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A hospital cluster of COVID-19 associated with a SARS-CoV-2 superspreading event.
Huang, Po-Yen; Wu, Ting-Shu; Cheng, Chun-Wen; Chen, Chih-Jung; Huang, Chung-Guei; Tsao, Kuo-Chien; Lin, Chun-Sui; Chung, Ting-Ying; Lai, Chi-Chun; Yang, Cheng-Ta; Chen, Yi-Ching; Chiu, Cheng-Hsun.
  • Huang PY; Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Wu TS; Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Cheng CW; Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Chen CJ; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
  • Huang CG; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University College of Medicine, Taoyuan, Taiwan; Research Center for Emerging Viral Infections, Chang Gu
  • Tsao KC; Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, Chang Gung University College of Medicine, Taoyuan, Taiwan; Research Center for Emerging Viral Infections, Chang Gu
  • Lin CS; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Chung TY; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Lai CC; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
  • Yang CT; Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
  • Chen YC; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Chiu CH; Infection Control Committee, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial
J Microbiol Immunol Infect ; 55(3): 436-444, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1336662
ABSTRACT
BACKGROUND/

PURPOSE:

Superspreading events (SSEs) are pivotal in the spread of SARS-CoV-2. This study aimed to investigate an SSE of COVID-19 in a hospital and explore the transmission dynamics and heterogeneity of SSE.

METHODS:

We performed contact tracing for all close contacts in a cluster. We did nasopharyngeal or throat swabbing for SARS-CoV-2 by real-time RT-PCR. Environmental survey was performed. The epidemiological and clinical characteristics of the SSE were studied.

RESULTS:

Patient 1 with congestive heart failure and cellulitis, who had onset of COVID-19 two weeks after hospitalization, was the index case. Patient 1 led to 8 confirmed cases, including four health care workers (HCW). Persons tested positive for SARS-CoV-2 were HCW (n = 4), patient 1's family (n = 2), an accompanying person of an un-infected in-patient (n = 1), and an in-patient admitted before the SSE (n = 1). The attack rate among the HCW was 3.2 % (4/127). Environmental survey confirmed contamination at the bed rails, mattresses, and sink in the room patient 1 stayed, suggesting fomite transmission. The index case's sputum remained positive on illness day 35. Except one asymptomatic patient, at least three patients acquired the infection from the index case at the pre-symptomatic period. The effective reproduction number (Rt) was 0.9 (8/9).

CONCLUSION:

The host factor (heart failure, longer viral shedding), transmissibility of SARS-CoV-2 (Rt, pre-symptomatic transmission), and possible multiple modes of transmission altogether contributed to the SSE. Rapid response and advance deployment of multi-level protection in hospitals could mitigate COVID-19 transmission to one generation, thereby reducing its impact on the healthcare system.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Microbiol Immunol Infect Journal subject: Allergy and Immunology / Microbiology Year: 2022 Document Type: Article Affiliation country: J.jmii.2021.07.006

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Microbiol Immunol Infect Journal subject: Allergy and Immunology / Microbiology Year: 2022 Document Type: Article Affiliation country: J.jmii.2021.07.006