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Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong.
Infect Control Hosp Epidemiol. 2020 05; 41(5):493-498.IC

Abstract

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.

Authors+Show Affiliations

Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China. Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China.Quality & Safety Division (Infection, Emergency, and Contingency), Hospital Authority, Hong Kong Special Administrative Region, China.Infectious Disease Center, Hospital Authority, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32131908

Citation

Cheng, Vincent C C., et al. "Escalating Infection Control Response to the Rapidly Evolving Epidemiology of the Coronavirus Disease 2019 (COVID-19) Due to SARS-CoV-2 in Hong Kong." Infection Control and Hospital Epidemiology, vol. 41, no. 5, 2020, pp. 493-498.
Cheng VCC, Wong SC, Chen JHK, et al. Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol. 2020;41(5):493-498.
Cheng, V. C. C., Wong, S. C., Chen, J. H. K., Yip, C. C. Y., Chuang, V. W. M., Tsang, O. T. Y., Sridhar, S., Chan, J. F. W., Ho, P. L., & Yuen, K. Y. (2020). Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infection Control and Hospital Epidemiology, 41(5), 493-498. https://doi.org/10.1017/ice.2020.58
Cheng VCC, et al. Escalating Infection Control Response to the Rapidly Evolving Epidemiology of the Coronavirus Disease 2019 (COVID-19) Due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol. 2020;41(5):493-498. PubMed PMID: 32131908.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. AU - Cheng,Vincent C C, AU - Wong,Shuk-Ching, AU - Chen,Jonathan H K, AU - Yip,Cyril C Y, AU - Chuang,Vivien W M, AU - Tsang,Owen T Y, AU - Sridhar,Siddharth, AU - Chan,Jasper F W, AU - Ho,Pak-Leung, AU - Yuen,Kwok-Yung, Y1 - 2020/03/05/ PY - 2020/3/7/pubmed PY - 2020/5/10/medline PY - 2020/3/6/entrez SP - 493 EP - 498 JF - Infection control and hospital epidemiology JO - Infect Control Hosp Epidemiol VL - 41 IS - 5 N2 - 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. SN - 1559-6834 UR - https://www.unboundmedicine.com/medline/citation/32131908/Escalating_infection_control_response_to_the_rapidly_evolving_epidemiology_of_the_Coronavirus_disease_2019__COVID_19__due_to_SARS_CoV_2_in_Hong_Kong_ L2 - https://www.cambridge.org/core/product/identifier/S0899823X20000586/type/journal_article DB - PRIME DP - Unbound Medicine ER -