=3566149. [Google

Scholar]

Parasa S, Desai M, Thoguluva Chandrasekar V, Patel HK, Kennedy KF, Roesch T, Spadaccini M, Colombo

M, Gabbiadini R, Artifon ELA, Repici A, Sharma P. Prevalence of gastrointestinal symptoms and fecal viral

shedding in patients with coronavirus disease 2019: a systematic review and meta-analysis. JAMA Netw Open.

Jun;3(6):e2011335. [PubMed] [Google Scholar]

Published
2021-09-30