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Investigation of a cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in a hospital administration building.
Jones, Lucas D; Chan, Ernest R; Cadnum, Jennifer L; Redmond, Sarah N; Navas, Maria E; Zabarsky, Trina F; Eckstein, Elizabeth C; Kovach, Jeffrey D; Linger, Marlin; Zimmerman, Peter A; Donskey, Curtis J.
  • Jones LD; Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Chan ER; Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio.
  • Cadnum JL; Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.
  • Redmond SN; Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
  • Navas ME; Pathology and Laboratory Medicine Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.
  • Zabarsky TF; Infection Control Department, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.
  • Eckstein EC; Infection Control Department, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.
  • Kovach JD; Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Linger M; The Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio.
  • Zimmerman PA; The Center for Global Health & Diseases, Case Western Reserve University, Cleveland, Ohio.
  • Donskey CJ; Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio.
Infect Control Hosp Epidemiol ; : 1-7, 2022 Feb 22.
Article in English | MEDLINE | ID: covidwho-1721301
ABSTRACT

OBJECTIVE:

To investigate a cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in employees working on 1 floor of a hospital administration building.

METHODS:

Contact tracing was performed to identify potential exposures and all employees were tested for SARS-CoV-2. Whole-genome sequencing was performed to determine the relatedness of SARS-CoV-2 samples from infected personnel and from control cases in the healthcare system with coronavirus disease 2019 (COVID-19) during the same period. Carbon dioxide levels were measured during a workday to assess adequacy of ventilation; readings >800 parts per million (ppm) were considered an indication of suboptimal ventilation. To assess the potential for airborne transmission, DNA-barcoded aerosols were released, and real-time polymerase chain reaction was used to quantify particles recovered from air samples in multiple locations.

RESULTS:

Between December 22, 2020, and January 8, 2021, 17 coworkers tested positive for SARS-CoV-2, including 13 symptomatic and 4 asymptomatic individuals. Of the 5 cluster SARS-CoV-2 samples sequenced, 3 were genetically related, but these employees denied higher-risk contacts with one another. None of the sequences from the cluster were genetically related to the 17 control sequences of SARS-CoV-2. Carbon dioxide levels increased during a workday but never exceeded 800 ppm. DNA-barcoded aerosol particles were dispersed from the sites of release to locations throughout the floor; 20% of air samples had >1 log10 particles.

CONCLUSIONS:

In a hospital administration building outbreak, sequencing of SARS-CoV-2 confirmed transmission among coworkers. Transmission occurred despite the absence of higher-risk exposures and in a setting with adequate ventilation based on monitoring of carbon dioxide levels.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2022 Document Type: Article