Patterns of Virus Exposure and Presumed Household Transmission among Persons with Coronavirus Disease, United States, January–April 2020

Burke, Rachel M.; Calderwood, Laura; Killerby, Marie E.; Ashworth, Candace E.; Berns, Abby L.; Brennan, Skyler; Bressler, Jonathan M.; Morano, Laurel Harduar; Lewis, Nathaniel M.; Markus, Tiffanie M.; Newton, Suzanne M.; Read, Jennifer S.; Rissman, Tamara; Taylor, Joanne; Tate, Jacqueline E.; Midgley, Claire M.

We characterized common exposures reported by a convenience sample of 202 US patients with coronavirus disease during January–April 2020 and identified factors associated with presumed household transmission. The most commonly reported settings of known exposure were households and healthcare facilities; among case-patients who had known contact with a confirmed case-patient compared with those who did not, healthcare occupations were more common. Among case-patients without known contact, use of public transportation was more common. Within the household, presumed transmission was highest from older (>65 years) index case-patients and from children to parents, independent of index case-patient age. These findings may inform guidance for limiting transmission and emphasize the value of testing to identify community-acquired infections.