Investigation of three clusters of COVID-19 in Singapore: implications for surveillance and response measures

Author/s
Pung R.,
Chiew C.J.,
Young B.E.,
Chin S.,
Chen M.I.-C.,
Clapham H.E.,
Cook A.R.,
Maurer-Stroh S.,
Toh M.P.H.S.,
Poh C.,
Low M.,
Lum J.,
Koh V.T.J.,
Mak T.M.,
Cui L.,
Lin R.V.T.P.,
Heng D.,
Leo Y.-S.,
Lye D.C.,
Lee V.J.M.,
Kam K.-Q.,
Kalimuddin S.,
Tan S.Y.,
Loh J.,
Thoon K.C.,
Vasoo S.,
Khong W.X.,
Suhaimi N.-A.,
Chan S.J.,
Zhang E.,
Oh O.,
Ty A.,
Tow C.,
Chua Y.X.,
Chaw W.L.,
Ng Y.,
Abdul-Rahman F.,
Sahib S.,
Zhao Z.,
Tang C.,
Low C.,
Goh E.H.,
Lim G.,
Hou Y.,
Roshan I.,
Tan J.,
Foo K.,
Nandar K.,
Kurupatham L.,
Chan P.P.,
Raj P.,
Lin Y.,
Said Z.,
Lee A.,
See C.,
Markose J.,
Chan G.,
See W.,
Peh X.,
Cai V.,
Chen W.K.,
Li Z.,
Soo R.,
Chow A.L.,
Wei W.,
Farwin A.,
Ang L.W.,
Singapore 2019 Novel Coronavirus Outbreak Research Team
Year
Language
English
Document Type
Article
Source Title
The Lancet
Publisher
Lancet Publishing Group

Description

Background: Three clusters of coronavirus disease 2019 (COVID-19) linked to a tour group from China, a company conference, and a church were identified in Singapore in February, 2020. Methods: We gathered epidemiological and clinical data from individuals with confirmed COVID-19, via interviews and inpatient medical records, and we did field investigations to assess interactions and possible modes of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Open source reports were obtained for overseas cases. We reported the median (IQR) incubation period of SARS-CoV-2. Findings: As of Feb 15, 2020, 36 cases of COVID-19 were linked epidemiologically to the first three clusters of circumscribed local transmission in Singapore. 425 close contacts were quarantined. Direct or prolonged close contact was reported among affected individuals, although indirect transmission (eg, via fomites and shared food) could not be excluded. The median incubation period of SARS-CoV-2 was 4 days (IQR 3ヨ6). The serial interval between transmission pairs ranged between 3 days and 8 days. Interpretation: SARS-CoV-2 is transmissible in community settings, and local clusters of COVID-19 are expected in countries with high travel volume from China before the lockdown of Wuhan and institution of travel restrictions. Enhanced surveillance and contact tracing is essential to minimise the risk of widespread transmission in the community. Funding: None. ᄅ 2020 Elsevier Ltd

Migration angle
Region/Country (by coverage)
Index Keywords

lopinavir plus ritonavir; adult; aged; Article; clinical article; communicable disease control; coronavirus disease 2019; coronavirus disease 2019; Coronavirus infection; coughing; diarrhea; disease surveillance; dyspnea; female; fever; gene sequence; hospital admission; hospitalization; human; incubation time; infant; lymphocytopenia; male; middle aged; myalgia; nausea; phylogeny; polymerase chain reaction; priority journal; quarantine; rhinorrhea; SARS coronavirus; severe acute respiratory syndrome coronavirus 2; Singapore; sore throat; thorax pain; thorax radiography; thrombocytopenia; travel; virus transmission; vomiting