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Epidemiological Investigation of the First 135 COVID-19 Cases in Brunei: Implications for Surveillance, Control, and Travel Restrictions.
Wong, Justin; Chaw, Liling; Koh, Wee Chian; Alikhan, Mohammad Fathi; Jamaludin, Sirajul Adli; Poh, Wan Wen Patricia; Naing, Lin.
  • Wong J; 1Disease Control Division, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam.
  • Chaw L; 2PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam.
  • Koh WC; 3Centre for Strategic and Policy Studies, Bandar Seri Begawan, Brunei Darussalam.
  • Alikhan MF; 1Disease Control Division, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam.
  • Jamaludin SA; 4Environmental Health Division, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam.
  • Poh WWP; 5Department of Dental Services, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam.
  • Naing L; 2PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei Darussalam.
Am J Trop Med Hyg ; 103(4): 1608-1613, 2020 10.
Article in English | MEDLINE | ID: covidwho-725814
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ABSTRACT
Studies on the early introduction of SARS-CoV-2 in a naive population have important epidemic control implications. We report findings from the epidemiological investigation of the initial 135 COVID-19 cases in Brunei and describe the impact of control measures and travel restrictions. Epidemiological and clinical information was obtained for all confirmed COVID-19 cases, whose symptom onset was from March 9 to April 5, 2020. The basic reproduction number (R0), incubation period, and serial interval (SI) were calculated. Time-varying R was estimated to assess the effectiveness of control measures. Of the 135 cases detected, 53 (39.3%) were imported. The median age was 36 (range = 0.5-72) years. Forty-one (30.4%) and 13 (9.6%) were presymptomatic and asymptomatic cases, respectively. The median incubation period was 5 days (interquartile range [IQR] = 5, range = 1-11), and the mean SI was 5.4 days (SD = 4.5; 95% CI 4.3, 6.5). The reproduction number was between 3.9 and 6.0, and the doubling time was 1.3 days. The time-varying reproduction number (Rt) was below one (Rt = 0.91; 95% credible interval 0.62, 1.32) by the 13th day of the epidemic. Epidemic control was achieved through a combination of public health measures, with emphasis on a test-isolate-trace approach supplemented by travel restrictions and moderate physical distancing measures but no actual lockdown. Regular and ongoing testing of high-risk groups to supplement the existing surveillance program and a phased easing of physical distancing measures has helped maintain suppression of the COVID-19 outbreak in Brunei, as evidenced by the identification of only six additional cases from April 5 to August 5, 2020.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Isolation / Pneumonia, Viral / Communicable Disease Control / Coronavirus Infections / Pandemics / Betacoronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Am J Trop Med Hyg Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Isolation / Pneumonia, Viral / Communicable Disease Control / Coronavirus Infections / Pandemics / Betacoronavirus Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Am J Trop Med Hyg Year: 2020 Document Type: Article