Characteristics of Household Transmission of COVID-19 during Its Outbreak in Okinawa, Japan from February to May 2020

The Okinawa prefecture confirmed 142 cases of coronavirus disease from February 14 to May 2020. Among them, 78 were the first cases of a household with 174 household contacts. Of the 174 contacts, 21 contracted the disease, indicating a secondary attack rate of 12.1% (95% confidence interval [CI] 7.6-17.9%). No significant differences were observed in the demographics and quantitative reverse transcription-polymerase chain reaction test results between the first cases that became the sources of infection to the household members. The secondary attack rates with respect to the various characteristics of the household members were significantly different: aged >69 years (40.9% [95% CI 20.7-63.6%]) and those with underlying diseases (36.0% [95% CI 18.0-57.5%]). When the period from the onset to isolation of the first household case was within 3 days, the secondary attack rate was low (4.5% [95% CI 0.1-22.8%]). Among the 21 secondary cases, 11 (52.4%) developed within 5 days of symptom onset in the first case within the same household. This indicates that secondary infection within the household occurred immediately after symptom onset in the first case. Therefore, isolation of a suspected patient can help reduce secondary household infections.