Territorywide Study of Early Coronavirus Disease Outbreak, Hong Kong, China

Emerg Infect Dis. 2021 Jan;27(1):196-204. doi: 10.3201/eid2701.201543.

Abstract

Initial cases of coronavirus disease in Hong Kong were imported from mainland China. A dramatic increase in case numbers was seen in February 2020. Most case-patients had no recent travel history, suggesting the presence of transmission chains in the local community. We collected demographic, clinical, and epidemiologic data from 50 patients, who accounted for 53.8% of total reported case-patients as of February 28, 2020. We performed whole-genome sequencing to determine phylogenetic relationship and transmission dynamics of severe acute respiratory syndrome coronavirus 2 infections. By using phylogenetic analysis, we attributed the community outbreak to 2 lineages; 1 harbored a common mutation, Orf3a-G251V, and accounted for 88.0% of the cases in our study. The estimated time to the most recent common ancestor of local coronavirus disease outbreak was December 24, 2019, with an evolutionary rate of 3.04 × 10-3 substitutions/site/year. The reproduction number was 1.84, indicating ongoing community spread.

Keywords: COVID-19; China; Hong Kong; SARS-CoV-2; clinical demographic; community outbreak; molecular evolutionary analysis; molecular phylogeny; novel coronavirus; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; whole genome sequencing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • COVID-19 / transmission
  • COVID-19 / virology*
  • Cluster Analysis
  • Disease Hotspot
  • Disease Outbreaks*
  • Evolution, Molecular
  • Female
  • Hong Kong / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Phylogeny
  • Phylogeography
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification
  • Viroporin Proteins / genetics
  • Whole Genome Sequencing
  • Young Adult

Substances

  • ORF3a protein, SARS-CoV-2
  • Viroporin Proteins