Transmission Dynamics and Rare Clustered Transmission Within an Urban University Population Before Widespread Vaccination

Jacquelyn Turcinovic, Kayla Kuhfeldt, Madison Sullivan, Lena Landaverde, Judy T. Platt, Yuriy O. Alekseyev, Lynn Doucette-Stamm, Davidson H. Hamer, Catherine Klapperich, Hannah E. Landsberg, John H. Connor

Research output: Contribution to journalArticlepeer-review


Background. Universities returned to in-person learning in 2021 while SARS-CoV-2 spread remained high. At the time, it was not clear whether in-person learning would be a source of disease spread. Methods. We combined surveillance testing, universal contact tracing, and viral genome sequencing to quantify introductions and identify likely on-campus spread. Results. Ninety-one percent of viral genotypes occurred once, indicating no follow-on transmission. Less than 5% of introductions resulted in >3 cases, with 2 notable exceptions of 40 and 47 cases. Both partially overlapped with outbreaks defined by contact tracing. In both cases, viral genomics eliminated over half the epidemiologically linked cases but added an equivalent or greater number of individuals to the transmission cluster. Conclusions. Public health interventions prevented within-university transmission for most SARS-CoV-2 introductions, with only 2 major outbreaks being identified January to May 2021. The genetically linked cases overlap with outbreaks identified by contact tracing; however, they persisted in the university population for fewer days and rounds of transmission than estimated via contact tracing. This underscores the effectiveness of test-trace-isolate strategies in controlling undetected spread of emerging respiratory infectious diseases. These approaches limit follow-on transmission in both outside-in and internal transmission conditions.

Original languageEnglish (US)
Pages (from-to)485-492
Number of pages8
JournalJournal of Infectious Diseases
Issue number2
StatePublished - Feb 15 2024
Externally publishedYes


  • epidemiology
  • SARS-CoV-2
  • viral genomics

ASJC Scopus subject areas

  • General Medicine


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