CDC says teen gave COVID-19 to 11 relatives across 4 states during a family vacation. Experts see a cautionary tale for holidays

A COVID-19 outbreak that infected 11 people across four states began with a 13-year-old girl who transmitted the virus during a three-week family vacation over the summer, according to a Centers for Disease Control report.

In Illinois — one of the states involved — a Cook County Department of Public Health spokeswoman said that the community where some of the family members live is not currently at risk from this particular outbreak, which occurred months ago.

But the case shows that kids and teens can contract and spread the virus, public health experts say. It also serves as a cautionary tale before the holiday season, a traditional time for many large family get-togethers.

“(The) outbreak highlights several important issues that are good to review before the holidays., a Cook County Department of Public Health spokeswoman said in an email.

The CDC noted that the case underscores the risk of exposure during gatherings, as well as the benefits of social distancing.

“SARS-CoV-2 (the virus that causes COVID-19) can spread efficiently during gathering, especially with prolonged, close contact,” the CDC report said. “Physical distancing, face mask use and hand hygiene reduce transmission; gatherings should be avoided when physical distancing and face mask use are not possible.”

The three-week family gathering involved five households from four states, according to the CDC report, which was released earlier this month. The report in a footnote mentioned public health departments in Rhode Island, Massachusetts, Illinois and Georgia; it did not give any other information about where the family gathering took place or the states where various relatives lived.

The report said the initial patient, a 13-year-old girl, was exposed to COVID-19 during a large outbreak in June. A rapid antigen test four days after her exposure came back negative, before her symptoms began. Two days later she had some nasal congestion, her only symptom. That day she traveled with her parents and two brothers to attend a large family gathering, which began the following day, according to the CDC report.

She was one of 14 relatives ranging in age from 9 to 72 who shared a five-bedroom, two-bathroom home for eight to 25 days, the report said. The relatives did not wear face masks or practice physical distancing, according to the report.

Eleven other family members contracted the virus; one was hospitalized and another went to the emergency room for treatment of respiratory symptoms, but both recovered, according to the report.

“This outbreak highlights several important issues,” the report said. “First, children and adolescents can serve as the source for COVID-19 outbreaks within families, even when their symptoms are mild. Better understanding of transmission by children and adolescents in different settings is needed to refine public health guidance.”

Six additional family members did not stay at the home but did visit on different occasions, maintaining physical distance from relatives from other households. None of those individuals developed symptoms, and four tested negative for the virus, the CDC found.

“None of the six family members

Teen spurs coronavirus outbreak, infects 11 family members

A coronavirus outbreak infecting 11 family members, stemming from a 13-year-old girl, recently prompted an investigation by several state health departments and the Centers for Disease Control and Prevention.

The teen was away from home in June when she was exposed to a large coronavirus outbreak. While she was asymptomatic, a rapid antigen test conducted four days after exposure came back negative, per a new CDC report.


A couple of days later, shortly before accompanying her siblings and parents on a large family vacation, the only symptom the young girl developed was nasal congestion.

A total of 14 relatives, ages ranging from 9 to 72, stayed together for up to three weeks in a five-bedroom house, ignoring masks and social distancing. The CDC says 12 of the 14 family members developed symptoms and had either probable, suspected, or confirmed COVID-19 cases. One person was hospitalized while another sought emergency care for respiratory symptoms, though both recovered.

Another six family members visited the house, but stayed outdoors; four later tested negative and two were not tested.

The 13-year-old girl (or “index patient;” the believed source of infection) later tested positive for COVID-19 antibodies.

The CDC theorized her rapid antigen test returned a false-negative result because it was done before she developed symptoms, adding “the only antigen test that had Food and Drug Administration Emergency Use Authorization at the time was intended for use within the first 5 days of symptoms.”

The CDC says to confirm coronavirus test results with a nasal swab test, RT-PCR given its higher sensitivity and therefore accuracy. (iStock)

The CDC says to confirm coronavirus test results with a nasal swab test, RT-PCR given its higher sensitivity and therefore accuracy. (iStock)


The event emphasizes multiple issues, the CDC wrote.

“Children and adolescents can serve as the source for COVID-19 outbreaks within families, even when their symptoms are mild,” the CDC said. Additionally, the outbreak offers further evidence for “physical distancing as a mitigation strategy to prevent SARS-CoV-2 transmission.”

Third, since rapid antigen tests are generally less sensitive than nasal swabs/RT-PCR testing, the CDC advises confirming negative rapid results with a swab test. The agency called for 14-day self-quarantine following exposure or travel, even if virus tests return negative.

“Finally, SARS-CoV-2 can spread efficiently during gatherings, especially with prolonged, close contact,” the CDC wrote. (On Monday the agency updated its recommendations to acknowledge the potential for infection from airborne transmission, especially in enclosed places with poor ventilation.)

To prevent infection, the CDC advises physical distancing, mask usage, adequate hand hygiene, and avoiding gatherings where physical distancing and mask use aren’t possible.


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A suicidal teen needed help. In Alabama, she found nothing but hurdles

On Sept. 24, 2019, Gina Moses received an unusual phone call from her teenage daughter. The girl was on vacation in Las Vegas and wanted her health insurance information.

When Moses asked why, everything tumbled out: The fight with her boyfriend, the suicide attempt and the trip to the emergency room. She called her mom from the hospital bed.

“She begged me to come get her,” Moses said. “She told me that she just wanted to come home.”

Moses lives in Albertville with her husband and two younger children. Within hours, she was on her way to Nevada.

“I stop and breathe and then pray for my daughter and for our family,” Moses wrote in a journal. “I pray for a safe trip to Vegas. I pray that I handle this in the right way to where it doesn’t affect the little ones.”

Moses and the teen spent the night in the same downtown Las Vegas hotel room where her daughter tried to take her life. When the boyfriend came back, the teen changed her mind about returning to Alabama.

“At that point, I realized just how delusional she was,” Moses said. “It was like she didn’t realize I had just flown all the way across the country to take her home.”

In Alabama, the daughter’s therapist said she would need residential treatment to learn how to subdue self-destructive thoughts. Under Moses’ insurance plan, the family’s out-of-pocket costs capped out at $875.

Then a problem emerged. Although the insurance plan covered residential mental health treatment, Blue Cross Blue Shield of Alabama wouldn’t approve payment for the types of private programs the girl’s therapist recommended.

Her issues mirror those of other insurance customers nationwide who struggle to get access to mental health benefits, in spite of two federal laws passed to make it easier to get coverage. Such challenges have persisted despite rising rates of suicide across the nation and in Alabama.

In Alabama, suicide is the second leading cause of death for people in their teens and early twenties, according to the Alabama Department of Public Health.

Alabama also has the nation’s smallest mental health workforce per capita, according to the United Health Foundation, and the least competitive insurance market. Blue Cross Blue Shield of Alabama covers nearly 3 million people, or 86 percent of the private insurance market in the state, according to the American Medical Association. That leaves Alabamians with few options for care and coverage of life-threatening mental illness.

“Do I think we would have had a second suicide attempt if we had been able to get residential treatment the first time around?” Moses asked. “No. She would have been there six months and she would have been over it.”

Guidelines and gatekeepers

Blue Cross Blue Shield of Alabama uses Kansas-based New Directions Behavioral Health to manage its mental health network and benefits.

New Directions acts as the gatekeeper for several Blue Cross plans, said Meiram Bendat, a California attorney involved in a lawsuit against the company.