Spread of infection occurs commonly through large virus containing droplets and aerosols (through coughing, sneezing or talking) and by indirect spread from respiratory secretions on hands, tissues, etc (1,2).
Less commonly it may spread through contaminated fomites. Children play an important role in the spread of the disease within communities and households:
The level of virus shedding is at its lowest before the symptoms starts and continues for 5–10 days after illness onset (peak virus shedding is seen 1 day before onset of symptoms to 3 days after onset) (1).
Few patients may catch the infection and pass it on without showing any symptoms (or with very mild symptoms) (2).
References:
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