Connecting clusters of COVID-19: an epidemiological and serological investigation.
Identifieur interne : 000190 ( Main/Exploration ); précédent : 000189; suivant : 000191Connecting clusters of COVID-19: an epidemiological and serological investigation.
Auteurs : Sarah Ee Fang Yong [Singapour] ; Danielle Elizabeth Anderson [Singapour] ; Wycliffe E. Wei [Singapour] ; Junxiong Pang [Singapour] ; Wan Ni Chia [Singapour] ; Chee Wah Tan [Singapour] ; Yee Leong Teoh [Singapour] ; Priyanka Rajendram [Singapour] ; Matthias Paul Han Sim Toh [Singapour] ; Cuiqin Poh [Singapour] ; Valerie T J. Koh [Singapour] ; Joshua Lum [Singapour] ; Nur-Afidah Md Suhaimi [Singapour] ; Po Ying Chia [Singapour] ; Mark I-Cheng Chen [Singapour] ; Shawn Vasoo [Singapour] ; Benjamin Ong [Singapour] ; Yee Sin Leo [Singapour] ; Linfa Wang [Singapour] ; Vernon J M. Lee [Singapour]Source :
- The Lancet. Infectious diseases [ 1474-4457 ] ; 2020.
Descripteurs français
- KwdFr :
- Analyse de regroupements (MeSH), Betacoronavirus (MeSH), Humains (MeSH), Immunoglobuline G (immunologie), Immunoglobuline G (sang), Infections à coronavirus (immunologie), Infections à coronavirus (sang), Infections à coronavirus (épidémiologie), Pandémies (MeSH), Pneumopathie virale (immunologie), Pneumopathie virale (sang), Pneumopathie virale (épidémiologie), Singapour (épidémiologie), Surveillance de la population (MeSH), Tests sérologiques (MeSH), Traçage des contacts (MeSH).
- MESH :
- immunologie : Immunoglobuline G, Infections à coronavirus, Pneumopathie virale.
- sang : Immunoglobuline G, Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Infections à coronavirus, Pneumopathie virale, Singapour.
- Analyse de regroupements, Betacoronavirus, Humains, Pandémies, Surveillance de la population, Tests sérologiques, Traçage des contacts.
- Wicri :
- geographic : Singapour.
English descriptors
- KwdEn :
- Betacoronavirus (MeSH), COVID-19 (MeSH), Cluster Analysis (MeSH), Contact Tracing (MeSH), Coronavirus Infections (blood), Coronavirus Infections (epidemiology), Coronavirus Infections (immunology), Humans (MeSH), Immunoglobulin G (blood), Immunoglobulin G (immunology), Pandemics (MeSH), Pneumonia, Viral (blood), Pneumonia, Viral (epidemiology), Pneumonia, Viral (immunology), Population Surveillance (MeSH), SARS-CoV-2 (MeSH), Serologic Tests (MeSH), Singapore (epidemiology).
- MESH :
- chemical , blood : Immunoglobulin G.
- geographic , epidemiology : Singapore.
- blood : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- immunology : Coronavirus Infections, Immunoglobulin G, Pneumonia, Viral.
- Betacoronavirus, COVID-19, Cluster Analysis, Contact Tracing, Humans, Pandemics, Population Surveillance, SARS-CoV-2, Serologic Tests.
Abstract
BACKGROUND
Elucidation of the chain of disease transmission and identification of the source of coronavirus disease 2019 (COVID-19) infections are crucial for effective disease containment. We describe an epidemiological investigation that, with use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, established links between three clusters of COVID-19.
METHODS
In Singapore, active case-finding and contact tracing were undertaken for all COVID-19 cases. Diagnosis for acute disease was confirmed with RT-PCR testing. When epidemiological information suggested that people might have been nodes of disease transmission but had recovered from illness, SARS-CoV-2 IgG serology testing was used to establish past infection.
FINDINGS
Three clusters of COVID-19, comprising 28 locally transmitted cases, were identified in Singapore; these clusters were from two churches (Church A and Church B) and a family gathering. The clusters in Church A and Church B were linked by an individual from Church A (A2), who transmitted SARS-CoV-2 infection to the primary case from Church B (F1) at a family gathering they both attended on Jan 25, 2020. All cases were confirmed by RT-PCR testing because they had active disease, except for A2, who at the time of testing had recovered from their illness and tested negative. This individual was eventually diagnosed with past infection by serological testing. ELISA assays showed an optical density of more than 1·4 for SARS-CoV-2 nucleoprotein and receptor binding domain antigens in titres up to 1/400, and viral neutralisation was noted in titres up to 1/320.
INTERPRETATION
Development and application of a serological assay has helped to establish connections between COVID-19 clusters in Singapore. Serological testing can have a crucial role in identifying convalescent cases or people with milder disease who might have been missed by other surveillance methods.
FUNDING
National Research Foundation (Singapore), National Natural Science Foundation (China), and National Medical Research Council (Singapore).
DOI: 10.1016/S1473-3099(20)30273-5
PubMed: 32330439
PubMed Central: PMC7173813
Affiliations:
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Koh</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Lum, Joshua" sort="Lum, Joshua" uniqKey="Lum J" first="Joshua" last="Lum">Joshua Lum</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Suhaimi, Nur Afidah Md" sort="Suhaimi, Nur Afidah Md" uniqKey="Suhaimi N" first="Nur-Afidah Md" last="Suhaimi">Nur-Afidah Md Suhaimi</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Chia, Po Ying" sort="Chia, Po Ying" uniqKey="Chia P" first="Po Ying" last="Chia">Po Ying Chia</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital</wicri:regionArea><wicri:noRegion>Singapore; Tan Tock Seng Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Mark I Cheng" sort="Chen, Mark I Cheng" uniqKey="Chen M" first="Mark I-Cheng" last="Chen">Mark I-Cheng Chen</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health</wicri:regionArea><wicri:noRegion>Singapore; Saw Swee Hock School of Public Health</wicri:noRegion></affiliation></author><author><name sortKey="Vasoo, Shawn" sort="Vasoo, Shawn" uniqKey="Vasoo S" first="Shawn" last="Vasoo">Shawn Vasoo</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital</wicri:regionArea><wicri:noRegion>Singapore; Tan Tock Seng Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Ong, Benjamin" sort="Ong, Benjamin" uniqKey="Ong B" first="Benjamin" last="Ong">Benjamin Ong</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore; National University Health System, Singapore; National University of Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health, Singapore; National University Health System, Singapore; National University of Singapore</wicri:regionArea><wicri:noRegion>Singapore; National University of Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Leo, Yee Sin" sort="Leo, Yee Sin" uniqKey="Leo Y" first="Yee Sin" last="Leo">Yee Sin Leo</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital</wicri:regionArea><wicri:noRegion>Singapore; Tan Tock Seng Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Linfa" sort="Wang, Linfa" uniqKey="Wang L" first="Linfa" last="Wang">Linfa Wang</name><affiliation wicri:level="1"><nlm:affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School</wicri:regionArea><wicri:noRegion>Duke-National University of Singapore Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Vernon J M" sort="Lee, Vernon J M" uniqKey="Lee V" first="Vernon J M" last="Lee">Vernon J M. Lee</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore; Saw Swee Hock School of Public Health, Singapore. Electronic address: vernon_lee@moh.gov.sg.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health, Singapore; Saw Swee Hock School of Public Health</wicri:regionArea><wicri:noRegion>Singapore; Saw Swee Hock School of Public Health</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32330439</idno><idno type="pmid">32330439</idno><idno type="doi">10.1016/S1473-3099(20)30273-5</idno><idno type="pmc">PMC7173813</idno><idno type="wicri:Area/Main/Corpus">000235</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000235</idno><idno type="wicri:Area/Main/Curation">000235</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000235</idno><idno type="wicri:Area/Main/Exploration">000235</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Connecting clusters of COVID-19: an epidemiological and serological investigation.</title><author><name sortKey="Yong, Sarah Ee Fang" sort="Yong, Sarah Ee Fang" uniqKey="Yong S" first="Sarah Ee Fang" last="Yong">Sarah Ee Fang Yong</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore; National University Health System, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health, Singapore; National University Health System</wicri:regionArea><wicri:noRegion>Singapore; National University Health System</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Danielle Elizabeth" sort="Anderson, Danielle Elizabeth" uniqKey="Anderson D" first="Danielle Elizabeth" last="Anderson">Danielle Elizabeth Anderson</name><affiliation wicri:level="1"><nlm:affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School</wicri:regionArea><wicri:noRegion>Duke-National University of Singapore Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Wei, Wycliffe E" sort="Wei, Wycliffe E" uniqKey="Wei W" first="Wycliffe E" last="Wei">Wycliffe E. Wei</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore; National Centre for Infectious Diseases, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health, Singapore; National Centre for Infectious Diseases</wicri:regionArea><wicri:noRegion>Singapore; National Centre for Infectious Diseases</wicri:noRegion></affiliation></author><author><name sortKey="Pang, Junxiong" sort="Pang, Junxiong" uniqKey="Pang J" first="Junxiong" last="Pang">Junxiong Pang</name><affiliation wicri:level="1"><nlm:affiliation>Centre for Infectious Disease Epidemiology and Research, Singapore; Saw Swee Hock School of Public Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Centre for Infectious Disease Epidemiology and Research, Singapore; Saw Swee Hock School of Public Health</wicri:regionArea><wicri:noRegion>Singapore; Saw Swee Hock School of Public Health</wicri:noRegion></affiliation></author><author><name sortKey="Chia, Wan Ni" sort="Chia, Wan Ni" uniqKey="Chia W" first="Wan Ni" last="Chia">Wan Ni Chia</name><affiliation wicri:level="1"><nlm:affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School</wicri:regionArea><wicri:noRegion>Duke-National University of Singapore Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Tan, Chee Wah" sort="Tan, Chee Wah" uniqKey="Tan C" first="Chee Wah" last="Tan">Chee Wah Tan</name><affiliation wicri:level="1"><nlm:affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School</wicri:regionArea><wicri:noRegion>Duke-National University of Singapore Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Teoh, Yee Leong" sort="Teoh, Yee Leong" uniqKey="Teoh Y" first="Yee Leong" last="Teoh">Yee Leong Teoh</name><affiliation wicri:level="1"><nlm:affiliation>Saw Swee Hock School of Public Health, Singapore; Singapore Clinical Research Institute, Singapore; Ministry of Health Office for Healthcare Transformation, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Saw Swee Hock School of Public Health, Singapore; Singapore Clinical Research Institute, Singapore; Ministry of Health Office for Healthcare Transformation</wicri:regionArea><wicri:noRegion>Singapore; Ministry of Health Office for Healthcare Transformation</wicri:noRegion></affiliation></author><author><name sortKey="Rajendram, Priyanka" sort="Rajendram, Priyanka" uniqKey="Rajendram P" first="Priyanka" last="Rajendram">Priyanka Rajendram</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Toh, Matthias Paul Han Sim" sort="Toh, Matthias Paul Han Sim" uniqKey="Toh M" first="Matthias Paul Han Sim" last="Toh">Matthias Paul Han Sim Toh</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health</wicri:regionArea><wicri:noRegion>Singapore; Saw Swee Hock School of Public Health</wicri:noRegion></affiliation></author><author><name sortKey="Poh, Cuiqin" sort="Poh, Cuiqin" uniqKey="Poh C" first="Cuiqin" last="Poh">Cuiqin Poh</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Koh, Valerie T J" sort="Koh, Valerie T J" uniqKey="Koh V" first="Valerie T J" last="Koh">Valerie T J. Koh</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Lum, Joshua" sort="Lum, Joshua" uniqKey="Lum J" first="Joshua" last="Lum">Joshua Lum</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Suhaimi, Nur Afidah Md" sort="Suhaimi, Nur Afidah Md" uniqKey="Suhaimi N" first="Nur-Afidah Md" last="Suhaimi">Nur-Afidah Md Suhaimi</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health</wicri:regionArea></affiliation></author><author><name sortKey="Chia, Po Ying" sort="Chia, Po Ying" uniqKey="Chia P" first="Po Ying" last="Chia">Po Ying Chia</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital</wicri:regionArea><wicri:noRegion>Singapore; Tan Tock Seng Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Mark I Cheng" sort="Chen, Mark I Cheng" uniqKey="Chen M" first="Mark I-Cheng" last="Chen">Mark I-Cheng Chen</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health</wicri:regionArea><wicri:noRegion>Singapore; Saw Swee Hock School of Public Health</wicri:noRegion></affiliation></author><author><name sortKey="Vasoo, Shawn" sort="Vasoo, Shawn" uniqKey="Vasoo S" first="Shawn" last="Vasoo">Shawn Vasoo</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital</wicri:regionArea><wicri:noRegion>Singapore; Tan Tock Seng Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Ong, Benjamin" sort="Ong, Benjamin" uniqKey="Ong B" first="Benjamin" last="Ong">Benjamin Ong</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore; National University Health System, Singapore; National University of Singapore, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health, Singapore; National University Health System, Singapore; National University of Singapore</wicri:regionArea><wicri:noRegion>Singapore; National University of Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Leo, Yee Sin" sort="Leo, Yee Sin" uniqKey="Leo Y" first="Yee Sin" last="Leo">Yee Sin Leo</name><affiliation wicri:level="1"><nlm:affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital</wicri:regionArea><wicri:noRegion>Singapore; Tan Tock Seng Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Linfa" sort="Wang, Linfa" uniqKey="Wang L" first="Linfa" last="Wang">Linfa Wang</name><affiliation wicri:level="1"><nlm:affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School</wicri:regionArea><wicri:noRegion>Duke-National University of Singapore Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Vernon J M" sort="Lee, Vernon J M" uniqKey="Lee V" first="Vernon J M" last="Lee">Vernon J M. Lee</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Singapore; Saw Swee Hock School of Public Health, Singapore. Electronic address: vernon_lee@moh.gov.sg.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Ministry of Health, Singapore; Saw Swee Hock School of Public Health</wicri:regionArea><wicri:noRegion>Singapore; Saw Swee Hock School of Public Health</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Lancet. Infectious diseases</title><idno type="eISSN">1474-4457</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Cluster Analysis (MeSH)</term><term>Contact Tracing (MeSH)</term><term>Coronavirus Infections (blood)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (immunology)</term><term>Humans (MeSH)</term><term>Immunoglobulin G (blood)</term><term>Immunoglobulin G (immunology)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (blood)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (immunology)</term><term>Population Surveillance (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Serologic Tests (MeSH)</term><term>Singapore (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Analyse de regroupements (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Humains (MeSH)</term><term>Immunoglobuline G (immunologie)</term><term>Immunoglobuline G (sang)</term><term>Infections à coronavirus (immunologie)</term><term>Infections à coronavirus (sang)</term><term>Infections à coronavirus (épidémiologie)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (immunologie)</term><term>Pneumopathie virale (sang)</term><term>Pneumopathie virale (épidémiologie)</term><term>Singapour (épidémiologie)</term><term>Surveillance de la population (MeSH)</term><term>Tests sérologiques (MeSH)</term><term>Traçage des contacts (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Immunoglobulin G</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Singapore</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Immunoglobuline G</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Coronavirus Infections</term><term>Immunoglobulin G</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Immunoglobuline G</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term><term>Singapour</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>COVID-19</term><term>Cluster Analysis</term><term>Contact Tracing</term><term>Humans</term><term>Pandemics</term><term>Population Surveillance</term><term>SARS-CoV-2</term><term>Serologic Tests</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Analyse de regroupements</term><term>Betacoronavirus</term><term>Humains</term><term>Pandémies</term><term>Surveillance de la population</term><term>Tests sérologiques</term><term>Traçage des contacts</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Singapour</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Elucidation of the chain of disease transmission and identification of the source of coronavirus disease 2019 (COVID-19) infections are crucial for effective disease containment. We describe an epidemiological investigation that, with use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, established links between three clusters of COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>In Singapore, active case-finding and contact tracing were undertaken for all COVID-19 cases. Diagnosis for acute disease was confirmed with RT-PCR testing. When epidemiological information suggested that people might have been nodes of disease transmission but had recovered from illness, SARS-CoV-2 IgG serology testing was used to establish past infection.</p></div><div type="abstract" xml:lang="en"><p><b>FINDINGS</b></p><p>Three clusters of COVID-19, comprising 28 locally transmitted cases, were identified in Singapore; these clusters were from two churches (Church A and Church B) and a family gathering. The clusters in Church A and Church B were linked by an individual from Church A (A2), who transmitted SARS-CoV-2 infection to the primary case from Church B (F1) at a family gathering they both attended on Jan 25, 2020. All cases were confirmed by RT-PCR testing because they had active disease, except for A2, who at the time of testing had recovered from their illness and tested negative. This individual was eventually diagnosed with past infection by serological testing. ELISA assays showed an optical density of more than 1·4 for SARS-CoV-2 nucleoprotein and receptor binding domain antigens in titres up to 1/400, and viral neutralisation was noted in titres up to 1/320.</p></div><div type="abstract" xml:lang="en"><p><b>INTERPRETATION</b></p><p>Development and application of a serological assay has helped to establish connections between COVID-19 clusters in Singapore. Serological testing can have a crucial role in identifying convalescent cases or people with milder disease who might have been missed by other surveillance methods.</p></div><div type="abstract" xml:lang="en"><p><b>FUNDING</b></p><p>National Research Foundation (Singapore), National Natural Science Foundation (China), and National Medical Research Council (Singapore).</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32330439</PMID><DateCompleted><Year>2020</Year><Month>07</Month><Day>10</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1474-4457</ISSN><JournalIssue CitedMedium="Internet"><Volume>20</Volume><Issue>7</Issue><PubDate><Year>2020</Year><Month>07</Month></PubDate></JournalIssue><Title>The Lancet. Infectious diseases</Title><ISOAbbreviation>Lancet Infect Dis</ISOAbbreviation></Journal><ArticleTitle>Connecting clusters of COVID-19: an epidemiological and serological investigation.</ArticleTitle><Pagination><MedlinePgn>809-815</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1473-3099(20)30273-5</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/S1473-3099(20)30273-5</ELocationID><Abstract><AbstractText Label="BACKGROUND">Elucidation of the chain of disease transmission and identification of the source of coronavirus disease 2019 (COVID-19) infections are crucial for effective disease containment. We describe an epidemiological investigation that, with use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, established links between three clusters of COVID-19.</AbstractText><AbstractText Label="METHODS">In Singapore, active case-finding and contact tracing were undertaken for all COVID-19 cases. Diagnosis for acute disease was confirmed with RT-PCR testing. When epidemiological information suggested that people might have been nodes of disease transmission but had recovered from illness, SARS-CoV-2 IgG serology testing was used to establish past infection.</AbstractText><AbstractText Label="FINDINGS">Three clusters of COVID-19, comprising 28 locally transmitted cases, were identified in Singapore; these clusters were from two churches (Church A and Church B) and a family gathering. The clusters in Church A and Church B were linked by an individual from Church A (A2), who transmitted SARS-CoV-2 infection to the primary case from Church B (F1) at a family gathering they both attended on Jan 25, 2020. All cases were confirmed by RT-PCR testing because they had active disease, except for A2, who at the time of testing had recovered from their illness and tested negative. This individual was eventually diagnosed with past infection by serological testing. ELISA assays showed an optical density of more than 1·4 for SARS-CoV-2 nucleoprotein and receptor binding domain antigens in titres up to 1/400, and viral neutralisation was noted in titres up to 1/320.</AbstractText><AbstractText Label="INTERPRETATION">Development and application of a serological assay has helped to establish connections between COVID-19 clusters in Singapore. Serological testing can have a crucial role in identifying convalescent cases or people with milder disease who might have been missed by other surveillance methods.</AbstractText><AbstractText Label="FUNDING">National Research Foundation (Singapore), National Natural Science Foundation (China), and National Medical Research Council (Singapore).</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Yong</LastName><ForeName>Sarah Ee Fang</ForeName><Initials>SEF</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore; National University Health System, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anderson</LastName><ForeName>Danielle Elizabeth</ForeName><Initials>DE</Initials><AffiliationInfo><Affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wei</LastName><ForeName>Wycliffe E</ForeName><Initials>WE</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore; National Centre for Infectious Diseases, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pang</LastName><ForeName>Junxiong</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Centre for Infectious Disease Epidemiology and Research, Singapore; Saw Swee Hock School of Public Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chia</LastName><ForeName>Wan Ni</ForeName><Initials>WN</Initials><AffiliationInfo><Affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tan</LastName><ForeName>Chee Wah</ForeName><Initials>CW</Initials><AffiliationInfo><Affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Teoh</LastName><ForeName>Yee Leong</ForeName><Initials>YL</Initials><AffiliationInfo><Affiliation>Saw Swee Hock School of Public Health, Singapore; Singapore Clinical Research Institute, Singapore; Ministry of Health Office for Healthcare Transformation, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajendram</LastName><ForeName>Priyanka</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Toh</LastName><ForeName>Matthias Paul Han Sim</ForeName><Initials>MPHS</Initials><AffiliationInfo><Affiliation>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poh</LastName><ForeName>Cuiqin</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koh</LastName><ForeName>Valerie T J</ForeName><Initials>VTJ</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lum</LastName><ForeName>Joshua</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Suhaimi</LastName><ForeName>Nur-Afidah Md</ForeName><Initials>NM</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chia</LastName><ForeName>Po Ying</ForeName><Initials>PY</Initials><AffiliationInfo><Affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Mark I-Cheng</ForeName><Initials>MI</Initials><AffiliationInfo><Affiliation>National Centre for Infectious Diseases, Singapore; Saw Swee Hock School of Public Health, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vasoo</LastName><ForeName>Shawn</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ong</LastName><ForeName>Benjamin</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore; National University Health System, Singapore; National University of Singapore, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leo</LastName><ForeName>Yee Sin</ForeName><Initials>YS</Initials><AffiliationInfo><Affiliation>National Centre for Infectious Diseases, Singapore; Tan Tock Seng Hospital, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Linfa</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Vernon J M</ForeName><Initials>VJM</Initials><AffiliationInfo><Affiliation>Ministry of Health, Singapore; Saw Swee Hock School of Public Health, Singapore. Electronic address: vernon_lee@moh.gov.sg.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Lancet Infect Dis</MedlineTA><NlmUniqueID>101130150</NlmUniqueID><ISSNLinking>1473-3099</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007074">Immunoglobulin G</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Infect Dis. 2020 Jul;20(7):758-759</RefSource><PMID Version="1">32330441</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016000" MajorTopicYN="N">Cluster Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016358" MajorTopicYN="N">Contact Tracing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007074" MajorTopicYN="N">Immunoglobulin G</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName><QualifierName UI="Q000276" MajorTopicYN="N">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000276" MajorTopicYN="Y">immunology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011159" MajorTopicYN="N">Population Surveillance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012698" MajorTopicYN="N">Serologic Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012846" MajorTopicYN="N" Type="Geographic">Singapore</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>03</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>03</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>03</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32330439</ArticleId><ArticleId IdType="pii">S1473-3099(20)30273-5</ArticleId><ArticleId IdType="doi">10.1016/S1473-3099(20)30273-5</ArticleId><ArticleId IdType="pmc">PMC7173813</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Singapour</li></country></list><tree><country name="Singapour"><noRegion><name sortKey="Yong, Sarah Ee Fang" sort="Yong, Sarah Ee Fang" uniqKey="Yong S" first="Sarah Ee Fang" last="Yong">Sarah Ee Fang Yong</name></noRegion><name sortKey="Anderson, Danielle Elizabeth" sort="Anderson, Danielle Elizabeth" uniqKey="Anderson D" first="Danielle Elizabeth" last="Anderson">Danielle Elizabeth Anderson</name><name sortKey="Chen, Mark I Cheng" sort="Chen, Mark I Cheng" uniqKey="Chen M" first="Mark I-Cheng" last="Chen">Mark I-Cheng Chen</name><name sortKey="Chia, Po Ying" sort="Chia, Po Ying" uniqKey="Chia P" first="Po Ying" last="Chia">Po Ying Chia</name><name sortKey="Chia, Wan Ni" sort="Chia, Wan Ni" uniqKey="Chia W" first="Wan Ni" last="Chia">Wan Ni Chia</name><name sortKey="Koh, Valerie T J" sort="Koh, Valerie T J" uniqKey="Koh V" first="Valerie T J" last="Koh">Valerie T J. Koh</name><name sortKey="Lee, Vernon J M" sort="Lee, Vernon J M" uniqKey="Lee V" first="Vernon J M" last="Lee">Vernon J M. Lee</name><name sortKey="Leo, Yee Sin" sort="Leo, Yee Sin" uniqKey="Leo Y" first="Yee Sin" last="Leo">Yee Sin Leo</name><name sortKey="Lum, Joshua" sort="Lum, Joshua" uniqKey="Lum J" first="Joshua" last="Lum">Joshua Lum</name><name sortKey="Ong, Benjamin" sort="Ong, Benjamin" uniqKey="Ong B" first="Benjamin" last="Ong">Benjamin Ong</name><name sortKey="Pang, Junxiong" sort="Pang, Junxiong" uniqKey="Pang J" first="Junxiong" last="Pang">Junxiong Pang</name><name sortKey="Poh, Cuiqin" sort="Poh, Cuiqin" uniqKey="Poh C" first="Cuiqin" last="Poh">Cuiqin Poh</name><name sortKey="Rajendram, Priyanka" sort="Rajendram, Priyanka" uniqKey="Rajendram P" first="Priyanka" last="Rajendram">Priyanka Rajendram</name><name sortKey="Suhaimi, Nur Afidah Md" sort="Suhaimi, Nur Afidah Md" uniqKey="Suhaimi N" first="Nur-Afidah Md" last="Suhaimi">Nur-Afidah Md Suhaimi</name><name sortKey="Tan, Chee Wah" sort="Tan, Chee Wah" uniqKey="Tan C" first="Chee Wah" last="Tan">Chee Wah Tan</name><name sortKey="Teoh, Yee Leong" sort="Teoh, Yee Leong" uniqKey="Teoh Y" first="Yee Leong" last="Teoh">Yee Leong Teoh</name><name sortKey="Toh, Matthias Paul Han Sim" sort="Toh, Matthias Paul Han Sim" uniqKey="Toh M" first="Matthias Paul Han Sim" last="Toh">Matthias Paul Han Sim Toh</name><name sortKey="Vasoo, Shawn" sort="Vasoo, Shawn" uniqKey="Vasoo S" first="Shawn" last="Vasoo">Shawn Vasoo</name><name sortKey="Wang, Linfa" sort="Wang, Linfa" uniqKey="Wang L" first="Linfa" last="Wang">Linfa Wang</name><name sortKey="Wei, Wycliffe E" sort="Wei, Wycliffe E" uniqKey="Wei W" first="Wycliffe E" last="Wei">Wycliffe E. 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