Comparison of new and emerging SARS-CoV-2 variant transmissibility through active contact testing. A comparative cross-sectional household seroprevalence study

Historically SARS-CoV-2 secondary attack rates (SAR) have been based on PCR positivity on screening symptomatic contacts; this misses transmission events and identifies only symptomatic contacts who are PCR positive at the time of sampling. We used serology to detect the relative transmissibility of...

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Bibliographic Details
Published in:PloS one 2023-04, Vol.18 (4), p.e0284372
Main Authors: Gaskell, Katherine M, El Kheir, Natalie, Mirfendesky, Mariyam, Rampling, Tommy, Marks, Michael, Houlihan, Catherine F, Lemonge, Norbert, Bristowe, Hannah, Aslam, Suhail, Kyprianou, Demetra, Nastouli, Eleni, Goldblatt, David, Fielding, Katherine, Moore, David A J
Format: Article
Language:English
Subjects:
Biology and life sciences
Communicable Disease Control
Comparative analysis
Consent
Coronaviruses
COVID-19
COVID-19 vaccines
Cross-Sectional Studies
Disease transmission
Ethnicity
Exposure
Health aspects
Hospital patients
Hospitals
Households
Humans
Immunization
Infections
Laboratories
Medicine and health sciences
Patients
Prevention
Questionnaires
SARS-CoV-2
Seroepidemiologic Studies
Serology
Severe acute respiratory syndrome coronavirus 2
Surveys
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Summary:Historically SARS-CoV-2 secondary attack rates (SAR) have been based on PCR positivity on screening symptomatic contacts; this misses transmission events and identifies only symptomatic contacts who are PCR positive at the time of sampling. We used serology to detect the relative transmissibility of Alpha Variant of Concern (VOC) to non-VOC SARS-CoV-2 to calculate household secondary attack rates. We identified index patients diagnosed with Alpha and non-VOC SARS-CoV-2 across two London Hospitals between November 2020 and January 2021 during a prolonged and well adhered national lockdown. We completed a household seroprevalence survey and found that 61.8% of non-VOC exposed household contacts were seropositive compared to 82.1% of Alpha exposed household contacts. The odds of infection doubled with exposure to an index diagnosed with Alpha. There was evidence of transmission events in almost all households. Our data strongly support that estimates of SAR should include serological data to improve accuracy and understanding.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0284372