Eurosurv. Investigation of a COVID-19 outbreak on the Charles de Gaulle aircraft carrier, March to April 2020: a retrospective cohort study

[tetano]

• Franck de Laval^1,2 , Hervé Chaudet^1,3,4 , Olivier Gorgé⁵ , Joffrey Marchi¹ , Constance Lacrosse¹ , Aissata Dia¹ , Vanessa Marbac⁶ , Bakridine Mmadi Mrenda¹ , Gaëtan Texier^1,3 , Flavie Letois¹ , Charles Chapus⁵ , Véronique Sarilar⁵ , Jean-Nicolas Tournier⁵ , Anthony Levasseur^4,7 , Jacques Cobola⁶ , Flora Nolent⁵ , Fabien Dutasta⁸ , Frédéric Janvier⁸ , PA-CDG COVID-19 investigation group⁹ , Jean-Baptiste Meynard^1,2 , Vincent Pommier de Santi^1,3

Background

SARS-CoV-2 emergence was a threat for armed forces. A COVID-19 outbreak occurred on the French aircraft carrier Charles de Gaulle from mid-March to mid-April 2020.

Aim

To understand how the virus was introduced, circulated then stopped circulation, risk factors for infection and severity, and effectiveness of preventive measures.

Methods

We considered the entire crew as a cohort and collected personal, clinical, biological, and epidemiological data. We performed viral genome sequencing and searched for SARS-CoV-2 in the environment.

Results

The attack rate was 65% (1,148/1,767); 1,568 (89%) were included. The male:female ratio was 6.9, and median age was 29 years (IQR: 24–36). We examined four clinical profiles: asymptomatic (13.0%), non-specific symptomatic (8.1%), specific symptomatic (76.3%), and severe (i.e. requiring oxygen therapy, 2.6%). Active smoking was not associated with severe COVID-19; age and obesity were risk factors. The instantaneous reproduction rate (Rt) and viral sequencing suggested several introductions of the virus with 4 of 5 introduced strains from within France, with an acceleration of Rt when lifting preventive measures. Physical distancing prevented infection (adjusted OR: 0.55; 95% CI: 0.40–0.76). Transmission may have stopped when the proportion of infected personnel was large enough to prevent circulation (65%; 95% CI: 62–68).

Conclusion

Non-specific clinical pictures of COVID-19 delayed detection of the outbreak. The lack of an isolation ward made it difficult to manage transmission; the outbreak spread until a protective threshold was reached. Physical distancing was effective when applied. Early surveillance with adapted prevention measures should prevent such an outbreak.

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.21.2100612

[sharon sanders]

bump this