tetano
Editor, Senior Moderator
Infect Control Hosp Epidemiol
. 2022 Feb 22;1-19.
doi: 10.1017/ice.2022.45. Online ahead of print.
Investigation of a cluster of severe acute respiratory syndrome coronavirus 2 infections in a hospital administration building
Lucas D Jones[SUP] #[/SUP][SUP] 1 [/SUP], Ernest R Chan[SUP] #[/SUP][SUP] 2 [/SUP], Jennifer L Cadnum[SUP] #[/SUP][SUP] 3 [/SUP], Sarah N Redmond[SUP] 4 [/SUP], Maria E Navas[SUP] 5 [/SUP], Trina F Zabarsky[SUP] 6 [/SUP], Elizabeth C Eckstein[SUP] 6 [/SUP], Jeffrey Kovach[SUP] 7 [/SUP], Marlin Linger[SUP] 8 [/SUP], Peter A Zimmerman[SUP] 8 [/SUP], Curtis J Donskey[SUP] 9 10 [/SUP]
Affiliations
Abstract
Objective: To investigate a cluster of coronavirus disease 2019 (COVID-19) 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 COVID-19 during the same period. Carbon dioxide levels were measured during a workday to assess adequacy of ventilation; readings above 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 co-workers 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 the employees denied higher-risk contacts with one another. None of the sequences from the cluster were genetically related to the 17 control SARS-CoV-2 sequences. 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 co-workers. Transmission occurred despite the absence of higher-risk exposures and in a setting with adequate ventilation based on monitoring of carbon dioxide levels.
. 2022 Feb 22;1-19.
doi: 10.1017/ice.2022.45. Online ahead of print.
Investigation of a cluster of severe acute respiratory syndrome coronavirus 2 infections in a hospital administration building
Lucas D Jones[SUP] #[/SUP][SUP] 1 [/SUP], Ernest R Chan[SUP] #[/SUP][SUP] 2 [/SUP], Jennifer L Cadnum[SUP] #[/SUP][SUP] 3 [/SUP], Sarah N Redmond[SUP] 4 [/SUP], Maria E Navas[SUP] 5 [/SUP], Trina F Zabarsky[SUP] 6 [/SUP], Elizabeth C Eckstein[SUP] 6 [/SUP], Jeffrey Kovach[SUP] 7 [/SUP], Marlin Linger[SUP] 8 [/SUP], Peter A Zimmerman[SUP] 8 [/SUP], Curtis J Donskey[SUP] 9 10 [/SUP]
Affiliations
- PMID: 35189996
- DOI: 10.1017/ice.2022.45
Abstract
Objective: To investigate a cluster of coronavirus disease 2019 (COVID-19) 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 COVID-19 during the same period. Carbon dioxide levels were measured during a workday to assess adequacy of ventilation; readings above 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 co-workers 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 the employees denied higher-risk contacts with one another. None of the sequences from the cluster were genetically related to the 17 control SARS-CoV-2 sequences. 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 co-workers. Transmission occurred despite the absence of higher-risk exposures and in a setting with adequate ventilation based on monitoring of carbon dioxide levels.