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MacCannell, Tara; Batson, Joshua; Bonin, Brandon; Astha, K C; Quenelle, Rebecca; Strong, Betsy; Lin, Wen; Rudman, Sarah L; Dynerman, David; Ayscue, Patrick; Han, George; Kistler, Amy; Villarino, Margarita Elsa; Khoshabian, Rensen; Diep, Melanie; Castillo, Daniel; Afable, Dante; Iqbal, Syeda; Boghos, Maro; Yeddulla, Nagateja; Munoz, Omar; Yamamoto, Emiko; Medrano, Doug; Ludman, Carrie; [...]

Genomic Epidemiology and Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Congregate Healthcare Facilities in Santa Clara County, California

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  • Medientyp: E-Artikel
  • Titel: Genomic Epidemiology and Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Congregate Healthcare Facilities in Santa Clara County, California
  • Beteiligte: MacCannell, Tara; Batson, Joshua; Bonin, Brandon; Astha, K C; Quenelle, Rebecca; Strong, Betsy; Lin, Wen; Rudman, Sarah L; Dynerman, David; Ayscue, Patrick; Han, George; Kistler, Amy; Villarino, Margarita Elsa; Khoshabian, Rensen; Diep, Melanie; Castillo, Daniel; Afable, Dante; Iqbal, Syeda; Boghos, Maro; Yeddulla, Nagateja; Munoz, Omar; Yamamoto, Emiko; Medrano, Doug; Ludman, Carrie; [...]
  • Erschienen: Oxford University Press (OUP), 2022
  • Erschienen in: Clinical Infectious Diseases
  • Sprache: Englisch
  • DOI: 10.1093/cid/ciab553
  • ISSN: 1058-4838; 1537-6591
  • Schlagwörter: Infectious Diseases ; Microbiology (medical)
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Outbreaks of SARS-CoV-2 in long-term care facilities (LTCFs) cause significant morbidity and mortality. Mapping viral transmission within and between facilities by combining genomic sequencing with epidemiologic investigations enables targeting infection-control interventions.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We conducted weekly surveillance of residents and staff in LTCFs in Santa Clara County, California, with ≥1 confirmed COVID-19 case between March and July 2020. Positive samples were referred for whole-genome sequencing. Epidemiological investigations and phylogenetic analyses of the largest outbreaks (&amp;gt;30 cases) were carried out in 6 LTCFs (Facilities A through F).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among the 61 LTCFs in the county, 41 had ≥1 confirmed case during the study period, triggering weekly SARS-CoV-2 testing. The 6 largest outbreaks accounted for 60% of cases and 90% of deaths in LTCFs, although the bed capacity of these facilities represents only 11% of the LTCF beds in the county. Phylogenetic analysis of 196 whole-genome sequences recovered from those facilities showed that each outbreak was monophyletic, with staff and residents sharing a common viral lineage. Outbreak investigations revealed that infected staff members often worked at multiple facilities, and in 1 instance, a staff member infected while working in 1 facility was the likely index case in another.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>We detected a pattern of rapid and sustained transmission after a single introduction of SARS-CoV-2 in 6 large LTCF outbreaks, with staff playing a key role in transmission within and between facilities. Infection control, testing, and occupational policies to reduce exposure and transmission risk for staff are essential components to keeping facility residents safe.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang