Outbreak of COVID-19 among children and young adults in a cancer centre daycare unit

• Published in: Epidemiology & Infection Vol. 150; p. e40
• Main Authors: Yun, Ki Wook, Kim, Ye Kyung, Song, Eun Sun, An, Hong Yul, Hong, Kyung Taek, Choi, Jung Yoon, Kang, Hyoung Jin, Chung, Seung Min, Park, In Kyung, Lee, Hyo Yeon, Kim, Nam Joong, Choi, Eun Hwa
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 21.02.2022
• Subjects: Adolescent; Adult; Adults; Aged; Asymptomatic; Cancer; Cancer Care Facilities; Caregivers; Child; Child, Preschool; Children; Children & youth; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - immunology; COVID-19 - transmission; Cross Infection - epidemiology; Cross Infection - immunology; Cross Infection - transmission; Day Care, Medical; Daycare; Disease Outbreaks; Disease transmission; Families & family life; Female; Fever; Hospitals; Humans; Immunocompromised Host; Immunocompromised hosts; Infant; Infectious Disease Transmission, Professional-to-Patient; Local government; Male; Masks; Medical personnel; Middle Aged; Neoplasms - immunology; Neoplasms - therapy; Nosocomial infection; Outbreaks; Patients; Quarantine; Republic of Korea - epidemiology; RNA polymerase; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Shedding; Short Paper; Viral diseases; Viruses; Young Adult; Young adults; Republic of Korea; South Korea; COVID-19; SARS-CoV-2; immunocompromised; nosocomial; children
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268822000012

Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7–8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.