Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence in Blood in a Large School Community Subject to a Coronavirus Disease 2019 Outbreak: A Cross-sectional Study.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
15 07 2021
Historique:
received: 12 06 2020
accepted: 07 07 2020
pubmed: 11 7 2020
medline: 21 7 2021
entrez: 11 7 2020
Statut: ppublish

Résumé

A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak affecting 52 people from a large school community in Santiago, Chile, was identified (12 March) 9 days after the first case in the country. We assessed the magnitude of the outbreak and the role students and staff played using self-administered antibody detection tests and a self-administered survey. The school was closed on 13 March, and the entire community was placed under quarantine. We implemented a home-delivery, self-administered, immunoglobin (Ig) G/IgM antibody test and survey to a classroom-stratified sample of students and all staff from 4-19 May. We aimed to determine the overall seroprevalence rates by age group, reported symptoms, and contact exposure, and to explore the dynamics of transmission. The antibody positivity rates were 9.9% (95% confidence interval [CI], 8.2-11.8) for 1009 students and 16.6% (95% CI, 12.1-21.9) for 235 staff. Among students, positivity was associated with a younger age (P = .01), a lower grade level (P = .05), prior real-time polymerase chain reaction (RT-PCR) positivity (P = .03), and a history of contact with a confirmed case (P < .001). Among staff, positivity was higher in teachers (P = .01) and in those previously RT-PCR positive (P < .001). Excluding RT-PCR-positive individuals, antibody positivity was associated with fever in adults and children (P = .02 and P = .002, respectively), abdominal pain in children (P = .001), and chest pain in adults (P = .02). Within antibody-positive individuals, 40% of students and 18% of staff reported no symptoms (P = .01). Teachers were more affected during the outbreak and younger children were at a higher risk for infection, likely because index case(s) were teachers and/or parents from the preschool. Self-administered antibody testing, supervised remotely, proved to be a suitable and rapid tool. Our study provides useful information for school reopenings.

Sections du résumé

BACKGROUND
A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak affecting 52 people from a large school community in Santiago, Chile, was identified (12 March) 9 days after the first case in the country. We assessed the magnitude of the outbreak and the role students and staff played using self-administered antibody detection tests and a self-administered survey.
METHODS
The school was closed on 13 March, and the entire community was placed under quarantine. We implemented a home-delivery, self-administered, immunoglobin (Ig) G/IgM antibody test and survey to a classroom-stratified sample of students and all staff from 4-19 May. We aimed to determine the overall seroprevalence rates by age group, reported symptoms, and contact exposure, and to explore the dynamics of transmission.
RESULTS
The antibody positivity rates were 9.9% (95% confidence interval [CI], 8.2-11.8) for 1009 students and 16.6% (95% CI, 12.1-21.9) for 235 staff. Among students, positivity was associated with a younger age (P = .01), a lower grade level (P = .05), prior real-time polymerase chain reaction (RT-PCR) positivity (P = .03), and a history of contact with a confirmed case (P < .001). Among staff, positivity was higher in teachers (P = .01) and in those previously RT-PCR positive (P < .001). Excluding RT-PCR-positive individuals, antibody positivity was associated with fever in adults and children (P = .02 and P = .002, respectively), abdominal pain in children (P = .001), and chest pain in adults (P = .02). Within antibody-positive individuals, 40% of students and 18% of staff reported no symptoms (P = .01).
CONCLUSIONS
Teachers were more affected during the outbreak and younger children were at a higher risk for infection, likely because index case(s) were teachers and/or parents from the preschool. Self-administered antibody testing, supervised remotely, proved to be a suitable and rapid tool. Our study provides useful information for school reopenings.

Identifiants

pubmed: 32649743
pii: 5869860
doi: 10.1093/cid/ciaa955
pmc: PMC7454451
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

e458-e465

Subventions

Organisme : Universidad de Chile
Organisme : Max Oemick
Organisme : Uber Flash Company

Informations de copyright

© 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.

Auteurs

Juan Pablo Torres (JP)

Departamento de Pediatría Oriente, Facultad de Medicina, Universidad de Chile, Providencia, Santiago, Chile.

Cecilia Piñera (C)

Departamento de Pediatría Sur, Facultad de Medicina, Universidad de Chile, San Miguel, Santiago, Chile.

Verónica De La Maza (V)

Dirección de Innovación, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile.

Anne J Lagomarcino (AJ)

Dirección de Innovación, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile.

Daniela Simian (D)

Subdirección de Investigación, Dirección Académica, Clínica Las Condes, Las Condes, Santiago, Chile.

Bárbara Torres (B)

Dirección de Innovación, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile.

Cinthya Urquidi (C)

Departamento de Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Los Andes, Las Condes, Santiago, Chile.

María Teresa Valenzuela (MT)

Departamento de Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Los Andes, Las Condes, Santiago, Chile.

Miguel O'Ryan (M)

Programa de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Independencia, Santiago, Chile.
Millenium Institute of Immunology and Immunotherapy, Faculty of Medicine, University of Chile, Santiago, Chile.

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