A Chinese woman, who returned to her native country from the United States in March, infected 71 people with the novel coronavirus by unwittingly contaminating surfaces in an empty elevator in her apartment building, Chinese researchers claim.
The claim is made in a paper titled in a paper titled "Large SARS-CoV-2 Outbreak Caused by Asymptomatic Traveler, China" by three researchers affiliated with Hubei University of Medicine in Shiyan, Huazhong University of Science and Technology and Tongji Hospital in Wuhan, where the virus is believed to have originated.
It was published in the September issue of the U.S. Centers for Disease Control and Prevention monthly journal Emerging Infectious Diseases.
"We believe [the traveler] was an asymptomatic carrier and that [a neighbor] was infected by contact with surfaces in the elevator in the building where they both lived," the researchers wrote. "Other residents in [the traveler's' building tested negative for SARS-CoV-2 nucleic acids and serum antibodies."
The traveler returned to Heilongjiang Province on March 19 and was asked to self-quarantine. She tested negative for the SARS-CoV-2 virus and serum antibody March 31 and April 3. A downstairs neighbor also used the elevator, albeit not at the same time, although the study did not specify when.
On March 26, the mother and mother's boyfriend visited the neighbor, and stayed the night, and three days later attended a party with another man and his two sons.
The man suffered a stroke April 2 and was admitted to a hospital, where he was tended to by the two sons. The stroke patient "shared the same clinical team and items, such as a microwave, with other patients in the ward," the researchers wrote.
The patient was transferred to another hospital four days after being admitted at the first because of a fever, accompanied by his two sons.
On April 7, the mother's boyfriend of the downstairs neighbor of the believed initial carrier showed symptoms of COVID-19, the flu-like respirator disease caused by the novel coronavirus, and tested positive two days later.
The downstairs neighbor, the mother and the stroke patient subsequently tested positive April 9 or April 10. The stroke patient was then quarantined but had already been in contact with 28 people in the first hospital, of which five nurses and a doctor tested positive. Patients on the ward subsequently contracted the virus and spread it to others, the research said.
At the second hospital, another 20 people were infected by the stroke patient.
After the initial positive test of the downstairs neighbor's mother's boyfriend, officials tracked down the traveler, who tested positive for the COVID-19 antibodies.
"The Chinese Center for Disease Control and Prevention sequenced the entire genomes of 21 samples from the cluster," the study said. "Viral genomes were identical in 18 cases and 3 other cases had a difference of 1–2 nucleotides, indicating that SARS-CoV-2 came from the same point of origin.
"As of April 22, 2020, [the traveler from the U.S.] remained asymptomatic, and a total of 71 SARS-CoV-2–positive cases had been identified in the cluster. Our results illustrate how a single asymptomatic SARS-CoV-2 infection could result in widespread community transmission."
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