Maximum incubation period for COVID-19 infection: Do we need to rethink the 14-day quarantine policy?
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ABSTRACT:
SUBMITTER: Bikbov B
PROVIDER: S-EPMC7816956 | biostudies-literature | 2021 Mar-Apr
REPOSITORIES: biostudies-literature
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Maximum incubation period for COVID-19 infection: Do we need to rethink the 14-day quarantine policy?
Bikbov Boris B Bikbov Alexander A
Travel medicine and infectious disease 20210118
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Project description:We analyzed data for 170 patients in South Korea who had laboratory-confirmed infection with Middle East respiratory syndrome coronavirus. A longer incubation period was associated with a reduction in the risk for death (adjusted odds ratio/1-day increase in incubation period 0.83, 95% credibility interval 0.68-1.03).
| S-EPMC4766874 | biostudies-literature
Project description:BackgroundFrom 2 January to 14 February 2021, a local outbreak of COVID-19 occurred in Shijiazhuang, the capital city of Hebei Province, with a population of 10 million. We analyzed the characteristics of the local outbreak of COVID-19 in Shijiazhuang and evaluated the effects of serial interventions.MethodsPublicly available data, which included age, sex, date of diagnosis, and other patient information, were used to analyze the epidemiological characteristics of the COVID-19 outbreak in Shijiazhuang. The maximum likelihood method and Hamiltonian Monte Carlo method were used to estimate the serial interval and incubation period, respectively. The impact of incubation period and different interventions were simulated using a well-fitted SEIR+q model.ResultsFrom 2 January to 14 February 2021, there were 869 patients with symptomatic COVID-19 in Shijiazhuang, and most cases (89.6%) were confirmed before 20 January. Overall, 40.2% of the cases were male, 16.3% were aged 0 to 19 years, and 21.9% were initially diagnosed as asymptomatic but then became symptomatic. The estimated incubation period was 11.6 days (95% CI 10.6, 12.7 days) and the estimated serial interval was 6.6 days (0.025th, 0.975th: 0.6, 20.0 days). The results of the SEIR+q model indicated that a longer incubation period led to a longer epidemic period. If the comprehensive quarantine measures were reduced by 10%, then the nucleic acid testing would need to increase by 20% or more to minimize the cumulative number of cases.ConclusionsIncubation period was longer than serial interval suggested that more secondary transmission may occur before symptoms onset. The long incubation period made it necessary to extend the isolation period to control the outbreak. Timely contact tracing and implementation of a centralized quarantine quickly contained this epidemic in Shijiazhuang. Large-scale nucleic acid testing also helped to identify cases and reduce virus transmission.
| S-EPMC8648499 | biostudies-literature
Project description: Not available
| S-EPMC3320416 | biostudies-literature
Project description:ObjectivesThis study aimed to validate the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, identify infection risk factors among air passengers subject to a 14-day mandatory quarantine, and evaluate the accuracy of mass symptom-based screening criteria at an airport.MethodsThis retrospective cohort study analyzed data from 116 004 air passengers who entered Thailand through Suvarnabhumi Airport in Bangkok from April 2020 to September 2020. The incidence of SARS-CoV-2 infection, risk characteristics, and accuracy indices of symptom-based screening were calculated.ResultsThe overall incidence of SARS-CoV-2 was 0.5%, or 540 infections per 100 000 air passengers. Identified risk factors included sex, nationality, continent of departure, on-arrival screening results, and month of travel. Positive screening results indicated a higher risk and positive likelihood ratio for SARS-CoV-2 infection. However, the on-arrival screening criteria demonstrated low sensitivity and area under the receiver operating characteristic curve.ConclusionsThe current study confirms previous findings that the risk of SARS-CoV-2 infection during air travel is low. However, this might result from strict pre-departure screening and the SARS-CoV-2 test requirement for arriving passengers. The symptom-based screening criteria used upon arrival showed a low probability of identifying positive cases, suggesting that incorporating additional criteria could help detect asymptomatic infections. The integrated screening and quarantine model proved effective in preventing the spread of the virus into local communities.
| S-EPMC11824645 | biostudies-literature
Project description:Epstein-Barr virus (EBV) is a human herpesvirus that causes acute infectious mononucleosis and is associated with cancer and autoimmune disease. While many studies have been performed examining acute disease in adults following primary infection, little is known about the virological and immunological events during EBV's lengthy 6 week incubation period owing to the challenge of collecting samples from this stage of infection. We conducted a prospective study in college students with special emphasis on frequent screening to capture blood and oral wash samples during the incubation period. Here we describe the viral dissemination and immune response in the 6 weeks prior to onset of acute infectious mononucleosis symptoms. While virus is presumed to be present in the oral cavity from time of transmission, we did not detect viral genomes in the oral wash until one week before symptom onset, at which time viral genomes were present in high copy numbers, suggesting loss of initial viral replication control. In contrast, using a sensitive nested PCR method, we detected viral genomes at low levels in blood about 3 weeks before symptoms. However, high levels of EBV in the blood were only observed close to symptom onset-coincident with or just after increased viral detection in the oral cavity. These data imply that B cells are the major reservoir of virus in the oral cavity prior to infectious mononucleosis. The early presence of viral genomes in the blood, even at low levels, correlated with a striking decrease in the number of circulating plasmacytoid dendritic cells well before symptom onset, which remained depressed throughout convalescence. On the other hand, natural killer cells expanded only after symptom onset. Likewise, CD4+ Foxp3+ regulatory T cells decreased two fold, but only after symptom onset. We observed no substantial virus specific CD8 T cell expansion during the incubation period, although polyclonal CD8 activation was detected in concert with viral genomes increasing in the blood and oral cavity, possibly due to a systemic type I interferon response. This study provides the first description of events during the incubation period of natural EBV infection in humans and definitive data upon which to formulate theories of viral control and disease pathogenesis.
| S-EPMC4666617 | biostudies-literature
Project description:To confine the spread of an infectious disease, setting a sensible quarantine time is crucial. To this end, it is imperative to well understand the distribution of incubation times of the disease. Regarding the ongoing COVID-19 pandemic, 14-days is commonly taken as a quarantine time to curb the virus spread in balancing the impacts of COVID-19 on diverse aspects of the society, including public health, economy, and humanity perspectives, etc. However, setting a sensible quarantine time is not trivial and it depends on various underlying factors. In this article, we take an angle of examining the distribution of the COVID-19 incubation time using likelihood-based methods. Our study is carried out on a dataset of 178 COVID-19 cases dated from January 20, 2020 to February 29, 2020, with the information of exposure periods and dates of symptom onset collected. To gain a good understanding of possible scenarios, we employ different models to describe incubation times of COVID-19. Our findings suggest that statistically, the 14-day quarantine time may not be long enough to control the probability of an early release of infected individuals to be small. While the size of the study data is not large enough to offer us a definitely acceptable quarantine time, and further in practice, the decision-makers may take account of other factors related to social and economic concerns to set up a practically acceptable quarantine time, our study demonstrates useful methods to determine a reasonable quarantine time from a statistical standpoint. Further, it reveals some associated complexity for fully understanding the COVID-19 incubation time distribution.Supplementary informationThe online version contains supplementary material available at 10.1007/s12561-021-09320-8.
| S-EPMC8428508 | biostudies-literature
Project description:Toscana virus (TOSV) is an emerging pathogen in the Mediterranean area and is neuroinvasive in its most severe form. Basic knowledge on TOSV biology is limited. We conducted a systematic review on travel-related infections to estimate the TOSV incubation period. We estimated the incubation period at 12.1 days.
| S-EPMC8632186 | biostudies-literature
Project description:Information about the Zika virus disease incubation period can help identify risk periods and local virus transmission. In 2015-2016, data from 197 symptomatic travelers with recent Zika virus infection indicated an estimated incubation period of 3-14 days. For symptomatic persons with symptoms >2 weeks after travel, transmission might be not travel associated.
| S-EPMC5403043 | biostudies-literature
Project description:Fitness costs of incubation ensue whenever the trade-off between incubation and foraging leads to suboptimal incubation or decreased parental body condition. We examined the costs of incubation in a wild population of house wrens, Troglodytes aedon, by experimentally extending or decreasing the incubation period by cross-fostering eggs between nests at different stages of incubation (eggs from control nests were cross-fostered at the same stage of incubation). We determined whether parents or offspring bear the costs of incubation by measuring effects on females and offspring within the same breeding season during which the manipulation occurred, but also by evaluating potential trade-offs between current and future reproduction by monitoring return rates of experimental females and recruitment rates of offspring in subsequent breeding seasons. There was no difference in hatching or fledging success across treatments. There was also no effect of incubation duration on female size-corrected mass, and females from different treatments were equally likely to produce a second brood. Nestlings produced by females did not differ in body mass, tarsus length or residual mass. Neither return rates of females, nor the number of offspring recruited, differed across treatments. We conclude, therefore, that although prolonged incubation entails increased energy expenditures, females are able to offset these losses while foraging, thereby mitigating the costs of incubation. This resiliency is more likely to be seen in income breeders, such as house wrens, that retain some ability to recoup energy expended in incubation, than in capital breeders that are constrained by stored energy reserves.
| S-EPMC6048971 | biostudies-literature
Project description:ObjectivesRecent large cholera outbreaks highlight the need for improved understanding of the pathogenesis and epidemiology of cholera. The incubation period of cholera has important implications for clinical and public health decision-making, yet statements of the incubation period of cholera are often imprecise. Here we characterize the distribution of cholera's incubation period.MethodsWe conducted a systematic review of the literature for statements of the incubation period of cholera and data that might aid in its estimation. We extracted individual-level data, parametrically estimated the distribution of toxigenic cholera's incubation period, and evaluated evidence for differences between strains.ResultsThe incubation period did not differ by a clinically significant margin between strains (except O1 El Tor Ogawa). We estimate the median incubation period of toxigenic cholera to be 1.4 days (95% CI, 1.3-1.6). Five percent of cholera cases will develop symptoms by 0.5 days (95% CI 0.4-0.5), and 95% by 4.4 days (95% CI 3.9-5.0) after infection.ConclusionsWe recommend that cholera investigations use a recall period of at least five days to capture relevant exposures; significantly longer than recent risk factor studies from the Haitian epidemic. This characterization of cholera's incubation period can help improve clinical and public health practice and advance epidemiologic research.
| S-EPMC3677557 | biostudies-literature