Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong.
升级感染控制应对迅速变化的流行病学的冠状病毒疾病 2019 (新型冠状病毒肺炎) 由于SARS-CoV-2 in Hong Kong.
- 作者列表："Cheng VCC","Wong SC","Chen JHK","Yip CCY","Chuang VWM","Tsang OTY","Sridhar S","Chan JFW","Ho PL","Yuen KY
OBJECTIVE:To describe the infection control preparedness measures undertaken for coronavirus disease (COVID-19) due to SARS-CoV-2 (previously known as 2019 novel coronavirus) in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019 (day 1) in Hong Kong. METHODS:A bundled approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental samples, and air samples were collected and analyzed. RESULTS:From day 1 to day 42, 42 of 1,275 patients (3.3%) fulfilling active (n = 29) and enhanced laboratory surveillance (n = 13) were confirmed to have the SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 of 13 confirmed cases (7.7%, day 22 to day 32) to 27 of 29 confirmed cases (93.1%, day 33 to day 42; P < .001). Among them, 28 patients (66.6%) came from 8 family clusters. Of 413 HCWs caring for these confirmed cases, 11 (2.7%) had unprotected exposure requiring quarantine for 14 days. None of these was infected, and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance was performed in the room of a patient with viral load of 3.3 × 106 copies/mL (pooled nasopharyngeal and throat swabs) and 5.9 × 106 copies/mL (saliva), respectively. SARS-CoV-2 was identified in 1 of 13 environmental samples (7.7%) but not in 8 air samples collected at a distance of 10 cm from the patient's chin with or without wearing a surgical mask. CONCLUSION:Appropriate hospital infection control measures was able to prevent nosocomial transmission of SARS-CoV-2.
目的: 描述SARS-CoV-2 (以前称为 20 1 9 冠状病毒) 引起的冠状病毒病 (COVID-1 9) 的感染控制准备措施新型冠状病毒在中国宣布肺炎群集后的前 42 天，12 月 3 1，20 1 9 (第 1 天) 在香港。 方法: 对医院中无保护暴露的医护人员 (HCWs) 实施积极和强化实验室监测、早期空气感染隔离、快速分子诊断检测和接触者追踪的捆绑方法。收集并分析确诊病例、环境样品和air样品的流行病学特征。 结果: 每天 1 至 42 天、 42 的 1 275 例 (3.3%) 开展活动 (n = 29) 和增强的实验室监测 (n = 1 3) 确诊为SARS-CoV-2 感染。在当地获得的情况下显著增加，从 1 的 1 3 确诊病例 (7.7%，日间 22 至第 32 天) 到 27 29 确诊病例 (93.1%，第 33 天至第 42 天; P <。00 1)。其中，28 例患者 (66.6%) 来自 8 个家庭集群。在照顾这些确诊病例的 413 名医务人员中，11 人 (2.7%) 的无保护暴露需要检疫天。所有病例均未发生感染，未发现SARS-CoV-2 的院内传播。对 1 例病毒载量分别为 3.3 × 106 拷贝/mL (混合鼻咽和咽喉拭子) 和 5.9 × 106 拷贝/mL (唾液) 的患者进行环境监测。在 1 3 个环境样本中的 1 个 (7.7%) 中发现了SARS-CoV-2，但在与患者下巴距离 1 0厘米处采集的 8 air样本中未发现，无论是否佩戴手术面罩。 结论: 采取相应的医院感染控制措施可有效预防SARS-CoV-2 的院内传播。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.