研究论文

新型冠状病毒在家庭环境中的主要传播途径

  • 雷浩 ,
  • 肖胜蓝 ,
  • 张楠 ,
  • 魏健健 ,
  • 金滔
展开
  • 1. 浙江大学公共卫生学院, 杭州 310058;
    2. 中山大学公共卫生学院(深圳), 深圳 518100;
    3. 北京工业大学建筑工程学院, 北京 100124;
    4. 浙江大学能源工程学院, 杭州 310058
雷浩,讲师,研究方向为传染病流行病学,电子信箱:leolei@zju.edu.cn;肖胜蓝(共同第一作者),副教授,研究方向为传染病流行病学,电子信箱:xiaoshlan3@mail.sysu.edu.cn

收稿日期: 2020-08-05

  修回日期: 2020-12-21

  网络出版日期: 2021-06-08

基金资助

浙江省自然科学基金项目(LQ20H260009);国家自然科学基金项目(51808488)

Exploring dominant transmission routes of COVID-19 in households

  • LEI Hao ,
  • XIAO Shenglan ,
  • ZHANG Nan ,
  • WEI Jianjian ,
  • JIN Tao
Expand
  • 1. School of Public Health, Zhejiang University, Hangzhou 310058, China;
    2. School of Public Health(Shenzhen), Sun Yat-sen University, Shenzhen 518100, China;
    3. College of Architecture and Civil Engineerin, Beijing University of Technology, Beijing 100124, China;
    4. College of Energy Engineering, Zhejiang University, Hangzhou 310058, China

Received date: 2020-08-05

  Revised date: 2020-12-21

  Online published: 2021-06-08

摘要

通过构建数学模型,定量研究了1个3人家庭环境中飞沫传播、接触传播和气溶胶传播在COVID-19传播中的作用。研究表明,飞沫传播和接触传播在COVID-19传播中起着最重要的作用。和患者交流时保持1.5~2 m的空间距离对控制飞沫传播至关重要,洗手和保护环境表面清洁是控制接触传播的最有效手段。虽然通过气溶胶途径传播风险相对较小,但当患者呼出飞沫中病原体浓度较高时(患者可能为超级感染者),在家庭环境中24 h暴露下,气溶胶传播风险依然可以高达26%。

本文引用格式

雷浩 , 肖胜蓝 , 张楠 , 魏健健 , 金滔 . 新型冠状病毒在家庭环境中的主要传播途径[J]. 科技导报, 2021 , 39(9) : 78 -86 . DOI: 10.3981/j.issn.1000-7857.2021.09.009

Abstract

By June 19, 2020, there had been 84940 COVID-19 confirmed cases in China, in which 83% of the clustered infections occurred within families. Thus, exploring the relative contributions of different transmission routes is significant for developing efficient intervention strategies in household. In this study, we build a mathematical model to quantify the relative degrees of importance of airborne, droplet and contact route in COVID-19 transmission in household environments. We find that the droplet and contact routes play the dominant role in COVID-19 transmission in household. Keeping a 1.5-2 m distance when communicating with the infector is the key intervention to control droplet transmission. Hand hygiene and surface cleaning are significant for controlling contact transmission. The infection risk by airborne route is relatively small, however, when the virus concentration in the droplets exhaled by the infector is high (possibly super-spreader), e. g. 107 mRNA copy/mL, the infection risk via the airborne route can be as high as 26%. This study may provide a theoretical guidance for developing targeted interventions in household environments.

参考文献

[1] Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of Novel coronavirus-infected pneumonia[J]. New England Journal of Medicine, 2020, 382:1199-1207.
[2] Coronavirus Disease (COVID-19) Situation Report-151[R]. Geneva:World Health Organization, 2020.
[3] 中华预防医学会新型冠状病毒肺炎防控专家组. 新型冠状病毒肺炎流行病学特征的最新认识[J]. 中华流行病学杂志, 2020, 10(2):86-92.
[4] Lei H, Xu X, Xiao S, et al. Household transmission of COVID-19-a systematic review and meta-analysis[J]. Journal of Infection, 2020, doi:10.1016/j.jinf.2020.08. 033.
[5] Atkinson M P, Wei L M. Quantifying the routes of transmission for pandemic influenza[J]. Bulletin of Mathematical Biology, 2008, 70(3):820-867.
[6] Nicas M, Jones R M. Relative contributions of four exposure pathways to influenza infection risk[J]. Risk Analysis, 2009, 29(9):1292-1303.
[7] Lei H, Li Y, Xiao S, et al. Routes of transmission of influenza A H1N1, SARS CoV and norovirus in air cabin:Comparative analyses[J]. Indoor Air, 2018, 28(3):394-403.
[8] Gao X C, Li Y, Wei J, et al. Multi-route respiratory infection:When a transmission route may dominate[J]. Science of the Total Environment, 2020, doi:10.1016/j. scitotenv.2020.141856.
[9] 国家统计局. 中国统计年鉴2019[M]. 北京:中国统计出版社, 2019.
[10] Chen W, Zhang N, Wei J, et al. Short-range airborne route dominates exposure of respiratory infection during close contact[J]. Building Environment, 2020, 176:106359.
[11] Nicas M, Jones R M. Relative contributions of four exposure pathways to influenza infection risk[J]. Risk Analysis, 2009, 29(9):1292-1303.
[12] Liu L, Li Y, Nielsen P V, et al. Short-range airborne transmission of expiratory droplets between two people[J]. Indoor Air, 2017, 27(2):452-462.
[13] Xie X, Li Y, Zhang T, et al. Bacterial survival in evaporating deposited droplets on a teflon-coated surface[J]. Applied Microbiology and Biotechnology, 2006, 73(3):703-712.
[14] Xiao S, Li Y, Sung M, et al. A study of the probable transmission routes of MERS-CoV during the first hospital outbreak in the Republic of Korea[J]. Indoor Air, 2018, 28(1):51-63.
[15] Xie X, Li Y, Chwang A T Y, et al. How far droplets can move in indoor environments-revisiting the wells evaporation-falling curve[J]. Indoor Air, 2007, 17(3):211-225.
[16] van Doremalen N, Bushmaker T, Morris D H, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1[J]. New England Journal of Medicine, 2020, 382(16):1564-1567.
[17] Thatcher T L, Lai A C K, Moreno-Jackson R, et al. Effects of room furnishings and air speed on particle deposition rates indoors[J]. Atmospheric Environment, 2002, 36(11):1811-1819.
[18] Wallace L A, Emmerich S J, Howard-Reed C. Continuous measurements of air change rates in an occupied house for 1 year:The effect of temperature, wind, fans, and windows[J]. Journal of Exposure Science & Environmental Epidemiology, 2002, 12(4):296-306.
[19] Chen S C, Chang C F, Liao C M. Predictive models of control strategies involved in containing indoor airborne infections[J]. Indoor Air, 2006(16):469-481.
[20] Sia S F, Yan L M, Chin A W H, et al. Pathogenesis and transmission of SARS-CoV-2 in golden hamsters[J]. Nature, 2020, 583(7818):1-7.
[21] Miura F, Watanabe T, Watanabe K, et al. Comparative assessment of primary and secondary infection risks in a norovirus outbreak using a household model simulation[J]. Journal of Environmental Sciences, 2016, 50:13-20.
[22] Hendley J O, Wenzel R P, Gwaltney Jr J M. Transmission of rhinovirus colds by self-inoculation[J]. New England Journal of Medicine, 1973, 288(26):1361-1364.
[23] Lopez G U. Transfer of microorganisms from fomites to hands and risk assessment of contaminated and disinfected surfaces[D]. Arizona:University of Arizona, 2013.
[24] Lopez G U, Gerba C P, Tamimi A H, et al. Transfer efficiency of bacteria and viruses from porous and nonporous fomites to fingers under different relative humidity conditions[J]. Applied and Environmental Microbiology. 2013, 79:5728-5734.
[25] Lee J Y, Choi J W, Kim H. Determination of hand surface area by sex and body shape using alginate[J]. Journal of Physiological Anthropology, 2007, 26:475-483.
[26] Wiertlewski M, Hayward V. Mechanical behavior of the fingertip in the range of frequencies and displacements relevant to touch[J]. Journal of Biomechanics, 2012, 45:1869-1874.
[27] Van Doremalen N, Bushmaker T, Munster V J. Stability of Middle East respiratory syndrome coronavirus (MERS-CoV) under different environmental conditions[J]. Eurosurveillance. 2013, 18:20590.
[28] Wolff M H, Sattar S A, Adegbunrin O, et al. Environmental survival and microbicide inactivation of coronaviruses, with special emphasis on first insights concerning SARS[M]. Birkhäuser:Springer, 2005:201-212.
[29] Pan Y, Zhang D, Yang P, et al. Viral load of SARSCoV-2 in clinical samples[J]. Lancet Infectious Diseases, 2020, 20(4):411-412.
[30] Liu Y, Ning Z, Chen Y, et al. Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals[J]. Nature, 2020, 582(7813):557-560.
[31] Lukassen S, Chua R L, Trefzer T, et al. SARS-CoV-2 receptor ACE 2 and TMPRSS 2 are primarily expressed in bronchial transient secretory cells[J]. EMBO Journal, 2020, 39(10):e105114.
[32] Atkinson J, Chartier Y, Pessoa-Silva C L, et al. Natural ventilation for infection control in health-care settings[R]. World Health Organization, 2009.
[33] Koo J R, Cook A R, Park M, et al. Interventions to mitigate early spread of SARS-CoV-2 in Singapore:A modelling study[J]. Lancet Infectious Diseases, 2020, 20(6):678-688.
[34] Coronavirus disease (COVID-19) advice for the public[R]. Geneva:World Health Organization, 2020.
[35] Lei H, Xiao S, Cowling B J, et al. Hand hygiene and surface cleaning should be paired for prevention of fomite transmission[J]. Indoor Air, 2020, 30(1):49-59.
文章导航

/