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Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes

BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among st...

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Autores principales: Ladhani, Shamez N, Chow, J. Yimmy, Janarthanan, Roshni, Fok, Jonathan, Crawley-Boevey, Emma, Vusirikala, Amoolya, Fernandez, Elena, Perez, Marina Sanchez, Tang, Suzanne, Dun-Campbell, Kate, Wynne-Evans, Edward, Bell, Anita, Patel, Bharat, Amin-Chowdhury, Zahin, Aiano, Felicity, Paranthaman, Karthik, Ma, Thomas, Saavedra-Campos, Maria, Myers, Richard, Ellis, Joanna, Lackenby, Angie, Gopal, Robin, Patel, Monika, Chand, Meera, Brown, Kevin, Hopkins, Susan, Consortium, CoG, Shetty, Nandini, Zambon, Maria, Ramsay, Mary E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Ltd on behalf of The British Infection Association. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387283/
https://www.ncbi.nlm.nih.gov/pubmed/32735893
http://dx.doi.org/10.1016/j.jinf.2020.07.027
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author Ladhani, Shamez N
Chow, J. Yimmy
Janarthanan, Roshni
Fok, Jonathan
Crawley-Boevey, Emma
Vusirikala, Amoolya
Fernandez, Elena
Perez, Marina Sanchez
Tang, Suzanne
Dun-Campbell, Kate
Wynne-Evans, Edward
Bell, Anita
Patel, Bharat
Amin-Chowdhury, Zahin
Aiano, Felicity
Paranthaman, Karthik
Ma, Thomas
Saavedra-Campos, Maria
Myers, Richard
Ellis, Joanna
Lackenby, Angie
Gopal, Robin
Patel, Monika
Chand, Meera
Brown, Kevin
Hopkins, Susan
Consortium, CoG
Shetty, Nandini
Zambon, Maria
Ramsay, Mary E
author_facet Ladhani, Shamez N
Chow, J. Yimmy
Janarthanan, Roshni
Fok, Jonathan
Crawley-Boevey, Emma
Vusirikala, Amoolya
Fernandez, Elena
Perez, Marina Sanchez
Tang, Suzanne
Dun-Campbell, Kate
Wynne-Evans, Edward
Bell, Anita
Patel, Bharat
Amin-Chowdhury, Zahin
Aiano, Felicity
Paranthaman, Karthik
Ma, Thomas
Saavedra-Campos, Maria
Myers, Richard
Ellis, Joanna
Lackenby, Angie
Gopal, Robin
Patel, Monika
Chand, Meera
Brown, Kevin
Hopkins, Susan
Consortium, CoG
Shetty, Nandini
Zambon, Maria
Ramsay, Mary E
author_sort Ladhani, Shamez N
collection PubMed
description BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. METHODS: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. RESULTS: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9–4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. CONCLUSIONS: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises.
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spelling pubmed-73872832020-07-29 Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes Ladhani, Shamez N Chow, J. Yimmy Janarthanan, Roshni Fok, Jonathan Crawley-Boevey, Emma Vusirikala, Amoolya Fernandez, Elena Perez, Marina Sanchez Tang, Suzanne Dun-Campbell, Kate Wynne-Evans, Edward Bell, Anita Patel, Bharat Amin-Chowdhury, Zahin Aiano, Felicity Paranthaman, Karthik Ma, Thomas Saavedra-Campos, Maria Myers, Richard Ellis, Joanna Lackenby, Angie Gopal, Robin Patel, Monika Chand, Meera Brown, Kevin Hopkins, Susan Consortium, CoG Shetty, Nandini Zambon, Maria Ramsay, Mary E J Infect Article BACKGROUND: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. METHODS: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. RESULTS: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9–4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. CONCLUSIONS: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises. Published by Elsevier Ltd on behalf of The British Infection Association. 2020-10 2020-07-29 /pmc/articles/PMC7387283/ /pubmed/32735893 http://dx.doi.org/10.1016/j.jinf.2020.07.027 Text en © 2020 Published by Elsevier Ltd on behalf of The British Infection Association. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Ladhani, Shamez N
Chow, J. Yimmy
Janarthanan, Roshni
Fok, Jonathan
Crawley-Boevey, Emma
Vusirikala, Amoolya
Fernandez, Elena
Perez, Marina Sanchez
Tang, Suzanne
Dun-Campbell, Kate
Wynne-Evans, Edward
Bell, Anita
Patel, Bharat
Amin-Chowdhury, Zahin
Aiano, Felicity
Paranthaman, Karthik
Ma, Thomas
Saavedra-Campos, Maria
Myers, Richard
Ellis, Joanna
Lackenby, Angie
Gopal, Robin
Patel, Monika
Chand, Meera
Brown, Kevin
Hopkins, Susan
Consortium, CoG
Shetty, Nandini
Zambon, Maria
Ramsay, Mary E
Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes
title Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes
title_full Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes
title_fullStr Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes
title_full_unstemmed Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes
title_short Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes
title_sort increased risk of sars-cov-2 infection in staff working across different care homes: enhanced covid-19 outbreak investigations in london care homes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387283/
https://www.ncbi.nlm.nih.gov/pubmed/32735893
http://dx.doi.org/10.1016/j.jinf.2020.07.027
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