Unravelling the modes of transmission of SARS-CoV-2 during a nursing home outbreak: looking beyond the church super-spread event.
Identifieur interne : 000029 ( Main/Exploration ); précédent : 000028; suivant : 000030Unravelling the modes of transmission of SARS-CoV-2 during a nursing home outbreak: looking beyond the church super-spread event.
Auteurs : Helene A C M. Voeten [Pays-Bas] ; Reina S. Sikkema [Pays-Bas] ; Marjolein Damen [Pays-Bas] ; Bas B. Oude Munnink [Pays-Bas] ; Carla Arends [Pays-Bas] ; Ellen Stobberingh [Pays-Bas] ; Ellen Hoogervorst [Pays-Bas] ; Marion P G. Koopmans [Pays-Bas] ; Ewout Fanoy [Pays-Bas]Source :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2020.
Abstract
BACKGROUND
An outbreak of COVID-19 in a nursing home in the Netherlands, following an on-site church service held on March 8 th, 2020, triggered an investigation to unravel sources and chain(s) of transmission.
METHODS
Epidemiological data were collected from registries and through a questionnaire among church attendees. Symptomatic residents and healthcare workers (HCWs) were tested for SARS-CoV-2 by RT-PCR and subjected to whole genome sequencing (WGS). Sequences from a selection of people from the same area were included as community reference.
RESULTS
After the church service, 30 of 39 attendees (77%) developed symptoms; 14 were tested and were positive for COVID-19 (11 residents and 3 non-residents). In the following five weeks, 62 of 300 residents (21%) and 30 of 640 HCWs (5%) tested positive for COVID-19; 21 of 62 residents (34%) died. The outbreak was controlled through a cascade of measures. WGS of samples from residents and HCWs identified a diversity of sequence types, grouped into eight clusters. Seven resident church attendees all were infected with distinct viruses, four of which belonged to two larger clusters in the nursing home.
CONCLUSIONS
Although initial investigation suggested the church service as source of the outbreak, detailed analysis showed a more complex picture, most consistent with widespread regional circulation of the virus in the weeks before the outbreak, and multiple introductions into the nursing home before the visitor ban. The findings underscore the importance of careful outbreak investigations to understand SARS-CoV-2 transmission to develop evidence-based mitigation measures.
DOI: 10.1093/cid/ciaa1664
PubMed: 33119065
PubMed Central: PMC7665385
Affiliations:
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Voeten</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Sikkema, Reina S" sort="Sikkema, Reina S" uniqKey="Sikkema R" first="Reina S" last="Sikkema">Reina S. Sikkema</name><affiliation wicri:level="3"><nlm:affiliation>Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Damen, Marjolein" sort="Damen, Marjolein" uniqKey="Damen M" first="Marjolein" last="Damen">Marjolein Damen</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Microbiology, Maasstad General Hospital, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Maasstad General Hospital, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Oude Munnink, Bas B" sort="Oude Munnink, Bas B" uniqKey="Oude Munnink B" first="Bas B" last="Oude Munnink">Bas B. Oude Munnink</name><affiliation wicri:level="3"><nlm:affiliation>Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Arends, Carla" sort="Arends, Carla" uniqKey="Arends C" first="Carla" last="Arends">Carla Arends</name><affiliation wicri:level="1"><nlm:affiliation>Het Van Weel-Bethesda General Hospital, CuraMare, Dirksland, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Het Van Weel-Bethesda General Hospital, CuraMare, Dirksland</wicri:regionArea><wicri:noRegion>Dirksland</wicri:noRegion></affiliation></author><author><name sortKey="Stobberingh, Ellen" sort="Stobberingh, Ellen" uniqKey="Stobberingh E" first="Ellen" last="Stobberingh">Ellen Stobberingh</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Hoogervorst, Ellen" sort="Hoogervorst, Ellen" uniqKey="Hoogervorst E" first="Ellen" last="Hoogervorst">Ellen Hoogervorst</name><affiliation wicri:level="1"><nlm:affiliation>Het Van Weel-Bethesda General Hospital, CuraMare, Dirksland, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Het Van Weel-Bethesda General Hospital, CuraMare, Dirksland</wicri:regionArea><wicri:noRegion>Dirksland</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Nieuw Rijsenburgh, CuraMare, Sommelsdijk, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Nieuw Rijsenburgh, CuraMare, Sommelsdijk</wicri:regionArea><wicri:noRegion>Sommelsdijk</wicri:noRegion></affiliation></author><author><name sortKey="Koopmans, Marion P G" sort="Koopmans, Marion P G" uniqKey="Koopmans M" first="Marion P G" last="Koopmans">Marion P G. Koopmans</name><affiliation wicri:level="3"><nlm:affiliation>Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Fanoy, Ewout" sort="Fanoy, Ewout" uniqKey="Fanoy E" first="Ewout" last="Fanoy">Ewout Fanoy</name><affiliation wicri:level="3"><nlm:affiliation>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author></analytic><series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title><idno type="eISSN">1537-6591</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>An outbreak of COVID-19 in a nursing home in the Netherlands, following an on-site church service held on March 8 th, 2020, triggered an investigation to unravel sources and chain(s) of transmission.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Epidemiological data were collected from registries and through a questionnaire among church attendees. Symptomatic residents and healthcare workers (HCWs) were tested for SARS-CoV-2 by RT-PCR and subjected to whole genome sequencing (WGS). Sequences from a selection of people from the same area were included as community reference.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>After the church service, 30 of 39 attendees (77%) developed symptoms; 14 were tested and were positive for COVID-19 (11 residents and 3 non-residents). In the following five weeks, 62 of 300 residents (21%) and 30 of 640 HCWs (5%) tested positive for COVID-19; 21 of 62 residents (34%) died. The outbreak was controlled through a cascade of measures. WGS of samples from residents and HCWs identified a diversity of sequence types, grouped into eight clusters. Seven resident church attendees all were infected with distinct viruses, four of which belonged to two larger clusters in the nursing home.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Although initial investigation suggested the church service as source of the outbreak, detailed analysis showed a more complex picture, most consistent with widespread regional circulation of the virus in the weeks before the outbreak, and multiple introductions into the nursing home before the visitor ban. The findings underscore the importance of careful outbreak investigations to understand SARS-CoV-2 transmission to develop evidence-based mitigation measures.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33119065</PMID><DateRevised><Year>2020</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Oct</Month><Day>29</Day></PubDate></JournalIssue><Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title><ISOAbbreviation>Clin Infect Dis</ISOAbbreviation></Journal><ArticleTitle>Unravelling the modes of transmission of SARS-CoV-2 during a nursing home outbreak: looking beyond the church super-spread event.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">ciaa1664</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/cid/ciaa1664</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">An outbreak of COVID-19 in a nursing home in the Netherlands, following an on-site church service held on March 8 th, 2020, triggered an investigation to unravel sources and chain(s) of transmission.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Epidemiological data were collected from registries and through a questionnaire among church attendees. Symptomatic residents and healthcare workers (HCWs) were tested for SARS-CoV-2 by RT-PCR and subjected to whole genome sequencing (WGS). Sequences from a selection of people from the same area were included as community reference.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">After the church service, 30 of 39 attendees (77%) developed symptoms; 14 were tested and were positive for COVID-19 (11 residents and 3 non-residents). In the following five weeks, 62 of 300 residents (21%) and 30 of 640 HCWs (5%) tested positive for COVID-19; 21 of 62 residents (34%) died. The outbreak was controlled through a cascade of measures. WGS of samples from residents and HCWs identified a diversity of sequence types, grouped into eight clusters. Seven resident church attendees all were infected with distinct viruses, four of which belonged to two larger clusters in the nursing home.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Although initial investigation suggested the church service as source of the outbreak, detailed analysis showed a more complex picture, most consistent with widespread regional circulation of the virus in the weeks before the outbreak, and multiple introductions into the nursing home before the visitor ban. The findings underscore the importance of careful outbreak investigations to understand SARS-CoV-2 transmission to develop evidence-based mitigation measures.</AbstractText><CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Voeten</LastName><ForeName>Helene A C M</ForeName><Initials>HACM</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sikkema</LastName><ForeName>Reina S</ForeName><Initials>RS</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Damen</LastName><ForeName>Marjolein</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medical Microbiology, Maasstad General Hospital, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oude Munnink</LastName><ForeName>Bas B</ForeName><Initials>BB</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arends</LastName><ForeName>Carla</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Het Van Weel-Bethesda General Hospital, CuraMare, Dirksland, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stobberingh</LastName><ForeName>Ellen</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hoogervorst</LastName><ForeName>Ellen</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Het Van Weel-Bethesda General Hospital, CuraMare, Dirksland, the Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Nieuw Rijsenburgh, CuraMare, Sommelsdijk, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koopmans</LastName><ForeName>Marion P G</ForeName><Initials>MPG</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fanoy</LastName><ForeName>Ewout</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>10</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Infect Dis</MedlineTA><NlmUniqueID>9203213</NlmUniqueID><ISSNLinking>1058-4838</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">nursing homes</Keyword><Keyword MajorTopicYN="N">outbreak</Keyword><Keyword MajorTopicYN="N">whole genome sequencing</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>09</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>29</Day><Hour>12</Hour><Minute>12</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33119065</ArticleId><ArticleId IdType="pii">5943000</ArticleId><ArticleId IdType="doi">10.1093/cid/ciaa1664</ArticleId><ArticleId IdType="pmc">PMC7665385</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Pays-Bas</li></country><region><li>Hollande-Méridionale</li></region><settlement><li>Rotterdam</li></settlement></list><tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Voeten, Helene A C M" sort="Voeten, Helene A C M" uniqKey="Voeten H" first="Helene A C M" last="Voeten">Helene A C M. 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Oude Munnink</name><name sortKey="Sikkema, Reina S" sort="Sikkema, Reina S" uniqKey="Sikkema R" first="Reina S" last="Sikkema">Reina S. Sikkema</name><name sortKey="Stobberingh, Ellen" sort="Stobberingh, Ellen" uniqKey="Stobberingh E" first="Ellen" last="Stobberingh">Ellen Stobberingh</name><name sortKey="Voeten, Helene A C M" sort="Voeten, Helene A C M" uniqKey="Voeten H" first="Helene A C M" last="Voeten">Helene A C M. Voeten</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Wicri/explor/CovidPublicV1/Data/Main/Exploration
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Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000029 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Wicri
|area= CovidPublicV1
|flux= Main
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|texte= Unravelling the modes of transmission of SARS-CoV-2 during a nursing home outbreak: looking beyond the church super-spread event.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:33119065" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidPublicV1
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