Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom.

COVID-19 SARS-CoV-2 IgG novel coronavirus pandemic

Journal

Journal of infection prevention
ISSN: 1757-1774
Titre abrégé: J Infect Prev
Pays: England
ID NLM: 101469725

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 11 06 2020
accepted: 26 10 2020
entrez: 23 7 2021
pubmed: 24 7 2021
medline: 24 7 2021
Statut: ppublish

Résumé

We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility. A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence. Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff. To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.

Sections du résumé

BACKGROUND BACKGROUND
We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility.
METHODOLOGY METHODS
A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence.
RESULTS RESULTS
Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff.
CONCLUSION CONCLUSIONS
To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.

Identifiants

pubmed: 34295376
doi: 10.1177/1757177420976798
pii: 10.1177_1757177420976798
pmc: PMC8274135
doi:

Types de publication

Journal Article

Langues

eng

Pagination

156-161

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Références

Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
Lancet. 2020 May 2;395(10234):e77-e78
pubmed: 32333843
Lancet Infect Dis. 2020 Aug;20(8):911-919
pubmed: 32353347
J Microbiol Immunol Infect. 2021 Feb;54(1):12-16
pubmed: 32425996

Auteurs

Kordo Saeed (K)

Microbiology Innovation and Research Unit (MIRU), Department of Microbiology, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.
Department of Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK.

Emanuela Pelosi (E)

Southampton Specialist Virology Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Nitin Mahobia (N)

Microbiology Innovation and Research Unit (MIRU), Department of Microbiology, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Nicola White (N)

Southampton Specialist Virology Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Christopher Labdon (C)

Southampton Specialist Virology Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Nusreen Ahmad-Saeed (N)

Southampton Specialist Virology Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Ashley Grieves (A)

Microbiology Innovation and Research Unit (MIRU), Department of Microbiology, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Penelope Johnstone (P)

Southampton Specialist Virology Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

David Higgs (D)

Trauma and Orthopaedics Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Sarah Jeramiah (S)

Infection Prevention Department, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Sue Dailly (S)

Infection Prevention Department, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Thelma Henderson (T)

Nuffield Health, Wessex Hospital, Southampton, UK.

Mary Stringfellow (M)

Nuffield Health, Wessex Hospital, Southampton, UK.

Eleri Wilson-Davies (E)

Southampton Specialist Virology Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Paul Grundy (P)

Wessex Neurological Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton School of Medicine, Southampton, UK.

Classifications MeSH