COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a cross-sectional study
Sikkema, Reina S; Pas, Suzan D; Nieuwenhuijse, David F; O'Toole, Áine; Verweij, Jaco; van der Linden, Anne; Chestakova, Irina; Schapendonk, Claudia; Pronk, Mark; Lexmond, Pascal; Bestebroer, Theo; Overmars, Ronald J; van Nieuwkoop, Stefan; van den Bijllaardt, Wouter; Bentvelsen, Robbert G; van Rijen, Miranda M L; Buiting, Anton G M; van Oudheusden, Anne J G; Diederen, Bram M; Bergmans, Anneke M C; van der Eijk, Annemiek; Molenkamp, Richard; Rambaut, Andrew; Timen, Aura; Kluytmans, Jan A J W; Oude Munnink, Bas B; Kluytmans van den Bergh, Marjolein F Q; Koopmans, Marion P G
(2020) The Lancet Infectious Diseases, volume 20, issue 11, pp. 1273 - 1280
(Article)
Abstract
BACKGROUND: 10 days after the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Netherlands (on Feb 27, 2020), 55 (4%) of 1497 health-care workers in nine hospitals located in the south of the Netherlands had tested positive for SARS-CoV-2 RNA. We aimed to gain
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insight in possible sources of infection in health-care workers. METHODS: We did a cross-sectional study at three of the nine hospitals located in the south of the Netherlands. We screened health-care workers at the participating hospitals for SARS-CoV-2 infection, based on clinical symptoms (fever or mild respiratory symptoms) in the 10 days before screening. We obtained epidemiological data through structured interviews with health-care workers and combined this information with data from whole-genome sequencing of SARS-CoV-2 in clinical samples taken from health-care workers and patients. We did an in-depth analysis of sources and modes of transmission of SARS-CoV-2 in health-care workers and patients. FINDINGS: Between March 2 and March 12, 2020, 1796 (15%) of 12 022 health-care workers were screened, of whom 96 (5%) tested positive for SARS-CoV-2. We obtained complete and near-complete genome sequences from 50 health-care workers and ten patients. Most sequences were grouped in three clusters, with two clusters showing local circulation within the region. The noted patterns were consistent with multiple introductions into the hospitals through community-acquired infections and local amplification in the community. INTERPRETATION: Although direct transmission in the hospitals cannot be ruled out, our data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers. FUNDING: EU Horizon 2020 (RECoVer, VEO, and the European Joint Programme One Health METASTAVA), and the National Institute of Allergy and Infectious Diseases, National Institutes of Health.
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Keywords: Adult, Aged, Betacoronavirus/genetics, COVID-19, Community-Acquired Infections/epidemiology, Coronavirus Infections/epidemiology, Cross Infection/epidemiology, Cross-Sectional Studies, Female, Genetic Variation, Health Personnel, Hospitals, Teaching, Humans, Male, Mass Screening/methods, Middle Aged, Netherlands/epidemiology, Pandemics, Pneumonia, Viral/epidemiology, SARS-CoV-2, Whole Genome Sequencing, Young Adult, Infectious Diseases, Research Support, Non-U.S. Gov't, Journal Article, Research Support, N.I.H., Extramural
ISSN: 1473-3099
Publisher: Lancet Publishing Group
Note: Funding Information: We thank David van der Vijver and Miranda de Graaf (Erasmus MC, Rotterdam, Netherlands) for technical support. This study has been partly funded by EU Horizon 2020 projects RECoVer (no 101003589), VEO (no 874735), and the European Joint Programme One Health METASTAVA (no 773830), and by the National Institute of Allergy and Infectious Diseases, National Institutes of Health (contract HHSN272201400008C). Publisher Copyright: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
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