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In December 2019, a novel pneumonia named coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, and has since spread to 25 countries. Current reports show that SARS-CoV-2 is closely related to severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV)1,2 and that it has a greater transmissibility than other coronaviruses. The confirmed transmission modes of SARS-CoV-2 include respiratory droplets and physical contact, and the incubation period for the virus is approximately 3 to 7 days, but it can be as long as 24 days.3 In this case series, we report a cluster-spreading event in Huai’an (700 km northeast of Wuhan) in Jiangsu Province, China, in which a patient with SARS-CoV-2 may have transmitted the virus to 8 other healthy individuals via bathing in a public bath center.
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Accepted for Publication: March 6, 2020.
Published: March 30, 2020. doi:10.1001/jamanetworkopen.2020.4583
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Luo C et al. JAMA Network Open.
Corresponding Authors: Qilong Wang, MD, PhD, Department of Central Laboratory, The Affiliated Huai’an No. 1 People’s Hospital, Nanjing Medical University, One West Huanghe Road, Huai’an 223300, China (email@example.com); Hongbing Shen, MD, PhD, Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Collaborative Innovation Center for Cancer Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing 211166, China (firstname.lastname@example.org).
Author Contributions: Drs Luo and Zhang had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Luo, L. Yao, and Zhang contributed equally as co–first authors. Drs Wang and Shen contributed equally as senior authors.
Concept and design: L. Yao, Wang.
Acquisition, analysis, or interpretation of data: Luo, Zhang, M. Yao, Chen, L. Yao, Shen.
Drafting of the manuscript: Luo, M. Yao, Wang.
Critical revision of the manuscript for important intellectual content: Zhang, Chen, L. Yao, Wang, Shen.
Statistical analysis: Luo, Zhang, M. Yao, Chen.
Obtained funding: Luo, Wang.
Administrative, technical, or material support: Luo, L. Yao.
Conflict of Interest Disclosures: None reported.
Funding/Support: This study was supported by the National Natural Science Foundation of China, with award 81772585 to Dr Wang, award 81972739 to Dr Luo, and award 81972738 to Dr Zhang and the Key Laboratory Projects of Huai’an, with award HAP201804 to Dr Wang and award HAP201910 to Dr Zhang.
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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