4.8 Article

Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 382, Issue 13, Pages 1199-1207

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa2001316

Keywords

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Funding

  1. Ministry of Science and Technology of China
  2. National Science and Technology Major Projects of China [2018ZX10201-002-008-002, 2018ZX10101002-003]
  3. China-U.S. Collaborative Program on Emerging and Re-emerging Infectious Disease [2018ZX10201002-008-002]
  4. National Mega-Projects for Infectious Disease [2018ZX10201002-008-002]
  5. National Natural Science Foundation [71934002]
  6. National Institute of Allergy and Infectious Diseases (Centers of Excellence for Influenza Research and Surveillance [CEIRS]) [HHSN272201400006C]
  7. Health and Medical Research Fund (Hong Kong)

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BackgroundThe initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. MethodsWe collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. ResultsAmong the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). ConclusionsOn the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.) The authors provide an epidemiologic analysis of the first 425 confirmed cases of infection with the novel coronavirus in Wuhan, China. This analysis provides estimates of the epidemic doubling time and the basic reproductive number and shows clear evidence of sustained human-to-human transmission.

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