Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China.

Adult Aged Aged, 80 and over Betacoronavirus / genetics COVID-19 China / epidemiology Coronavirus Infections / epidemiology Disease Outbreaks Family Female Health Personnel Hospitals Humans Infectious Disease Incubation Period Infectious Disease Transmission, Patient-to-Professional / statistics & numerical data Length of Stay Male Middle Aged Pandemics Pneumonia, Viral / epidemiology Reverse Transcriptase Polymerase Chain Reaction SARS-CoV-2 Virus Shedding Whole Genome Sequencing

Journal

The European respiratory journal

ISSN: 1399-3003

Titre abrégé: Eur Respir J

Pays: England

ID NLM: 8803460

Informations de publication

Date de publication:
06 2020

Historique:

received: 04 03 2020

accepted: 08 04 2020

pubmed: 6 5 2020

medline: 13 6 2020

entrez: 6 5 2020

Statut: epublish

Résumé

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members. We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed. Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability. SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.

Sections du résumé

BACKGROUND

METHODS

We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed.

RESULTS

Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability.

CONCLUSIONS

SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.

Identifiants

DOI: 10.1183/13993003.00544-2020 PMID: 32366488 PMC: PMC7236818

pubmed: 32366488

pii: 13993003.00544-2020

doi: 10.1183/13993003.00544-2020

pmc: PMC7236818

pii:

doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Informations de copyright

Déclaration de conflit d'intérêts

Conflict of interest: X. Wang has nothing to disclose. Conflict of interest: Q. Zhou has nothing to disclose. Conflict of interest: Y. He has nothing to disclose. Conflict of interest: L. Liu has nothing to disclose. Conflict of interest: X. Ma has nothing to disclose. Conflict of interest: X. Wei has nothing to disclose. Conflict of interest: N. Jiang has nothing to disclose. Conflict of interest: L. Liang has nothing to disclose. Conflict of interest: Y. Zheng has nothing to disclose. Conflict of interest: L. Ma has nothing to disclose. Conflict of interest: Y. Xu has nothing to disclose. Conflict of interest: D. Yang has nothing to disclose. Conflict of interest: J. Zhang has nothing to disclose. Conflict of interest: B. Yang has nothing to disclose. Conflict of interest: N. Jiang has nothing to disclose. Conflict of interest: T. Deng has nothing to disclose. Conflict of interest: B. Zhai has nothing to disclose. Conflict of interest: Y. Gao has nothing to disclose. Conflict of interest: W. Liu has nothing to disclose. Conflict of interest: X. Bai has nothing to disclose. Conflict of interest: T. Pan has nothing to disclose. Conflict of interest: G. Wang has nothing to disclose. Conflict of interest: Y. Chang has nothing to disclose. Conflict of interest: Z. Zhang has nothing to disclose. Conflict of interest: H. Shi has nothing to disclose. Conflict of interest: W-L. Ma has nothing to disclose. Conflict of interest: Z. Gao has nothing to disclose.

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