Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’

Enrico Lavezzo; Elisa Franchin; Constanze Ciavarella; Gina Cuomo-Dannenburg; Luisa Barzon; Claudia Del Vecchio; Lucia Rossi; Riccardo Manganelli; Arianna Loregian; Nicolò Navarin; Davide Abate; Manuela Sciro; Stefano Merigliano; Ettore De Canale; Maria Cristina Vanuzzo; Valeria Besutti; Francesca Saluzzo; Francesco Onelia; Monia Pacenti; Saverio G. Parisi; Giovanni Carretta; Daniele Donato; Luciano Flor; Silvia Cocchio; Giulia Masi; Alessandro Sperduti; Lorenzo Cattarino; Renato Salvador; Michele Nicoletti; Federico Caldart; Gioele Castelli; Eleonora Nieddu; Beatrice Labella; Ludovico Fava; Matteo Drigo; Katy A.M. Gaythorpe; Kylie E.C. Ainslie; Marc Baguelin; Samir Bhatt; Adhiratha Boonyasiri; Olivia Boyd; Lorenzo Cattarino; Constanze Ciavarella; Helen L. Coupland; Zulma Cucunubá; Gina Cuomo-Dannenburg; Bimandra A. Djafaara; Christl A. Donnelly; Ilaria Dorigatti; Swapnil Mishra; Imperial College COVID-19 Response Team

doi:10.1038/s41586-020-2488-1

Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’

Enrico Lavezzo, Elisa Franchin, Constanze Ciavarella, Gina Cuomo-Dannenburg, Luisa Barzon, Claudia Del Vecchio, Lucia Rossi, Riccardo Manganelli, Arianna Loregian, Nicolò Navarin, Davide Abate, Manuela Sciro, Stefano Merigliano, Ettore De Canale, Maria Cristina Vanuzzo, Valeria Besutti, Francesca Saluzzo, Francesco Onelia, Monia Pacenti, Saverio G. ParisiGiovanni Carretta, Daniele Donato, Luciano Flor, Silvia Cocchio, Giulia Masi, Alessandro Sperduti, Lorenzo Cattarino, Renato Salvador, Michele Nicoletti, Federico Caldart, Gioele Castelli, Eleonora Nieddu, Beatrice Labella, Ludovico Fava, Matteo Drigo, Katy A.M. Gaythorpe, Kylie E.C. Ainslie, Marc Baguelin, Samir Bhatt, Adhiratha Boonyasiri, Olivia Boyd, Lorenzo Cattarino, Constanze Ciavarella, Helen L. Coupland, Zulma Cucunubá, Gina Cuomo-Dannenburg, Bimandra A. Djafaara, Christl A. Donnelly, Ilaria Dorigatti, Swapnil Mishra, Imperial College COVID-19 Response Team

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

661 Citationer (Scopus)

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Abstract

On 21 February 2020, a resident of the municipality of Vo’, a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection¹. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province². In response, the regional authorities imposed the lockdown of the whole municipality for 14 days³. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo’ at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1–3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8–1.8%). Notably, 42.5% (95% CI: 31.5–54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9–9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon–Mann–Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures.

Originalsprog	Engelsk
Tidsskrift	Nature
Vol/bind	584
Udgave nummer	7821
Sider (fra-til)	425-429
Antal sider	5
ISSN	0028-0836
DOI	https://doi.org/10.1038/s41586-020-2488-1
Status	Udgivet - 2020
Udgivet eksternt	Ja

Bibliografisk note

Funding Information:
Acknowledgements We thank the Mayor of the municipality of Vo’, G. Martini, for his unreserved support throughout the study; a special thanks to the population of Vo’ who volunteered en masse to this study; M. Perilli and S. Guglielmo for assistance in data collection and consistency check; and F. Bosa and G. Rupolo from the Italian Red Cross for the support in patient samplings. This work was supported by the Veneto region and was jointly funded by the UK Medical Research Council (MRC; grant MR/R015600/1), the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, the Abdul Latif Jameel Foundation and is also part of the EDCTP2 programme supported by the European Union. I.D. acknowledges research funding from a Sir Henry Dale Fellowship funded by the Royal Society and Wellcome Trust (grant 213494/Z/18/Z). C.C. acknowledges funding from the Wellcome Trust (grant 203851/Z/16/Z). L.C.O. from the Imperial College COVID-19 Response Team and G.C.-D. acknowledge research funding from The Royal Society. L.B., E.L. and S.T. acknowledge research funding from the European Union's Horizon 2020 research and innovation programme, under grant agreement no. 874735 (VEO).

Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.

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Citationsformater

Lavezzo, E., Franchin, E., Ciavarella, C., Cuomo-Dannenburg, G., Barzon, L., Del Vecchio, C., Rossi, L., Manganelli, R., Loregian, A., Navarin, N., Abate, D., Sciro, M., Merigliano, S., De Canale, E., Vanuzzo, M. C., Besutti, V., Saluzzo, F., Onelia, F., Pacenti, M., ... Imperial College COVID-19 Response Team (2020). Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’. Nature, 584(7821), 425-429. https://doi.org/10.1038/s41586-020-2488-1

Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’. / Lavezzo, Enrico; Franchin, Elisa; Ciavarella, Constanze; Cuomo-Dannenburg, Gina; Barzon, Luisa; Del Vecchio, Claudia; Rossi, Lucia; Manganelli, Riccardo; Loregian, Arianna; Navarin, Nicolò; Abate, Davide; Sciro, Manuela; Merigliano, Stefano; De Canale, Ettore; Vanuzzo, Maria Cristina; Besutti, Valeria; Saluzzo, Francesca; Onelia, Francesco; Pacenti, Monia; Parisi, Saverio G.; Carretta, Giovanni; Donato, Daniele; Flor, Luciano; Cocchio, Silvia; Masi, Giulia; Sperduti, Alessandro; Cattarino, Lorenzo; Salvador, Renato; Nicoletti, Michele; Caldart, Federico; Castelli, Gioele; Nieddu, Eleonora; Labella, Beatrice; Fava, Ludovico; Drigo, Matteo; Gaythorpe, Katy A.M.; Ainslie, Kylie E.C.; Baguelin, Marc; Bhatt, Samir; Boonyasiri, Adhiratha; Boyd, Olivia; Cattarino, Lorenzo; Ciavarella, Constanze; Coupland, Helen L.; Cucunubá, Zulma; Cuomo-Dannenburg, Gina; Djafaara, Bimandra A.; Donnelly, Christl A.; Dorigatti, Ilaria; Mishra, Swapnil; Imperial College COVID-19 Response Team.

I: Nature, Bind 584, Nr. 7821, 2020, s. 425-429.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Lavezzo, E, Franchin, E, Ciavarella, C, Cuomo-Dannenburg, G, Barzon, L, Del Vecchio, C, Rossi, L, Manganelli, R, Loregian, A, Navarin, N, Abate, D, Sciro, M, Merigliano, S, De Canale, E, Vanuzzo, MC, Besutti, V, Saluzzo, F, Onelia, F, Pacenti, M, Parisi, SG, Carretta, G, Donato, D, Flor, L, Cocchio, S, Masi, G, Sperduti, A, Cattarino, L, Salvador, R, Nicoletti, M, Caldart, F, Castelli, G, Nieddu, E, Labella, B, Fava, L, Drigo, M, Gaythorpe, KAM, Ainslie, KEC, Baguelin, M, Bhatt, S, Boonyasiri, A, Boyd, O, Cattarino, L, Ciavarella, C, Coupland, HL, Cucunubá, Z, Cuomo-Dannenburg, G, Djafaara, BA, Donnelly, CA, Dorigatti, I, Mishra, S & Imperial College COVID-19 Response Team 2020, 'Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’', Nature, bind 584, nr. 7821, s. 425-429. https://doi.org/10.1038/s41586-020-2488-1

Lavezzo, Enrico ; Franchin, Elisa ; Ciavarella, Constanze ; Cuomo-Dannenburg, Gina ; Barzon, Luisa ; Del Vecchio, Claudia ; Rossi, Lucia ; Manganelli, Riccardo ; Loregian, Arianna ; Navarin, Nicolò ; Abate, Davide ; Sciro, Manuela ; Merigliano, Stefano ; De Canale, Ettore ; Vanuzzo, Maria Cristina ; Besutti, Valeria ; Saluzzo, Francesca ; Onelia, Francesco ; Pacenti, Monia ; Parisi, Saverio G. ; Carretta, Giovanni ; Donato, Daniele ; Flor, Luciano ; Cocchio, Silvia ; Masi, Giulia ; Sperduti, Alessandro ; Cattarino, Lorenzo ; Salvador, Renato ; Nicoletti, Michele ; Caldart, Federico ; Castelli, Gioele ; Nieddu, Eleonora ; Labella, Beatrice ; Fava, Ludovico ; Drigo, Matteo ; Gaythorpe, Katy A.M. ; Ainslie, Kylie E.C. ; Baguelin, Marc ; Bhatt, Samir ; Boonyasiri, Adhiratha ; Boyd, Olivia ; Cattarino, Lorenzo ; Ciavarella, Constanze ; Coupland, Helen L. ; Cucunubá, Zulma ; Cuomo-Dannenburg, Gina ; Djafaara, Bimandra A. ; Donnelly, Christl A. ; Dorigatti, Ilaria ; Mishra, Swapnil ; Imperial College COVID-19 Response Team. / Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’. I: Nature. 2020 ; Bind 584, Nr. 7821. s. 425-429.

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title = "Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo{\textquoteright}",

abstract = "On 21 February 2020, a resident of the municipality of Vo{\textquoteright}, a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection1. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo{\textquoteright} at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1–3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8–1.8%). Notably, 42.5% (95% CI: 31.5–54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9–9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon–Mann–Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures.",

author = "Enrico Lavezzo and Elisa Franchin and Constanze Ciavarella and Gina Cuomo-Dannenburg and Luisa Barzon and {Del Vecchio}, Claudia and Lucia Rossi and Riccardo Manganelli and Arianna Loregian and Nicol{\`o} Navarin and Davide Abate and Manuela Sciro and Stefano Merigliano and {De Canale}, Ettore and Vanuzzo, {Maria Cristina} and Valeria Besutti and Francesca Saluzzo and Francesco Onelia and Monia Pacenti and Parisi, {Saverio G.} and Giovanni Carretta and Daniele Donato and Luciano Flor and Silvia Cocchio and Giulia Masi and Alessandro Sperduti and Lorenzo Cattarino and Renato Salvador and Michele Nicoletti and Federico Caldart and Gioele Castelli and Eleonora Nieddu and Beatrice Labella and Ludovico Fava and Matteo Drigo and Gaythorpe, {Katy A.M.} and Ainslie, {Kylie E.C.} and Marc Baguelin and Samir Bhatt and Adhiratha Boonyasiri and Olivia Boyd and Lorenzo Cattarino and Constanze Ciavarella and Coupland, {Helen L.} and Zulma Cucunub{\'a} and Gina Cuomo-Dannenburg and Djafaara, {Bimandra A.} and Donnelly, {Christl A.} and Ilaria Dorigatti and Swapnil Mishra and {Imperial College COVID-19 Response Team}",

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year = "2020",

doi = "10.1038/s41586-020-2488-1",

language = "English",

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T1 - Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo’

AU - Lavezzo, Enrico

AU - Franchin, Elisa

AU - Ciavarella, Constanze

AU - Cuomo-Dannenburg, Gina

AU - Barzon, Luisa

AU - Del Vecchio, Claudia

AU - Rossi, Lucia

AU - Manganelli, Riccardo

AU - Loregian, Arianna

AU - Navarin, Nicolò

AU - Abate, Davide

AU - Sciro, Manuela

AU - Merigliano, Stefano

AU - De Canale, Ettore

AU - Vanuzzo, Maria Cristina

AU - Besutti, Valeria

AU - Saluzzo, Francesca

AU - Onelia, Francesco

AU - Pacenti, Monia

AU - Parisi, Saverio G.

AU - Carretta, Giovanni

AU - Donato, Daniele

AU - Flor, Luciano

AU - Cocchio, Silvia

AU - Masi, Giulia

AU - Sperduti, Alessandro

AU - Cattarino, Lorenzo

AU - Salvador, Renato

AU - Nicoletti, Michele

AU - Caldart, Federico

AU - Castelli, Gioele

AU - Nieddu, Eleonora

AU - Labella, Beatrice

AU - Fava, Ludovico

AU - Drigo, Matteo

AU - Gaythorpe, Katy A.M.

AU - Ainslie, Kylie E.C.

AU - Baguelin, Marc

AU - Bhatt, Samir

AU - Boonyasiri, Adhiratha

AU - Boyd, Olivia

AU - Cattarino, Lorenzo

AU - Ciavarella, Constanze

AU - Coupland, Helen L.

AU - Cucunubá, Zulma

AU - Cuomo-Dannenburg, Gina

AU - Djafaara, Bimandra A.

AU - Donnelly, Christl A.

AU - Dorigatti, Ilaria

AU - Mishra, Swapnil

AU - Imperial College COVID-19 Response Team

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N2 - On 21 February 2020, a resident of the municipality of Vo’, a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection1. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo’ at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1–3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8–1.8%). Notably, 42.5% (95% CI: 31.5–54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9–9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon–Mann–Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures.

AB - On 21 February 2020, a resident of the municipality of Vo’, a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection1. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo’ at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1–3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8–1.8%). Notably, 42.5% (95% CI: 31.5–54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9–9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon–Mann–Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures.

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DO - 10.1038/s41586-020-2488-1

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C2 - 32604404

AN - SCOPUS:85087134507

VL - 584

SP - 425

EP - 429

JO - Nature

JF - Nature

SN - 0028-0836

IS - 7821

ER -