Infect Control Hosp Epidemiol . Investigation of a cluster of severe acute respiratory syndrome coronavirus 2 infections in a hospital administration building

[tetano]

Infect Control Hosp Epidemiol


. 2022 Feb 22;1-19.
doi: 10.1017/ice.2022.45. Online ahead of print.
Investigation of a cluster of severe acute respiratory syndrome coronavirus 2 infections in a hospital administration building


Lucas D Jones ^{# 1} , Ernest R Chan ^{# 2} , Jennifer L Cadnum ^{# 3} , Sarah N Redmond ⁴ , Maria E Navas ⁵ , Trina F Zabarsky ⁶ , Elizabeth C Eckstein ⁶ , Jeffrey Kovach ⁷ , Marlin Linger ⁸ , Peter A Zimmerman ⁸ , Curtis J Donskey ^{9 10}



Affiliations

• PMID: 35189996
• DOI: 10.1017/ice.2022.45

Abstract

Objective: To investigate a cluster of coronavirus disease 2019 (COVID-19) infections in employees working on 1 floor of a hospital administration building.
Methods: Contact tracing was performed to identify potential exposures and all employees were tested for SARS-CoV-2. Whole genome sequencing was performed to determine the relatedness of SARS-CoV-2 samples from infected personnel and from control cases in the healthcare system with COVID-19 during the same period. Carbon dioxide levels were measured during a workday to assess adequacy of ventilation; readings above 800 parts per million (ppm) were considered an indication of suboptimal ventilation. To assess the potential for airborne transmission, DNA-barcoded aerosols were released, and real-time polymerase-chain reaction was used to quantify particles recovered from air samples in multiple locations.
Results: Between December 22, 2020 and January 8, 2021, 17 co-workers tested positive for SARS-CoV-2, including 13 symptomatic and 4 asymptomatic individuals. Of the 5 cluster SARS-CoV-2 samples sequenced, 3 were genetically related but the employees denied higher-risk contacts with one another. None of the sequences from the cluster were genetically related to the 17 control SARS-CoV-2 sequences. Carbon dioxide levels increased during a workday but never exceeded 800 ppm. DNA-barcoded aerosol particles were dispersed from the sites of release to locations throughout the floor; 20% of air samples had >1 log10 particles.
Conclusions: In a hospital administration building outbreak, sequencing of SARS-CoV-2 confirmed transmission among co-workers. Transmission occurred despite the absence of higher-risk exposures and in a setting with adequate ventilation based on monitoring of carbon dioxide levels.