A CASE STUDY OF INTRA-FAMILY CLUSTERING OF COVID-19 IN INDIA

Dr. Anita Basavaraj*, Dr. Somanath Magdum, Dr. Vaibhav Lamdhade, Amol Chavan, Dr. Kruteesh Kumar, Dr. Vidya Mave

ABSTRACT

Background: With unprecedented COVID-19 disease-related morbidity and mortality globally, understanding the transmission dynamics of this disease is of paramount importance for disease control efforts. Despite the lockdown in India, there has been reported an ever-increasing number of infected cases, suggesting clustering of cases. As our first 25 cases belonged to a single family we undertook the study with the objective of finding the cluster dynamics by charting the family tree. Methods: We conducted a retrospective case study of twenty-five confirmed COVID-19 disease cases belonging to a single-family in rural Maharashtra, India. Four members of the family returned from foreign travel and developed COVID-19 symptoms and tested positive by RT-PCR of throat swab on day 7 of their travel. A contact investigation of 52 household members revealed 21 new infections and all 24 members of the family were placed in hospital quarantine. Results: Of the 25 cases, 11(44%) were male and 14 (56%) were female; 2 were children. Of the 23 adults, 7 (30%) were asymptomatic at diagnosis while 16 (70%) had only mild symptoms. All were placed on a course of hydroxychloroquine, azithromycin, and oseltamivir; none required intensive care admission. All tested negative on repeated throat swab on day 14 of quarantine and were discharged. Interpretation and Conclusion: Our case study of the intrafamily transmission of COVID-19 in rural Maharashtra highlights how clustering of cases occurs within families that could become a potential source of high transmission. Clustering of cases within families and communities may in part explain the rise in COVID-19 cases despite lockdown in India.

Keywords: COVID-19, clusters, intra-family, transmission.