Two Positive Tests At Interval Of 102 Days With One Negative Defined As SARS-CoV-2 Re-Infection: ICMR Study

Two Positive Tests At Interval Of 102 Days With One Negative Defined As SARS-CoV-2 Re-Infection: ICMR Study

While COVID-19 re-infection is still rarely reported, nonetheless, immunity should not be assumed and public health measures such as physical distancing, hand-hygiene, and use of masks should be followed after recovery from first event of infection, said ICMR study
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Two Positive Tests At Interval Of 102 Days With One -Ve Defined As SARS-CoV-2 Re-Infection: ICMR StudyCurrently, there is no consensus regarding the working definition of COVID-19 re-infection: ICMR
Highlights
  • SARS-CoV-2 re-infection is still a rare phenomenon but concerning: ICMR
  • ICMR's new study has defined COVID-19 re-infections
  • Re-infections means a person testing positive twice after a gap: ICMR

New Delhi: Two positive tests at an interval of at least 102 days with one interim negative test have been defined as SARS-CoV-2 re-infection by Indian scientists for establishing surveillance systems, according to an ICMR (Indian Council of Medical Research) study. But a confirmation of the re-infection will require a whole genome sequencing, it stated. While SARS-CoV-2 re-infection is still a rare phenomenon, Indian scientists have developed an easy-to-use epidemiological definition of re-infection for establishing surveillance systems.

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According to the study ‘SARS-CoV-2 re-infection: development of an epidemiological definition from India’ which has been published by Cambridge in the Epidemiology and Infection journal, an investigation was conducted with the objective to develop an epidemiological case definition of possible SARS CoV-2 re-infection and assess its magnitude in India.

SARS-CoV-2 re-infection is an emerging concern and there is a need to define it, the scientists highlighted. Therefore, working epidemiological case definition for re-infection was developed and its magnitude was explored via archive-based, telephonic survey. The epidemiological case definition for SARS-CoV-2 reinfection was developed from literature review of data on viral kinetics.

Re-infection with SARS CoV-2 was defined as two positive tests at an interval of at least 102 days with one interim negative test. During the archive based, telephonic survey, thirty-eight of the 58 eligible patients could be contacted, with twelve (31.6 per cent) being healthcare workers. Majority of the participants were asymptomatic and had higher Ct value during their first episode.

To conclude, a working epidemiological case definition of SARS CoV-2 re-infection is important to strengthen surveillance. The present investigation contributes to this goal and records reinfection in 4.5 per cent of SARS CoV-2 infected individuals in India, the study stated.

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Taking available evidence into consideration, re-infection with SARS CoV-2 in our study was defined as any individual who tested positive for SARS-CoV-2 on two separate occasions by either molecular tests or rapid antigen test at an interval of at least 102 days with one negative molecular test in between, the study stated.

While SARSCoV-2 re-infection is still a rare phenomenon, there is a need for an epidemiological definition of re-infection for establishing surveillance systems and this study contributes to such goal, it said.

Some respondents in the study had a symptomatic second episode as opposed to the first one. The rate and duration of hospitalisation was not compared as during the initial phase of the pandemic in India all cases were being hospitalized for at least 14 days, irrespective of symptom severity.

Currently, there is no consensus regarding the working definition of re-infection, based only on epidemiological features; a resource intensive method like whole genome sequencing being the only confirmation.

It is not logistically feasible to store the samples of millions of positive cases for future sequencing to identify an important phenomenon like SARS CoV-2 re-infection, the study said.

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Centers for Disease Control and Prevention (CDC) has considered the duration of 90 days between two positive SARS-CoV-2 RNA along with genomic evidence of re-infection as an investigative criterion to understand the phenomenon of reinfection. Both CDC and European CDC suggested the use of genomic evidence for confirmation of reinfection, However, an epidemiological working definition will be more pragmatic and helpful to assess the magnitude of re-infection in most population and resource constrained settings.

While COVID-19 re-infection is still rarely reported, nonetheless, immunity should not be assumed and public health measures such as physical distancing, hand-hygiene, and use of masks should be followed after recovery from first event of infection, the study stated.

Further well-designed cohort studies must be undertaken to understand the natural history of COVID-19, including its immunogenicity, susceptibility to re-infection, antibody dependent enhancement and the severity of re-infections. It may also be suggested that the samples of healthcare workers may be stored for genomic analysis to study suspected COVID-19 reinfections, particularly in resource limited settings as chances of them encountering such events are higher due to potential high-risk occupational exposure.

Also Read: Administer 5-10 Million COVID Vaccine Doses Per Day, Do Genomic Surveillance For Variants: Expert On COVID In India

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

19,89,21,889Cases
6,44,02,340Active
13,02,83,678Recovered
42,35,871Deaths
Coronavirus has spread to 194 countries. The total confirmed cases worldwide are 19,89,21,889 and 42,35,871 have died; 6,44,02,340 are active cases and 13,02,83,678 have recovered as on August 3, 2021 at 3:55 am.

India

3,17,26,507 30,549Cases
4,04,9588,760Active
3,08,96,354 38,887Recovered
4,25,195 422Deaths
In India, there are 3,17,26,507 confirmed cases including 4,25,195 deaths. The number of active cases is 4,04,958 and 3,08,96,354 have recovered as on August 3, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

63,15,063 4,869

78,700 3,650

61,03,325 8,429

1,33,038 90

Kerala

34,25,473 13,984

1,65,834 2,057

32,42,684 15,923

16,955 118

Karnataka

29,08,284 1,285

24,045 123

28,47,627 1,383

36,612 25

Tamil Nadu

25,63,544 1,957

20,385 139

25,09,029 2,068

34,130 28

Andhra Pradesh

19,70,008 1,546

20,582 437

19,36,016 1,968

13,410 15

Uttar Pradesh

17,08,500 24

646 18

16,85,091 42

22,763

West Bengal

15,29,295 575

10,803 171

15,00,331 734

18,161 12

Delhi

14,36,401 51

538 44

14,10,809 95

25,054

Chhattisgarh

10,02,458 236

1,918 1

9,87,012 234

13,528 3

Odisha

9,79,737 1,032

13,318 820

9,60,386 1,785

6,033 67

Rajasthan

9,53,704 16

241 9

9,44,509 25

8,954

Gujarat

8,24,922 22

251 3

8,14,595 25

10,076

Madhya Pradesh

7,91,862 17

132 7

7,81,217 10

10,513

Haryana

7,69,956 14

703 12

7,59,614 25

9,639 1

Bihar

7,24,917 37

401 34

7,14,872 71

9,644

Telangana

6,45,997 591

8,819 54

6,33,371 643

3,807 2

Punjab

5,99,162 32

473 31

5,82,395 63

16,294

Assam

5,68,257 1,275

12,429 213

5,50,534 1,469

5,294 19

Jharkhand

3,47,223 23

239 15

3,41,855 38

5,129

Uttarakhand

3,42,198 37

574 35

3,34,261 71

7,363 1

Jammu And Kashmir

3,21,725 118

1,254 43

3,16,090 73

4,381 2

Himachal Pradesh

2,06,369 208

1,304 75

2,01,543 132

3,522 1

Goa

1,71,295 90

1,027 16

1,67,118 72

3,150 2

Puducherry

1,21,059 54

944 38

1,18,320 92

1,795

Manipur

99,872 541

9,814 591

88,480 1,120

1,578 12

Tripura

79,026 304

3,104 12

75,167 292

755

Meghalaya

65,939 350

5,843 200

58,987 537

1,109 13

Chandigarh

61,960 6

33 3

61,116 3

811

Arunachal Pradesh

48,565 305

3,508 167

44,823 469

234 3

Mizoram

40,111 748

12,316 127

27,642 618

153 3

Nagaland

28,004 59

1,300 44

26,130 99

574 4

Sikkim

26,880 126

3,323 131

23,211 256

346 1

Ladakh

20,345 5

57 0

20,081 5

207

Dadra And Nagar Haveli

10,650

15 9

10,631 9

4

Lakshadweep

10,207 12

79 4

10,078 8

50

Andaman And Nicobar Islands

7,539

6 1

7,404 1

129

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