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Use of serial testing to interrupt a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) outbreak on a hospital medical floor—Minnesota, October–December 2020

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  28 February 2022

Rajesh M. Prabhu Open the ORCID record for Rajesh M. Prabhu [Opens in a new window] ,
Melanie J. Firestone Open the ORCID record for Melanie J. Firestone [Opens in a new window] ,
Kari L. Bergman ,
Amanda L. Beaudoin ,
Tammy Hale ,
Alexandra J. Lorentz ,
Jacob Garfin ,
Xiong Wang  and
Stacy M. Holzbauer
Rajesh M. Prabhu*
Affiliation:
Essentia Health, Duluth, Minnesota
Melanie J. Firestone
Affiliation:
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia Minnesota Department of Health, St Paul, Minnesota
Kari L. Bergman
Affiliation:
Essentia Health, Duluth, Minnesota
Amanda L. Beaudoin
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Tammy Hale
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Alexandra J. Lorentz
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Jacob Garfin
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Xiong Wang
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Stacy M. Holzbauer
Affiliation:
Minnesota Department of Health, St Paul, Minnesota Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Author for correspondence: Rajesh M. Prabhu, MD, E-mail: Rajesh.Prabhu@essentiahealth.org
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Abstract

Objective:

Describe a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) hospital outbreak and the role of serial testing of patients and healthcare personnel (HCP) in interrupting SARS-CoV-2 transmission.

Design:

Outbreak investigation.

Setting:

Medical floor of a tertiary-care center in Minnesota.

Methods:

Serial testing for SARS-CoV-2 and whole-genome sequencing (WGS) of positive specimens from HCP and patients were used. An outbreak-associated case was defined as a positive SARS-CoV-2 molecular test in an HCP who worked on the floor prior to testing positive or in a patient who was hospitalized on the medical floor bewteen October 27 and December 1, 2020. WGS was used to determine potential routes of transmission.

Results:

The outbreak was detected after a patient hospitalized for 12 days tested positive for SARS-CoV-2. Serial testing of patients and HCP was conducted in response. Overall, 247 HCP and 41 patients participated in serial SARS-CoV-2 testing; 52 HCP (21%) and 19 hospitalized patients (46%) tested positive. One additional HCP tested positive outside serial testing. The WGS of specimens from 27 (51%) HCP and 15 (79%) patients identified 3 distinct transmission clusters. WGS and epidemiologic evidence suggested intrafacility transmission. The proportions of asymptomatic and presymptomatic patients who tested positive (63%) and HCP who worked during their infectious period (75%) highlight the need for serial testing of asymptomatic patients and HCP during outbreaks.

Conclusions:

Coupled with preventive measures such as personal protective equipment use and physical distancing, serial testing of HCP and patients could help detect and prevent transmission within healthcare facilities during outbreaks and when nosocomial transmission is suspected.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 3 , March 2023 , pp. 427 - 432
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

a

Authors of equal contribution.

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