Super-spreader a must for becoming a hot
spot of Corona
Without a super spreader the cases in the
Country may die out of its own
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA
Super-spreader are individual patients who pass on an
infection to large numbers of people and is a feature of nearly every outbreak.
Infact the primary case of every epidemic is a super spreader. China cases in
Wuhan also might have started with a super spreader.
On average, each person infected with the new
coronavirus is passing it on to between two and three other people. But this is
only an average; some people will pass it on to nobody while others pass their
infection on to far more.
In 2015, a super-spreading event led to 82 people
being infected from a single hospital patient with Middle East respiratory
syndrome (Mers).
And in the Ebola epidemic in West Africa, most cases
(61%) came from just a tiny handful of patients (3%).
Some just encounter far more people - either because
of their job or where they live - and that means they can spread more of the
disease, whether they themselves have symptoms. Others are
"super-shedders", who release unusually large amounts of virus (or
other bug) from their bodies, so anybody encountering them is more likely to
become infected.
Hospitals treating severe acute respiratory syndrome
(Sars) became a major centre of super-spreading because the sickest patients
were also the most infectious and they encountered lots of healthcare workers.
It plays a big role at the beginning of any outbreak,
when the virus is trying to get established. When it makes the jump into the
first patient, the disease might fizzle out before it can cause a large
outbreak. But if it can quickly find its way into a super-spreader, then it
gives the outbreak a boost. The same rules apply when cases are imported into
other countries.
"Typhoid Mary", Irish cook Mary Mallon
(1869-1938), unknowingly passed on typhoid fever when she had no symptoms and
ended up spending decades in exile and forced quarantine.
HIV person coinfected with STI becomes a super
spreader.
A heterosexual man
co-infected with HIV, hepatitis C virus, and herpes simplex 2 virus has
unusually high semen HIV RNA levels.
20/80 rule, a small
percentage of individuals within any population was observed to control most
transmission events.
1. China first case looks like was a super spreader
2. The cases in Diamond Princess ship was a case of
super spreader focal outbreak
3. The lady in South Korea cult church was a super spreader.
There were 28
cases of the coronavirus in South Korea on Feb. 13. Four days had passed
without a new confirmed infection. President Moon Jae-in predicted that the
outbreak would “disappear before long,” while the prime minister assured people
that it was OK not to wear surgical masks outdoors. They probably missed the
super spreader possibility. The virus had been rapidly spreading at the time
through a large, secretive
church in Daegu, with the
presence of a super spreader, where it has since mushroomed into the largest
epidemic of the coronavirus outside China, with 1,766 cases, including 13
deaths. Now the president is facing a political backlash over his response as
the number of cases continues to climb — 505 new infections on Thursday alone.
4. Iran
outbreak is possibly from a super spreader
Possibilities of finding super spreaders
1. Person
with lower respiratory corona illness
2. Person
with coronas pneumonia
3. Critically
ill or terminal corona infected patients
4. Immunocompromised
persons with corona infection
5. Person
who have not suffered from any other corona illness in past with non-virulent
strains
6. Rapidly
developing corona illness with very short incubation period
7. Direct
exposure to a super spreader compared to secondary or tertiary cases
8. Co-infection with another pathogen
9. Delayed identification and hospital admission
of a super spreader
In India we got three cases and none of them was a
super spreader. Lots of Afghanis are coming from IRAN, a possible source of
super spreader. And if one super spreader come to India it will create a havoc.
Summary
1. Low
grade transmission: Through a spreader
2. High
grade transmission: through a super spreader, usually will end up with
community spread.
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