Investigation of a severe SARS-CoV-2 outbreak in a long-term care home early in the pandemic
| Autor: | Gary Garber, Monika Goetz, Andrea Saunders, Sandra Zittermann, Anne Marie Holt, Nahuel Fittipaldi, Vidya Sunil, Alireza Eshaghi, A. Lynn Noseworthy, Michelle Murti, Jennifer L. Guthrie, Jonathan B. Gubbay, Heather Rilkoff, Sandra Callery, Sarah Teatero |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Psychological intervention Vulnerable Populations 03 medical and health sciences 0302 clinical medicine Case fatality rate Epidemiology Pandemic medicine Infection control Humans 030212 general & internal medicine Pandemics Phylogeny Ontario Infection Control business.industry SARS-CoV-2 Public health Research Outbreak COVID-19 General Medicine Long-Term Care Nursing Homes Long-term care 030104 developmental biology Emergency medicine business |
| Zdroj: | CMAJ : Canadian Medical Association Journal |
| ISSN: | 1488-2329 0820-3946 |
| Popis: | BACKGROUND: The implementation of outbreak management measures has decreased the frequency and severity of SARS-CoV-2 outbreaks in Ontario long-term care homes. We describe the epidemiological and laboratory data from one of the first such outbreaks in Ontario to assess factors associated with its severity, and the impact of progressive interventions for infection control over the course of the outbreak. METHODS: We obtained line list and outbreak data from the public health unit to describe resident and staff cases, severity and distribution of cases over time and within the outbreak facility. Where available, we obtained data on laboratory specimens from the Public Health Ontario Laboratory and performed whole genome sequencing and phylogenetic analysis of viral specimens from the outbreak. RESULTS: Among 65 residents of the long-term care home, 61 (94%) contracted SARS-CoV-2, with a case fatality rate of 45% (28/61). Among 67 initial staff, 34 (51%) contracted the virus and none died. When the outbreak was declared, 12 staff, 2 visitors and 9 residents had symptoms. Resident cases were located in 3 of 4 areas of the home. Phylogenetic analysis showed tight clustering of cases, with only 1 additional strain of genetically distinct SARS-CoV-2 identified from a staff case in the third week of the outbreak. No cases were identified among 26 new staff brought into the home after full outbreak measures were implemented. INTERPRETATION: Rapid and undetected viral spread in a long-term care home led to high rates of infection among residents and staff. Progressive implementation of outbreak measures after the peak of cases prevented subsequent staff cases and are now part of long-term care outbreak policy in Ontario. |
| Databáze: | OpenAIRE |
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