RESEARCH ARTICLE


Analysis of a Typical COVID-19 Outbreak Spread by Tourist Groups



Ling Zheng1, #, Jinxi Yao2, #, Yunhui Yu1, Bo Wang1, Bin Luo1, *
1 School of Public Health, Lanzhou University, Gansu 730000, China
2 Gansu Center for Disease Control and Prevention, Gansu 730000, China


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Creative Commons License
© 2022 Zheng et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the School of Public Health, Lanzhou University, 199 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, China; E-mail addresses: luob@lzu.edu.cn
#These authors contributed equally


Abstract

Background:

Novel coronavirus disease (SARS-COV-2 infection or COVID-19) is a respiratory tract infection that has been linked to severe acute respiratory syndrome transmitted particularly through touching and respiration. The purpose of this study is to understand the epidemiological characteristics of COVID-19 cases in a typical tourist-related outbreak and explore the possible route for its transmission.

Methods:

All data and epidemiological survey reports of COVID-19 cases in the outbreak were reported by provincial and urban (county) Centers for Disease Control and Prevention and Health Commissions nationwide from October 16th to November 5th, 2021. The epidemiological survey reports included information on gender, age, source of infection (imported from other provinces or locally acquired), daily life track and itinerary, date of symptom onset, and date of diagnosis. The data were analyzed using descriptive statistical methods, one-way analysis of variance, independent t-test, and Chi-square tests. Histograms and percentage stacked area plots were used to describe the epidemiological characteristics of the outbreaks.

Results:

The COVID-19 outbreak associated with the tourist groups has involved 551 COVID-19 cases, with a median age of 44 years (interquartile range: 30-59 years), gradually spreading from the northwestern region to the national level across 15 provinces of China. One-fifth of the cases (16.0%) had traveled to Ejin Banner, resulting in 68 second-generation cases. We estimated an outbreak on 11 flights and 19 trains, accounting for a total of 27 confirmed cases. In addition, 42 clusters of outbreak cases were also reported to occur, 21 (50.0%) in households and 10 (23.81%) in restaurants. About 106 confirmed cases were related to the gatherings in restaurants. The median incubation period for this COVID-19 outbreak was 7 days (inter-quartile range: 5-10 days).

Conclusion:

The survey results indicated that this COVID-19 outbreak originated in Ejin Banner and was spread by tourist groups, which was a typical infection outbreak promoted by travel. Our results further confirmed that travel needs to be more strictly weighed in pandemics like COVID-19, and people need to pay more attention to the prevention against infectious diseases, particularly when traveling in a tourist group.

Keywords: COVID-19 pandemic, Tourist groups transmission, Clusters, Train transmission, Incubation period, Anti-epidemic measures.