Cross sectional investigation of a COVID-19 outbreak at a London Army barracks: Neutralising antibodies and virus isolation

Taylor, Hannah; Wall, William E.; Ross, David J.; Janarthanan, Roshni; Wang, Liyang; Aiano, Felicity; Ellis, Joanna; Gopal, Robin; Andrews, Nick; Patel, Monika; Lackenby, Angela; Ramsay, Mary; Chow, Ji‐Jian; Zambon, Maria; Ladhani, Shamez

doi:10.1016/j.lanepe.2020.100015

Cited by 9 publications

(8 citation statements)

References 29 publications

(30 reference statements)

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“…Neutralising antibodies are important for protection against reinfection, as shown in animal models 31 and case reports of human infections. 32 , 33 Studies based on modelling predictions and synthesis of observational studies suggest that neutralising antibody titres can be predicted at which there is 50% protection against infection, and that this titre lies at approximately 20% (95% CI 4·4–28·4) of mean convalescent titres of neutralising antibodies of 1:10 to 1:30 in most studies. 34 This empirical observation is consistent with our observed differences in antibody titres between those with and without confirmed reinfection.…”

Section: Discussionmentioning

confidence: 99%

Reinfection with new variants of SARS-CoV-2 after natural infection: a prospective observational cohort in 13 care homes in England

Jeffery-Smith

Rowland

Patel

et al. 2021

The Lancet Healthy Longevity

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Background Understanding the duration of protection and risk of reinfection after natural infection is crucial to planning COVID-19 vaccination for at-risk groups, including care home residents, particularly with the emergence of more transmissible variants. We report on the duration, neutralising activity, and protection against the alpha variant of previous SARS-CoV-2 infection in care home residents and staff infected more than 6 months previously. Methods We did this prospective observational cohort surveillance in 13 care homes in Greater London, England. All staff and residents were included. Staff and residents had regular nose and throat screening for SARS-CoV-2 by RT-PCR according to national guidelines, with ad hoc testing of symptomatic individuals. From January, 2021, antigen lateral flow devices were also used, but positive tests still required RT-PCR confirmation. Staff members took the swab samples for themselves and the residents. The primary outcome was SARS-CoV-2 RT-PCR positive primary infection or reinfection in previously infected individuals, as determined by previous serological testing and screening or diagnostic RT-PCR results. Poisson regression and Cox proportional hazards models were used to estimate protective effectiveness of previous exposure. SARS-CoV-2 spike, nucleoprotein, and neutralising antibodies were assessed at multiple timepoints as part of the longitudinal follow-up. Findings Between April 10 and Aug 3, 2020, we recruited and tested 1625 individuals (933 staff and 692 residents). 248 participants were lost to follow-up (123 staff and 125 residents) and 1377 participants were included in the follow-up period to Jan 31, 2021 (810 staff and 567 residents). There were 23 reinfections (ten confirmed, eight probable, five possible) in 656 previously infected individuals (366 staff and 290 residents), compared with 165 primary infections in 721 susceptible individuals (444 staff and 277 residents). Those with confirmed reinfections had no or low neutralising antibody concentration before reinfection, with boosting of titres after reinfection. Kinetics of binding and neutralising antibodies were similar in older residents and younger staff. Interpretation SARS-CoV-2 reinfections were rare in older residents and younger staff. Protection from SARS-CoV-2 was sustained for longer than 9 months, including against the alpha variant. Reinfection was associated with no or low neutralising antibody before reinfection, but significant boosting occurred on reinfection. Funding Public Health England.

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Section: Discussionmentioning

confidence: 99%

Reinfection with new variants of SARS-CoV-2 after natural infection: a prospective observational cohort in 13 care homes in England

Jeffery-Smith

Rowland

Patel

et al. 2021

The Lancet Healthy Longevity

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“…After accounting for potential overlap in cases, this study utilized 36 articles from 17 countries—the U.S. ( n = 17), Israel ( n = 2), Switzerland ( n = 2), and the United Kingdom ( n = 2) and one each from Belgium, Bolivia, Brazil, Canada, Djibouti, France, India, Italy, Norway, Philippines, South Korea, Sri Lanka, and Tunisia [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. The Israel-based study by Talmy et al was solely used for the meta-analysis of specific symptoms since it was the only Israeli study reporting symptoms breakdown [ 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…The following supporting information can be downloaded at: . References [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] are cited in the Supplementary Materials.…”

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confidence: 99%

SARS-CoV-2 Transmission in the Military during the Early Phase of the Pandemic—A Systematic Analysis

Gwee

Chua

Pang

2022

IJERPH

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Militaries worldwide have been affected by COVID-19 pandemic. However, the impact and epidemiological characteristics of transmission during the early phase of the pandemic is not well-studied. This study aims to systematically estimate the baseline incidence of COVID-19 in the military worldwide and identify the potential risk factors of transmission and clinical characteristics of the cases. English and Chinese literature reporting COVID-19 cases in military worldwide published on four electronic databases (PubMed, Scopus, EMBASE, and CKNI) through 28 May 2021 were systematically screened and synthesized qualitatively. Forty-six studies involving at least 711,408 military personnel in 17 countries were synthesized. Low incidence of cases was observed in the military with pooled COVID-19 incidence of 0.19% (95%CI: 0.00–9.18%). We observed a higher incidence among those (1) with overseas exposure (39.85%; 95%CI: 0.00–95.87%) rather than local exposure (3.03%; 95%CI: 0.00–12.53%), (2) who were on either local/overseas military deployment (26.78%; 95%CI: 0.00–71.51%) as compared to those not deployed (4.37%; 95%CI: 0.00–17.93%), and (3) on overseas military deployment (39.84%; 95%CI: 0.00–95.87%) as compared to local military deployment (3.03%; 95%CI: 2.37–3.74%). The majority of the cases were symptomatic (77.90% (95%CI: 43.91–100.00%)); hospitalization and mortality rates were low at 4.43% (95%CI: 0.00–25.34%) and 0.25% (95%CI: 0.00–0.85%), respectively; and headache, anosmia, ageusia, myalgia, nasal congestion, and cough were the most commonly observed symptoms. Overseas and local deployment were observed to have higher risk of SARS-CoV-2 transmission. Sustainable, active SARS-CoV-2 surveillance strategies are crucial to detect and contain transmission early during military deployments.

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“…The military population is well-known for its vulnerability to various types of communicable diseases due to its collective and closed living environments [7][8][9]. In South Korea, outbreak of tuberculosis and respiratory syncytial virus had been reported among military population, which demonstrates its vulnerability to communicable diseases [7,8,10].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 outbreak in a military unit in Korea

Kim

Heo

et al. 2021

Epidemiol Health

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Objectives This study presents the response of a military unit to the COVID-19 outbreak in Gyeonggi Province. As soon as two soldiers were identified as index cases, the infectious disease investigators of the Gyeonggi Provincial Government, Korea Disease Control and Prevention Agency and the Armed Forces Epidemiologic Investigation Center, discussed the investigation and response plan for an imminent massive outbreak.Methods The joint immediate response team (IRT) conducted interviews with confirmed patients with COVID-19, reviewed medical records, performed contact tracing using global positioning system (GPS), and undertook a field investigation. For risk assessment, the joint IRT visited all eight sites of the military units and the army chaplain's church to evaluate the transmission risk of each site. The evaluation items included the size of the site, the use of air conditioning, whether windows were opened, and whether masks were worn. A pooled testing was used for a low-risk population to quickly detect the spread of COVID-19 in the military base.Results A day before the symptom onset of the index case, the lecturer and >50% of the attendees were infected with COVID-19 while attending a lecture that lasted 2 h and 30 min. Attendees were not wearing masks and were in a poorly ventilated room.Conclusions Since the disease can be spread before symptom onset, contact tracing must be performed to investigate potential exposures prior to symptom onset and manage any exposed persons.

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Cross sectional investigation of a COVID-19 outbreak at a London Army barracks: Neutralising antibodies and virus isolation

Cited by 9 publications

References 29 publications

Reinfection with new variants of SARS-CoV-2 after natural infection: a prospective observational cohort in 13 care homes in England

Reinfection with new variants of SARS-CoV-2 after natural infection: a prospective observational cohort in 13 care homes in England

SARS-CoV-2 Transmission in the Military during the Early Phase of the Pandemic—A Systematic Analysis

COVID-19 outbreak in a military unit in Korea

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