Two weeks after Wisconsin’s April 7 election amid the COVID-19 pandemic, it’s unclear if in-person voting led to significant spread of the coronavirus, with recent surges in Dane and Brown counties attributed to other factors and just seven cases in Milwaukee officially linked to voting.

Dane County reported 17 new cases Monday, the largest increase in nearly three weeks. Most of those cases were inmates at the county jail, and no connection to the election has been found, officials said.

In Brown County, health officials said a surge of more than 100 new cases over last weekend includes a cluster of cases at a JBS Packerland meatpacking plant in Green Bay.

In Milwaukee, which has seen about 50 new cases a day the past week, officials identified seven people who appear to have contracted the coronavirus through activities related to the April 7 election.

“We have not yet seen indications of an impact from the election,” state Department of Health Services Secretary Andrea Palm said Monday. “We will continue to monitor that.”

Because of a lag between when people become infected, get sick, see a doctor, get tested and results come back, it can take a lengthy time for such a link to unfold, Palm said.

Most of Dane County’s 17 new cases Monday were at the jail, where officials on Tuesday said four inmates from the same pod in the Public Safety Building jail tested positive over the weekend. That prompted the testing of 22 more inmates, of whom 12 tested positive.

“We have not seen evidence in Dane County of confirmed cases linked to in-person voting,” said Sarah Mattes, spokeswoman for Public Health Madison and Dane County.

That’s likely because of a high number of polling places and high absentee ballot usage in the county, the department said.

Health officials in Brown and Waukesha counties told the State Journal there is no established correlation between an increase of cases and the election. Waukesha County Public Health spokeswoman Linda Wickstrom said the county reviewed confirmed cases who identified as in-person voters and can’t confirm that voting was the exposure that caused their diagnosis.

Shawn Benjamin, a spokesman for the Milwaukee health department, said in an email to The Associated Press that his agency confirmed the seven infections connected to the election there. Commissioner of Health Jeanette Kowalik said six of the cases involve Milwaukee voters and one is a Milwaukee poll worker, the Milwaukee Journal Sentinel reported.

Officials hope to have additional information on the cases by the end of the week, including whether any of them were concentrated in any of the city’s five polling places or if any resulted in death, Kowalik said Monday.

Democratic Gov. Tony Evers’ spokeswoman didn’t respond to an email Tuesday morning seeking comment on the Milwaukee infections.

Election effect?

Public health agencies discover potential links among cases of infectious diseases, such as COVID-19, tuberculosis or foodborne illnesses such as salmonella or norovirus, by interviewing people who become ill or test positive, and asking where they’ve been and who they’ve been in contact with. Through contact tracing, they talk to the contacts and see if they develop symptoms.

If a location or event, such as a restaurant, a party or mass gathering such as the election emerges as a commonality, disease investigators study the possibility, assess other factors and determine if there’s a link.

“Hollywood often depicts this contact investigation process as complicated — think of bulletin boards with hundreds of strings coming off a central patient,” Public Health Madison and Dane County said in a blog post at the beginning of the COVID-19 outbreak in Wisconsin. “While following up with contacts is time intensive, it’s rather straightforward for us. Remember we do this every day for certain communicable diseases!”

Palm said health departments statewide are looking at the election as a possible link among new cases as they would any other potential factor. The state has trained about 150 state employees who typically do other work to become contact tracers and plans to hire another 1,000 contact tracers statewide as part of Evers’ Badger Bounce Back plan to reopen the economy.

Health officials say symptoms of COVID-19 typically appear within two weeks of exposure to the virus, and Tuesday is the 14th day since the election. That means more voters and poll workers could come forward with infections in the coming days.

The coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. As of Tuesday, 242 people have died in Wisconsin and nearly 4,620 have tested positive.

The vote goes on

Wisconsin officials refused to postpone the spring election to protect voters and poll workers from the virus. Evers and Republicans initially agreed that in-person voting should go on as scheduled. Both Evers and the GOP said the ballot included hundreds of local officials whose terms end in April and a delay could leave crucial local offices vacant during the pandemic.

Democrats and their allies ramped up pressure on Evers to postpone the proceedings as Election Day drew near. Evers issued an executive order the day before the election pushing in-person voting back to June, but the conservative-leaning state Supreme Court struck it down within hours. The U.S. Supreme Court reversed a lower court ruling allowing ballots to be mailed in after Election Day, which likely caused more people to vote in person.

Voters who went to the polls in Milwaukee stood in long lines, many for several hours. Many had no protective gear. And thousands of Wisconsin voters stayed home, unwilling to risk their health and unable to be counted because requested absentee ballots never arrived.

Aides for Assembly Speaker Robin Vos and Senate Majority Leader Scott Fitzgerald — both Republicans — didn’t respond to emails Tuesday seeking comment on the seven election-related infections.

Wisconsin’s election has been a flashpoint of contention as Democrats and Republicans grapple with how to conduct elections in the coronavirus era as the November presidential race approaches.

Democrats and voting rights groups have filed lawsuits to expand mail and absentee voting options, and pushed for an extra $2 billion to help states adjust their election systems. National Republicans are fighting those efforts, while President Donald Trump claims without evidence that mail-in voting is vulnerable to fraud.

State Journal reporter Riley Vetterkind and The Associated Press contributed to this report.

Photos: Wisconsinites vote in spring primary despite COVID-19 danger