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Congregate work settings are at increased risk for SARS?CoV?2 transmission and predispose to super spreader events. We investigated a COVID?19 outbreak among security guards to identify the risk factors and propose recommendations. We defined a COVID?19 case as a laboratory?confirmed reverse transcription polymerase chain reaction?positive case. We traced the contacts actively and described the cases by time, place, and person. We conducted a case–control study and collected data on potential exposures. We identified 20 (27%) COVID?19 cases among 75 security guards. Among the cases, 17 (85%) were male and 12 (60%) were symptomatic. We recruited all the 20 COVID?19?confirmed cases and 55 COVID?19?negative controls for the case–control study. SARS?CoV?2 infection was higher among those had high?risk exposure (60%, [12/20]) than who did not (16%, [9/55], adjusted odds ratio = 5.9, 95% confidence interval = 1.6?22.1). Having had high?risk exposure with COVID?19 cases led to COVID?19 outbreak among the security guards. We recommended avoiding the activities predisposed to high?risk exposure.
RESUMO
Resumen Introducción: La infección por SARS Cov2 en los niños tiene un comportamiento clínico menos severo que en adultos y por lo tanto menor mortalidad. Esta infección puede afectar neonatos y estos pueden adquirir la infección por trasmisión horizontal, con manifestaciones clínicas variables. Si bien, el neonato hijo de madre positiva para SARS CoV 2 ha sido el de mayor foco de atención, otros neonatos pueden adquirir la infección por casos positivos domiciliarios, sintomáticos o no. Reporte del caso: Recién nacido previamente sano, de 22 días con manifestaciones sistémicas como fiebre, síntomas respiratorios leves y deposiciones liquidas frecuentes, sin moco ni sangre. Sin antecedentes de infecciones en la familia. El tratamiento fue sintomático, con acetaminofén, líquidos endovenosos y con evolución adecuada. Los laboratorios fueron inespecíficos, y se realizó estudio para SARS Cov2 por la pandemia actual. El reporte fue positivo y la familia rechazó realizarse pruebas. Discusión: La infección neonatal por SARS-CoV2 ha sido relacionada con síntomas como fiebre, cuadros respiratorios y gastrointestinales leves, generalmente con noción de contagio de personas sintomáticas o asintomáticas, que pueden ser subestimados. Es posible que el diagnóstico neonatal, sea la señal de adultos asintomáticos. Actualmente, ante los reportes literarios y la pandemia actual, se deberían realizar pruebas a neonatos febriles y con otros síntomas sistémicos. Además de realizar seguimiento a los neonatos afectados.
Abstract Introduction: SARS Cov2 infection in children has a clinical evolution not as severe as in adults and therefore lower mortality. This infection can affect neonates and they can acquire the infection by horizontal transmission, with variable clinical manifestations. Although the neonate born to a mother positive for SARS-CoV 2 has been the one with the greatest focus of attention, other neonates can acquire the infection from positive cases at home, symptomatic or not. Case report: A 22-day-old, previously healthy newborn with systemic manifestations such as fever, mild respiratory symptoms and frequent liquid stools, without mucus or blood. No history of infections in the family. The treatment was symptomatic, with acetaminophen, intravenous fluids and with good evolution. Laboratories were nonspecific, and the study for SARS Cov2 was realized due to the current pandemic. The report was positive and the family refused to carry out tests. Discussion: Neonatal SARS CoV2 infection has been associated with symptoms such as fever, mild respiratory and gastrointestinal symptoms, usually with a positive notion of contagion from symptomatic or asymptomatic people, that can be underestimated.. It is possible that the diagnosis in a neonate could be the alarm on asymptomatic adults. Currently, due to the reported cases and the SARS CoV2 pandemic, newborns with fever and other systemic symptoms should be tested in the neonatal period. On the other hand, perform a follow-up of affected newborns.