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Infectious Diseases

Possible Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in a Public Bath Center in Huai’an, Jiangsu Province, China

Educational Objective
To understand the possible transmission of COVID-19 in a high temperature, high humidity environment.

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JAMA Network Open

Published Online: March 30, 2020

Research Letter

Article Information and Disclosures

Xiaofei Chen, MD, PhD³;

Qilong Wang, MD, PhD¹;

Hongbing Shen, MD, PhD⁴

Author Affiliations

¹Department of Central Laboratory, The Affiliated Huai’an No. 1 People’s Hospital, Nanjing Medical University, Huai’an, China
²Department of Infection Diseases, Huai’an No. 4 Hospital, Huai’an, China
³Department of Clinical Oncology, The Affiliated Huai’an No. 1 People’s Hospital, Nanjing Medical University, Huai’an, China
⁴Department 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, Nanjing, China

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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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Article Information

Accepted for Publication: March 6, 2020.

Published: March 30, 2020. doi:10.1001/jamanetworkopen.2020.4583

Correction: This article was corrected on August 5, 2020, to fix an error in Funding/Support.

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 (qlwang@njmu.edu.cn); 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 (hbshen@njmu.edu.cn).

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.

Supervision: Shen.

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 81800149 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.

References

Zhu N , Zhang D , Wang W , et al; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. doi:10.1056/NEJMoa2001017 PubMed Google Scholar Crossref

Li Q , Guan X , Wu P , et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. Published online January 29, 2020. doi:10.1056/NEJMoa2001316 PubMed Google Scholar

Y Yang , Lu Q , Liu M , et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. Published online February 11, 2020. Accessed March 10, 2020. https://www.medrxiv.org/content/10.1101/2020.02.10.20021675v2

Lowen AC , Mubareka S , Steel J , Palese P . Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog. 2007;3(10):1470-1476. doi:10.1371/journal.ppat.0030151 PubMed Google Scholar Crossref

Possible Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in a Public Bath Center in Huai’an, Jiangsu Province, China

Error in Funding/Support

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