Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in High-Density Settings, Minnesota, USA, March–June 2020

Lehnertz, Nicholas; Wang, Xiong; Garfin, Jacob; Taylor, Joanne; Zipprich, Jennifer; VonBank, Brittany; Martin, Karen; Eikmeier, Dana; Medus, Carlota; Wiedinmyer, Brooke; Bernu, Carmen; Plumb, Matthew R.; Pung, Kelly; Honein, Margaret A.; Carter, Rosalind; MacCannell, Duncan; Smith, Kirk E.; Como‐Sabetti, Kathryn; Ehresmann, Kris; Danila, Richard; Lynfield, Ruth

doi:10.3201/eid2708.204838

Cited by 10 publications

(9 citation statements)

References 29 publications

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“…Based on previous research, there is high confidence that sequences within 0 to 2 SNVs are part of the same cluster or outbreak. 17,18 The WGS results supported evidence of transmission from the index case to the remaining individuals and from a primary case to a social secondary case.…”

Section: Discussionmentioning

confidence: 81%

Transmission of and Infection With COVID-19 Among Vaccinated and Unvaccinated Attendees of an Indoor Wedding Reception in Minnesota

et al. 2022

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IMPORTANCECharacterizing rates of SARS-CoV-2 infection among vaccinated and unvaccinated persons with the same exposure is critical to understanding the association of vaccination with the risk of infection with the Delta variant. Additionally, evidence of Delta variant transmission by children to vaccinated adults has important public health implications. OBJECTIVE To characterize transmission and infection of SARS-CoV-2 among vaccinated and unvaccinated attendees of an indoor wedding reception. DESIGN, SETTING, AND PARTICIPANTS This cohort study included attendees at an indoor wedding reception in Minnesota in July 2021. Data were collected from REDCap surveys and routine surveillance interviews. The full list of attendees and a partial list of emails were obtained. Fiftyseven attendees completed the emailed survey. Eighteen additional attendees were identified from the state health department COVID-19 surveillance database. EXPOSURES Attendance at an indoor event. MAIN OUTCOMES AND MEASURES Risk of SARS-CoV-2 infection among vaccinated and unvaccinated attendees, identification of an index case, whole genome sequencing (WGS) to identify the COVID-19 variant, understanding of transmission patterns, and assessment of secondary transmission. The primary case definition was an individual with a positive SARS-CoV-2 test who attended the wedding in the 14 days prior to their illness. RESULTS Data were gathered for 75 attendees (mean [SE] age, 37.5 [13.7] years; 57 [76%] female individuals), of whom 56 (75%) were fully vaccinated, 4 (5%) were partially vaccinated, and 15 (20%)were unvaccinated. Of 62 attendees who were tested, 29 (47%) tested positive, including 16 of 46 fully vaccinated attendees (35%), 2 of 4 partially vaccinated attendees (50%), and 11 of 12 unvaccinated attendees (92%). Being unvaccinated was associated with a higher risk of infection compared with being vaccinated (risk ratio, 2.64; 95% CI, 1.71-4.06; P = .001). One unvaccinated adult required hospitalization. An unvaccinated child who was symptomatic on the event date was identified as the index case. Eleven specimens were available for WGS. All sequenced specimens were closely related and were identified as the Delta variant. WGS supported secondary transmission from a vaccinated individual with SARS-CoV-2. CONCLUSIONS AND RELEVANCEThis cohort study identified a COVID-19 Delta variant outbreak at an indoor event despite a high proportion of vaccinated attendees. It found that vaccination was associated with a reduced risk of infection.

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Section: Discussionmentioning

confidence: 81%

Transmission of and Infection With COVID-19 Among Vaccinated and Unvaccinated Attendees of an Indoor Wedding Reception in Minnesota

et al. 2022

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“…Although 'pneumonia of unknown origin' was the diagnosis assigned to the initial patients who underwent hospitalization, COVID-19 hospitalization was necessary in 5-7% of the initial cases, meaning that occupational health surveillance in Wuhan's wet market could have identified SARS-CoV-2 among the other 95-93% of persons with asymptomatic or mild symptoms (8) and allowed earlier contingency of the very first infected individuals. Although the wet market was most likely the epicenter of the virus spillover, other workplaces with lower risks of virus emergence also contribute to SARS-CoV-2 chains of transmission (10,11).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Molecular Epidemiology Can Be Enhanced by Occupational Health: The Experience of Monitoring Variants of Concern in Workplaces in Rio de Janeiro, Brazil

et al. 2022

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The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to extra caution in workplaces to avoid the coronavirus disease 2019 (COVID-19). In the occupational environment, SARS-CoV-2 testing is a powerful approach in providing valuable information to detect, monitor, and mitigate the spread of the virus and preserve productivity. Here a centralized Occupational Health Center provided molecular diagnosis and genomic sequences for companies and industries in Rio de Janeiro, Brazil. From May to August 2021, around 20% of the SARS-CoV-2 positive nasopharyngeal swabs from routinely tested workers were sequenced and reproduced the replacement of Gamma with Delta variant observed in regular surveillance programs. Moreover, as a proof-of-concept on the sensibility of the occupational health genomic surveillance program described here, it was also found: i) the primo-identification of B.1.139 and A.2.5 viral genomes in Brazil and ii) an improved dating of Delta VoC evolution, by identifying earlier cases associated with AY-related genomes. We interpret that SARS-CoV-2 molecular testing of workers, independent of symptom presentation, provides an earlier opportunity to identify variants. Thus, considering the continuous monitoring of SARS-CoV-2 in workplaces, positive samples from occupation health programs should be regarded as essential to improve the knowledge on virus genetic diversity and VoC emergence.

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“…[1][2][3][4][5][6] SARS-CoV-2 can spread rapidly in SNFs, in part due to unrecognized asymptomatic and presymptomatic infection. 1,7,8 The rapid transmission dynamics and high morbidity and mortality that occur in SNFs underscore the need for early detection of cases and rapid outbreak response. 1,7,8 Symptom-based screening alone is insufficient to identify or control an outbreak of SARS-CoV-2 among SNF residents.…”

Section: Introductionmentioning

confidence: 99%

“…1,7,8 The rapid transmission dynamics and high morbidity and mortality that occur in SNFs underscore the need for early detection of cases and rapid outbreak response. 1,7,8 Symptom-based screening alone is insufficient to identify or control an outbreak of SARS-CoV-2 among SNF residents. 8,9 For these reasons, easily obtainable quantitative indicators for presymptomatic SARS-CoV-2 infection are needed.…”

Section: Introductionmentioning

confidence: 99%

“…Skilled nursing facilities (SNFs) across the United States have been disproportionately impacted by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), the virus that causes coronavirus disease 2019 (COVID‐19) 1–6 . SARS‐CoV‐2 can spread rapidly in SNFs, in part due to unrecognized asymptomatic and presymptomatic infection 1,7,8 . The rapid transmission dynamics and high morbidity and mortality that occur in SNFs underscore the need for early detection of cases and rapid outbreak response 1,7,8 .…”

Section: Introductionmentioning

confidence: 99%

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Temperature and oxygen saturation in skilled nursing facility residents positive for SARS‐CoV‐2 prior to symptom onset

Lehnertz

Lifson

Galloway

et al. 2021

J American Geriatrics Society

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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spreads rapidly amongst residents of skilled nursing facilities (SNFs). The rapid transmission dynamics and high morbidity and mortality that occur in SNFs emphasize the need for early detection of cases. We hypothesized that residents of SNFs infected with SARS-CoV-2 would demonstrate an acute change in either temperature or oxygen saturation (SpO 2 ) prior to symptom onset. The Minnesota Department of Health (MDH) conducted a retrospective analysis of both temperature and SpO 2 at two separate SNFs to assess the utility of these quantitative markers to identify SARS-CoV-2 infection prior to the development of symptoms. Methods: A retrospective analysis was conducted of 165 individuals positive for SARS-CoV-2 who were residents of SNFs that experienced coronavirus disease 2019 (COVID-19) outbreaks during April-June 2020 in a metropolitan area of Minnesota. Age, sex, symptomology, temperature and SpO 2 values, date of symptom onset, and date of positive SARS-CoV-2 test were analyzed. Temperature and SpO 2 values for the period 14 days before and after the date of initial positive test were included. Descriptive analyses evaluated changes in temperature and SpO 2 , defined as either exceeding a set threshold or demonstrating an acute change between consecutive measurements.Results: Two (1%) residents had a temperature value ≥100 F, and 30 (18%) had at least one value ≥99 F within 14 days before symptom development.One hundred and sixteen residents (70%) had at least one SpO 2 value ≤94%, while 131 (80%) had an acute decrease in SpO 2 of ≥3% between consecutive values in the 14 days prior to symptom onset. Conclusions: Our results suggest that acute change in SpO 2 might be useful in the identification of SARS-CoV-2 infection prior to the development of symptoms among residents living in SNFs. Facilities may consider addingThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

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Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in High-Density Settings, Minnesota, USA, March–June 2020

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Cited by 10 publications

References 29 publications

Transmission of and Infection With COVID-19 Among Vaccinated and Unvaccinated Attendees of an Indoor Wedding Reception in Minnesota

Transmission of and Infection With COVID-19 Among Vaccinated and Unvaccinated Attendees of an Indoor Wedding Reception in Minnesota

SARS-CoV-2 Molecular Epidemiology Can Be Enhanced by Occupational Health: The Experience of Monitoring Variants of Concern in Workplaces in Rio de Janeiro, Brazil

Temperature and oxygen saturation in skilled nursing facility residents positive for SARS‐CoV‐2 prior to symptom onset

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