{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T21:29:38Z","timestamp":1775078978230,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2025,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Identifying transmission events that trigger epidemic spread is paramount for informing outbreak control. This study characterised the population diffusion patterns of SARS\u2010CoV\u20102 across exposure settings and evaluate their ramifications in epidemic growth.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In Hong Kong, COVID\u201019 clusters delineated through case\u2010based surveillance during the pandemic period were classified into eight exposure settings: residence, home gathering, neighbourhood, workplace (office)\/school, workplace (non\u2010office), daily activity, social activity and healthcare. Diffusion patterns characterised by outbreak size, speed and likelihood of spillover (cases seeding a new cluster) were compared among settings. With different clusters emerging, the lagged effect on effective reproduction number (\n R<\/jats:italic>\n \n t<\/jats:italic>\n <\/jats:sub>\n ) was evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Between January 2020 and January 2022, some 2800 clusters involving 14,202 cases were identified over five epidemic waves precipitated by outbreaks occurring in daily activity (wave I\/III), social activity (wave II\/IV) and neighbourhood (wave V\u2014Omicron). Adjusted for variations by epidemic wave, the largest and fastest spread was observed in neighbourhood, averaging a size of 11.9 and daily generation of 1.18 cases per cluster. Spillover was the most common for social activity clusters with each of which normally breeding 3.73 onward clusters, compared to 0.18 for residential clusters. A cluster emerging in neighbourhood, social activity and daily activity was estimated to raise the\n R<\/jats:italic>\n \n t<\/jats:italic>\n <\/jats:sub>\n by 0.021\u20130.025, 0.013\u20130.024 and 0.008\u20130.015, respectively, on the ensuing 7 days.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Neighbourhood and social activity outbreaks were inclined to induce epidemic spread, warranting the need for prioritised mitigation and targeted implementation of precautionary measures during both epidemics and peak season of respiratory infection.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/irv.70125","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T01:01:00Z","timestamp":1748826060000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Variability in the Population Diffusion Patterns of SARS\u2010CoV\u20102 by Exposure Setting and Its Roles in Driving Epidemic Dynamics"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0756-1658","authenticated-orcid":false,"given":"Chin\u00a0Pok","family":"Chan","sequence":"first","affiliation":[{"name":"S.H. Ho Research Centre for Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngai\u00a0Sze","family":"Wong","sequence":"additional","affiliation":[{"name":"S.H. Ho Research Centre for Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsz\u00a0Ho","family":"Kwan","sequence":"additional","affiliation":[{"name":"S.H. Ho Research Centre for Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eng\u00a0Kiong","family":"Yeoh","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China"},{"name":"Centre for Health Systems & Policy Research The Chinese University of Hong Kong Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shui\u00a0Shan","family":"Lee","sequence":"additional","affiliation":[{"name":"S.H. Ho Research Centre for Infectious Diseases The Chinese University of Hong Kong Hong Kong China"},{"name":"Stanley Ho Centre for Emerging Infectious Diseases The Chinese University of Hong Kong Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2196\/51498"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2022.09.023"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.0589"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ina.12766"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20200213"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2021.08.016"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.7878"},{"key":"e_1_2_9_9_1","unstructured":"\u201cTogether We Fight the Virus! [Internet] \u201d The Government of the Hong Kong Special Administrative Region (2023) [cited 2023 Mar 3] https:\/\/www.coronavirus.gov.hk\/eng\/index.html."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.2020.1556"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1183877"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocab175"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2020.100052"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/09603123.2022.2064438"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2019.100356"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2196\/26645"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41562\u2010021\u201001079\u20108"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1008409"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666\u20105247(23)00005\u20108"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.buildenv.2022.109323"},{"key":"e_1_2_9_21_1","unstructured":"\u201cGovernment Makes \u201cRestriction\u2010Testing Declaration\u201d and Issues Compulsory Testing Notice in Respect of Specified \u201cRestricted Area\u201d in Kwai Chung [Internet] \u201d The Government of the Hong Kong Special Administrative Region (2022) [cited 2023 Mar Apr 1] https:\/\/www.info.gov.hk\/gia\/general\/202201\/22\/P2022012200081.htm?fontSize=1."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.buildenv.2015.09.026"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2005476117"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1112.040949"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19010220"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6945a5"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac158"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad603"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277\u20109536(85)90269\u20102"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11205\u2010022\u201002971\u20100"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100929"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab100"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdae025"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010021\u201002139\u20106"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010023\u201015915\u20101"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab079"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010021\u201027202\u2010x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2023.03.069"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1140\/epjb\/s10051\u2010021\u201000222\u20108"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abb6936"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41541\u2010023\u201000773\u20100"}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.70125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T22:32:16Z","timestamp":1751495536000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.70125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/irv.70125"],"URL":"https:\/\/doi.org\/10.1111\/irv.70125","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/IRV.70125\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.70125\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.70125\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.70125\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.70125\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.70125\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.70125\/v2\/review1","asserted-by":"object"}]},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"value":"1750-2640","type":"print"},{"value":"1750-2659","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2024-11-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70125"}}