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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

Is it safe to travel for the holidays in 2020 during the pandemic?

(CNN) — The end of the year is sneaking up, and people are weighing travel plans to join friends and family for the holidays — all against the backdrop of a deadly pandemic.

Gathering with others — probably the most universal holiday tradition — has never required so much meticulous forethought.

Should you travel for the holidays in 2020? What precautions will make it safer? Who will be there and how careful have they been?

CNN spoke with medical experts on how to reduce the risks around holiday travel and when you really should skip it altogether.

Should you travel for the holidays this year?

“Probably not, if you are anxious or vulnerable,” says Dr. Richard Dawood, a travel medicine specialist and director at Fleet Street Clinic in London.

But traveling is fine if you’re willing to be cautious, follow the rules and adapt easily to changes of plan, he said.

There's a lot more to consider when planning holiday travel in 2020.

There’s a lot more to consider when planning holiday travel in 2020.

Daniel Slim/AFP/Getty Images

“I think the threshold for travel at this time should still be higher than before the pandemic,” says Dr. Henry Wu, director of Emory TravelWell Center and associate professor of infectious diseases at Emory University School of Medicine in Atlanta.

“If you do choose to travel, try to keep gatherings small and take precautions,” such as wearing a mask and practicing social distancing and good hand hygiene, Wu said.

Who should skip it?

“Are you older, are you frail, do you have chronic underlying illnesses?” are the questions to ask, says Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, Tennessee.

People who are considering meeting up with vulnerable relatives or friends should really weigh the implications of introducing illness to them, Wu said.

“There are well-documented Covid-19 clusters associated with family gatherings, including ones that resulted in deaths,” he said.

Driving is not without risks,  but your interactions with others can be more easily controlled than with air travel.

Driving is not without risks, but your interactions with others can be more easily controlled than with air travel.

Jason Connolly/AFP/Getty Images

Are some locations safer than others?

Gatherings are likely safer in areas around the world where infections remain low, although the standard precautions still apply.

For example, it may be possible to have a “relatively normal” Thanksgiving gathering in parts of the United States where infections are very low, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“But in other areas of the country … you’d better hold off and maybe just have immediate family,” Fauci told CNN’s Chris Cuomo. As always, wear masks and keep gatherings small to reduce the risk of infection.

“I’d like to say that everything is going to be great by Thanksgiving, but honestly … I’m not so sure it is,” he said.

Does testing provide protection?

Testing can help catch coronavirus infections before travel, Wu said,”but testing is not foolproof.”

“It can be falsely negative, or just miss infections you are still incubating,” he said. “You could certainly also get infected during travel