A COVID-19 outbreak that infected 11 people across four states began with a 13-year-old girl who transmitted the virus during a three-week family vacation over the summer, according to a Centers for Disease Control report.
In Illinois - one of the states involved - a Cook County Department of Public Health spokeswoman said that the community where some of the family members live is not currently at risk from this particular outbreak, which occurred months ago.
But the case shows that kids and teens can contract and spread the virus, public health experts say. It also serves as a cautionary tale before the holiday season, a traditional time for many large family get-togethers.
"(The) outbreak highlights several important issues that are good to review before the holidays., a Cook County Department of Public Health spokeswoman said in an email.
The CDC noted that the case underscores the risk of exposure during gatherings, as well as the benefits of social distancing.
“SARS-CoV-2 (the virus that causes COVID-19) can spread efficiently during gathering, especially with prolonged, close contact,” the CDC report said. “Physical distancing, face mask use and hand hygiene reduce transmission; gatherings should be avoided when physical distancing and face mask use are not possible.”
The three-week family gathering involved five households from four states, according to the CDC report, which was released earlier this month. The report in a footnote mentioned public health departments in Rhode Island, Massachusetts, Illinois and Georgia; it did not give any other information about where the family gathering took place or the states where various relatives lived.
The report said the initial patient, a 13-year-old girl, was exposed to COVID-19 during a large outbreak in June. A rapid antigen test four days after her exposure came back negative, before her symptoms began. Two days later she had some nasal congestion, her only symptom. That day she traveled with her parents and two brothers to attend a large family gathering, which began the following day, according to the CDC report.
She was one of 14 relatives ranging in age from 9 to 72 who shared a five-bedroom, two-bathroom home for eight to 25 days, the report said. The relatives did not wear face masks or practice physical distancing, according to the report.
Eleven other family members contracted the virus; one was hospitalized and another went to the emergency room for treatment of respiratory symptoms, but both recovered, according to the report.
“This outbreak highlights several important issues,” the report said. “First, children and adolescents can serve as the source for COVID-19 outbreaks within families, even when their symptoms are mild. Better understanding of transmission by children and adolescents in different settings is needed to refine public health guidance.”
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Six additional family members did not stay at the home but did visit on different occasions, maintaining physical distance from relatives from other households. None of those individuals developed symptoms, and four tested negative for the virus, the CDC found.
“None of the six family members who maintained outdoor physical distance without face masks during two visits to the family gathering developed symptoms; the four who were tested for SARS-CoV-2 had negative test results,” according to the report.
Local public health experts added that the report shows the importance of isolating after possible exposure to the virus, even if a COVID-19 test comes back negative. Rapid antigen tests in particular tend to have a lower sensitivity compared to nasal swab and saliva tests, and negative tests should be confirmed with other forms of testing when there’s a high probability of infection, such as known exposure, the CDC report noted.
“Regardless of negative test results, persons should self-quarantine for 14 days after a known exposure or after travel when mandated by state, territorial, tribal or local authorities,” the Cook County Public Health Department said.
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