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COVID-19 Outbreak Among College Students After a Spring Break Trip to Mexico – Austin, Texas, March 26-April 5, 2020

Our take —

This study was an outbreak investigation of cases in Austin, Texas, United States, associated with travel for a spring break trip to Cabo San Lucas, Mexico, from March 14 to 19, 2020. Contact tracing was conducted to identify additional cases as well as establish control measures to prevent future onward transmission. RT-PCR testing was conducted to identify cases. Among 231 tested through the investigation, 28% overall tested positive for SARS-CoV-2, and among the 183 Cabo San Lucas travelers 33% tested positive. Of the 64 cases identified, 22% were asymptomatic and 78% were symptomatic at the time of testing. These data provide further evidence of the susceptibility of young adults to COVID-19 and potential for large outbreaks within this age group.

Study design

Other

Study population and setting

This study was an outbreak investigation of cases associated with a confirmed case of COVID-19 among students in Austin, Texas, United States, with the first case identified on March 28, 2020. Contact tracing was conducted to identify additional cases as well as establish control measures to prevent future onward transmission. Contract tracing linked infections to a spring break trip to Cabo San Lucas, Mexico, from March 14 to 19, 2020. SARS-CoV-2 reverse transcription–polymerase chain reaction (RT-PCR) testing was conducted to identify cases among those recommended for testing.

Summary of Main Findings

Among 298 persons identified during the investigation, 289 (97%) were interviewed. Among those tested (n=231), 28% (n=64) tested positive for SARS-CoV-2. Among the 183 Cabo San Lucas travelers 33% (n=60) tested positive; 8% (1/13) of household contacts of Cabo San Lucas travelers and 9% (3/35) of community contacts of Cabo San Lucas travelers tested positive. Of cases identified, 22% (n=14) were asymptomatic and 78% (n=50) were symptomatic at the time of testing. No identified cases were hospitalized or died. No differences were observed in smoking status among persons with positive and negative test results.

Study Strengths

Contact tracing was used to actively identify individuals with potential exposure.

Limitations

The study did not distinguish between pre-symptomatic and asymptomatic cases, and therefore may be subject to misclassification bias. Missing data was present, with 17% missing underlying health conditions and smoking status, and 14% on symptom presentation. Most individuals were only tested once during the investigation, and therefore infection results are subject to test limitations or stage of infection.

Value added

Outbreak investigation of a cluster associated with travel among a young group of students provides insights on transmission among young adults.

This review was posted on: 12 August 2020