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Presymptomatic, asymptomatic and post-symptomatic transmission of SARS-CoV-2 : joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance
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Mugglestone, Moira A., Ratnaraja, Natasha V., Bak, Aggie, Islam, Jasmin, Wilson, Jennie A., Bostock, Jennifer, Moses, Samuel E., Price, James R., Weinbren, Michael, Loveday, Heather P., Rivett, Lucy, Stoneham, Simon M. and Wilson, A. Peter R. (2022) Presymptomatic, asymptomatic and post-symptomatic transmission of SARS-CoV-2 : joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance. BMC Infectious Diseases, 22 (1). 453. doi:10.1186/s12879-022-07440-0
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WRAP-Presymptomatic-asymptomatic-and-post-symptomatic-transmission-of-SARS-CoV-2-Ratnaraja-22.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (971Kb) | Preview |
Official URL: http://dx.doi.org/10.1186/s12879-022-07440-0
Abstract
This is the second of two guidance articles produced by the British Infection Association (BIA), the Healthcare Infection Society (HIS), the Infection Prevention Society (IPS) and the Royal College of Pathologists (RCPath). Both articles refer to the pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Using evidence that emerged during the first wave of the pandemic, the articles summarise aspects of the transmission dynamics of SARS-CoV-2 and provide guidance on how to reduce the risk of transmission. This article focuses on the risks of presymptomatic, asymptomatic and post-symptomatic SARS-CoV-2 transmission, allowing healthcare workers and the public to understand how transmission occurs and to take action to protect themselves and others. The guidance recognises further waves of the pandemic, the possibility of reinfection, the emergence of new variants of the virus and ongoing immunisation programmes.
Having considered the evidence, the COVID-19 Rapid Guidance Working Party concluded that:
presymptomatic transmission (meaning that an index case has no symptoms during the exposure period of their close contacts, but later develops symptoms) is confirmed
asymptomatic transmission (meaning that an index case never develops symptoms or signs of infection) is probable.
The Working Party was unable to assess the likelihood of post-symptomatic transmission (meaning that an index case has no symptoms during the exposure period of their close contacts, but previously had symptoms) because of an absence of evidence.
The Working Party formulated recommendations for practice taking account of the evidence reviewed. The recommendations were developed for acute healthcare settings (with particular reference to clinical staff and infection prevention and control teams), but they might be useful in other health and care settings such as dental practices and care homes. The Working Party also identified areas for future research.
Recommendations
Be aware that:
people without noticeable symptoms may transmit the SARS-CoV-2 virus to other people
transmission of SARS-CoV-2 from people without symptoms may occur in all settings in which people are in close proximity
however, it is likely that the risk of transmission of SARS-CoV-2 is greater from people who have symptoms compared with those who do not.
Even in the absence of symptoms, adhere to legislation and guidance regarding measures to reduce the risk of transmission of SARS-CoV-2 (such as social distancing, hand hygiene, use of personal protective equipment and ventilation of enclosed spaces).
Be aware that the future transmissibility of SARS-CoV-2 from people carrying the virus without symptoms might depend on the:
nature of further waves or outbreaks of COVID-19
emergence and circulation of SARS-CoV-2 variants of concern
potential for people who have had COVID-19 previously to be reinfected
effectiveness of available vaccines, including the longevity of immunity they confer.
Be aware that it is not yet known to what extent or for how long people recovering from acute infection can transmit the SARS-CoV-2 virus to other people.
| Item Type: | Journal Item | ||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
| Library of Congress Subject Headings (LCSH): | COVID-19 (Disease) , COVID-19 (Disease) -- Etiology, COVID-19 (Disease) -- Transmission -- Prevention | ||||||||
| Journal or Publication Title: | BMC Infectious Diseases | ||||||||
| Publisher: | BioMed Central Ltd. | ||||||||
| ISSN: | 1471-2334 | ||||||||
| Official Date: | 12 May 2022 | ||||||||
| Dates: |
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| Volume: | 22 | ||||||||
| Number: | 1 | ||||||||
| Number of Pages: | 15 | ||||||||
| Article Number: | 453 | ||||||||
| DOI: | 10.1186/s12879-022-07440-0 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 5 July 2022 | ||||||||
| Date of first compliant Open Access: | 6 July 2022 |
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