Case report of a COVID-19 family cluster originating from a boarding school

Main Article Content

Citra Cesilia
Silvia Sudarmaji
Djatnika Setiabudi
Heda Melinda Nataprawira


Since it was first identified in Wuhan City, Hubei Province, China in December 2019, SARS-CoV-2 has spread to 195 countries and infected more than 8 million people globally. Indonesia, an archipelago consisting of thousands of islands and 34 provinces, has the largest number of confirmed cases and mortality in Southeast Asia. A total of 464 districts/cities in Indonesia have been affected by COVID-19, of which 189 districts/cities are considered to be local transmission areas. Riau Province, located in Sumatra Island, consists of 12 districts/cities with a population of more than 6.8 million. This province has the 1st largest number of COVID-19 cases on Sumatra Island. Currently, more than 3000 childrens have been infected with case fatality rate <0.3% and recovery rate >90%. In May 2020, the public health office of Riau reported that just 34 children were confirmed to have COVID-19, with symptoms varying from asymptomatic to moderate with only a few family clusters identified. During the pandemic, contact tracing is the main approach to detect and isolate sources of infection in order to reduce viral transmission. This method has also been used to control transmission of other respiratory diseases such as tuberculosis (TB), MERS, and SARS. We report here on a familial cluster of COVID-19 in the Meranti Island Regency, which is located 145 km from the city of Pekanbaru (Riau Province). The island can only be reached in four hours by speed boat.

Article Details

How to Cite
Cesilia C, Sudarmaji S, Setiabudi D, Nataprawira H. Case report of a COVID-19 family cluster originating from a boarding school. PI [Internet]. 20Jan.2021 [cited 7Mar.2021];61(1):53-0. Available from:
Case Report
Received 2020-09-27
Accepted 2021-01-20
Published 2021-01-20


1. Dirjen Pencegahan dan Pengendalian Penyakit, Kemenkes RI. Pedoman pencegahan dan pengendalian coronavirus disease (covid-19) revisi ke-4. Jakarta: Kemenkes RI; 2020. p.?
2. Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109:1088-95. DOI: 10.1111/apa.15270.
3. Pan X, Chen D, Xia Y, Wu X, Li T, Ou X, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis. 2020;20:410-1. DOI:10.1016/S1473-3099(20)30114-6.
4. Yang M, Hung P, Wu Y, Peng M, Chao Y, Su W. A three-generation family cluster with COVID-19 infection: should quarantine be prolonged? Public Health. 2020;185:31-3. DOI: 10.1016/j.puhe.2020.05.043.
5. Chen D, Li Y, Deng X, Huang H, Ou X, Lin Y, et al. Four cases from a family cluster were diagnosed as COVID‐19 after 14‐day of quarantine period. J Med Virol. 2020;10.1002:25849. DOI: 10.1002/jmv.25849.
6. Götzinger F, Santiago-garcía B, Noguera-julián A, Lanaspa M, Lancella L, Carducci FIC. Articles COVID-19 in children and adolescents in Europe : a multinational , multicentre cohort study. 2020;653–61.
7. Ji L, Chao S, Wang Y, Li X, Mu X, Lin M, et al. Clinical features of pediatric patients with COVID-19: a report of two family cluster cases. World J Pediatr. 2020;16:267-70. DOI: 10.1007/s12519-020-00356-2.
8. Le H, Nguyen L, Tran D, Do H, Tran H, Le Y, et al. The first infant case of COVID-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health. 2020;4:405-6. DOI: 10.1016/S2352-4642(20)30091-2.
9. Acta Paediatrica. Why is COVID-19 so mild in children ? Acta Paediatr. 2020;1082–3. DOI: 10.1111/apa.15271.
10. Pavel AB, Wu J, Yuval YR. SARS-CoV-2 receptor ACE2 protein expression in serum is significantly associated with age. Eur J Allergy Clin Immunol [Internet]. 2020;(July):1–4. DOI: 10.1111/all.14522.
11. Zitek T. The Appropriate Use of Testing for COVID-19. West J Emerg Med. 2020; DOI: 10.5811/westjem.2020.4.47370.
12. Gp JW, Penny F. Interpreting a covid-19 test result. 2020;1808(May):1–7. Available from: DOI:10.1136/bmj.m1808.
13. Bahreini F, Najafi R, Amini R, Khazaei S, Bashirian S. Reducing False Negative PCR Test for COVID-19. Int J Matern Child Heal AIDS. 2020;9(3):408–10. DOI: 0.21106/ijma.421.
14. Simon AK, Hollander GA, McMichael A. Evolution of the immune system in humans from infancy to old age. Proc R Soc B Biol Sci. 2015;282(1821). DOI:10.1098/rspb.2014.3085.
15. Gezer N. How to deal with COVID-19 pandemic: a radiologic approach. Turk Thorac J. 2020;21:219-20. DOI: 10.5152/TurkThoracJ.2020.20044.
16. La Scola B, Le Bideau M, Andreani J, Hoang VT, Grimaldier C, Colson P, et al. Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards. Eur J Clin Microbiol Infect Dis. 2020;39:1059–61. DOI: 10.1007/s10096-020-03913-9.
17. Academy of Medicine Singapore. Position Statement from the National Centre for Infectious Diseases and the Chapter of Infectious Disease Physicians. 2020. [cited 2020 July 7]. Available from:
18. Agrawal S, Gupta N, Goel A. Evidence based treatment of SARS-CoV2: a narrative review. Turk Thorac J. 2020;21:221-2. DOI: 10.5152/TurkThoracJ.2020.20041.
19. Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The Incubation Period of Coronavirus Disease 2019 ( COVID-19 ) From Publicly Reported Confirmed Cases : Estimation and Application. 2020. DOI: 10.1101/2020.02.02 .20020016.
20. Ansari M, Ahmadi Yousefabad S. Potential threats of COVID-19 on quarantined families. Public Health. 2020;183:1. DOI: 10.1016/j.puhe.2020.04.014.
21. Indonesia M of H. Pedoman Pencegahan dan Pengendalian COVID-19. 2020. 1–214 p
22. Surkova E, Nikolayevskyy V, Drobniewski F. False-positive COVID-19 results : hidden problems and costs. Lancet Respir [Internet]. 2020;8(12):1167–8. Available from:
23. Perhimpunan Dokter Spesialis Mikrobiologi Klinis Indonesia. Apakah arti klinis nilai cycle treshold pada hasil pemeriksaan real time RT-PCR. 2020. [cited 2020 December 22]. Available from: