Transmission of SARS-CoV-2 among healthcare workers and patients in a teaching hospital in the Netherlands confirmed by whole-genome sequencing

• Published in: The Journal of hospital infection Vol. 110; pp. 178 - 183
• Main Authors: Paltansing, S., Sikkema, R.S., de Man, S.J., Koopmans, M.P.G., Oude Munnink, B.B., de Man, P.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2021; The Healthcare Infection Society. Published by Elsevier Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Cohort Studies; COVID-19; COVID-19 - epidemiology; COVID-19 - transmission; Female; Health Personnel - statistics & numerical data; Healthcare worker; Hospitals, Teaching - statistics & numerical data; Humans; Infectious Disease Transmission, Patient-to-Professional - statistics & numerical data; Inpatients - statistics & numerical data; Male; Middle Aged; Molecular typing; Netherlands - epidemiology; Outbreak; Pandemics - statistics & numerical data; SARS-CoV-2; SARS-CoV-2 - genetics; SARS-CoV-2 - isolation & purification; WGS; Netherlands; COVID-19; Healthcare worker; SARS-CoV-2; Molecular typing; WGS; Outbreak
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2021.02.005

To investigate the sources of infection among healthcare workers (HCWs) and patients in a teaching hospital in the Netherlands during the early stages of the coronavirus disease 2019 (COVID-19) pandemic using epidemiological and whole-genome sequencing data. From 3rd April to 11th May 2020, 88 HCWs and 215 patients were diagnosed with COVID-19. Whole-genome sequences were obtained for 30 HCWs and 20 patients. Seven and 11 sequence types were identified in HCWs and patients, respectively. Cluster A was the most common sequence type, detected in 23 (77%) HCWs; of these, 14 (61%) had direct patient contact and nine (39%) had indirect patient contact. In addition, seven patients who were not hospitalized in the COVID-19 cohort isolation ward who became positive during their admission were infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cluster A. Following universal masking of all HCWs and emphasis on physical distancing during meals and breaks, no further evidence was found for patient-to-HCW or HCW-to-HCW transmission or vice versa. The finding that patients and HCWs were infected with SARS-CoV-2 cluster A suggests both HCW-to-HCW and HCW-to-patient transmission.