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Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong.
J Hosp Infect. 2020 Jun; 105(2):119-127.JH

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) was first reported in Wuhan in December 2019 and has rapidly spread across different cities within and outside China. Hong Kong started to prepare for COVID-19 on 31st December 2019 and infection control measures in public hospitals were tightened to limit nosocomial transmission within healthcare facilities. However, the recommendations on the transmission-based precautions required for COVID-19 in hospital settings vary from droplet and contact precautions, to contact and airborne precautions with placement of patients in airborne infection isolation rooms.

AIM

To describe an outbreak investigation of a patient with COVID-19 who was nursed in an open cubicle of a general ward before the diagnosis was made.

METHOD

Contacts were identified and risk categorized as 'close' or 'casual' for decisions on quarantine and/or medical surveillance. Respiratory specimens were collected from contacts who developed fever, and/or respiratory symptoms during the surveillance period and were tested for SARS-CoV-2.

FINDINGS

A total of 71 staff and 49 patients were identified from contact tracing, seven staff and 10 patients fulfilled the criteria of 'close contact'. At the end of 28-day surveillance, 76 tests were performed on 52 contacts and all were negative, including all patient close contacts and six of the seven staff close contacts. The remaining contacts were asymptomatic throughout the surveillance period.

CONCLUSION

Our findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene.

Authors+Show Affiliations

Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Department of Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region.Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region; Infection control Team, Queen Elizabeth Hospital, Hong Kong Special Administrative Region. Electronic address: lungdc@ha.org.hk.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32259546

Citation

Wong, S C Y., et al. "Risk of Nosocomial Transmission of Coronavirus Disease 2019: an Experience in a General Ward Setting in Hong Kong." The Journal of Hospital Infection, vol. 105, no. 2, 2020, pp. 119-127.
Wong SCY, Kwong RT, Wu TC, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect. 2020;105(2):119-127.
Wong, S. C. Y., Kwong, R. T., Wu, T. C., Chan, J. W. M., Chu, M. Y., Lee, S. Y., Wong, H. Y., & Lung, D. C. (2020). Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. The Journal of Hospital Infection, 105(2), 119-127. https://doi.org/10.1016/j.jhin.2020.03.036
Wong SCY, et al. Risk of Nosocomial Transmission of Coronavirus Disease 2019: an Experience in a General Ward Setting in Hong Kong. J Hosp Infect. 2020;105(2):119-127. PubMed PMID: 32259546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. AU - Wong,S C Y, AU - Kwong,R T-S, AU - Wu,T C, AU - Chan,J W M, AU - Chu,M Y, AU - Lee,S Y, AU - Wong,H Y, AU - Lung,D C, Y1 - 2020/04/04/ PY - 2020/03/11/received PY - 2020/03/27/accepted PY - 2020/4/8/pubmed PY - 2020/6/17/medline PY - 2020/4/8/entrez KW - COVID-19 KW - Contact tracing KW - Coronavirus disease-2019 KW - Infection control KW - Outbreak KW - SARS-CoV-2 SP - 119 EP - 127 JF - The Journal of hospital infection JO - J. Hosp. Infect. VL - 105 IS - 2 N2 - BACKGROUND: Coronavirus disease 2019 (COVID-19) was first reported in Wuhan in December 2019 and has rapidly spread across different cities within and outside China. Hong Kong started to prepare for COVID-19 on 31st December 2019 and infection control measures in public hospitals were tightened to limit nosocomial transmission within healthcare facilities. However, the recommendations on the transmission-based precautions required for COVID-19 in hospital settings vary from droplet and contact precautions, to contact and airborne precautions with placement of patients in airborne infection isolation rooms. AIM: To describe an outbreak investigation of a patient with COVID-19 who was nursed in an open cubicle of a general ward before the diagnosis was made. METHOD: Contacts were identified and risk categorized as 'close' or 'casual' for decisions on quarantine and/or medical surveillance. Respiratory specimens were collected from contacts who developed fever, and/or respiratory symptoms during the surveillance period and were tested for SARS-CoV-2. FINDINGS: A total of 71 staff and 49 patients were identified from contact tracing, seven staff and 10 patients fulfilled the criteria of 'close contact'. At the end of 28-day surveillance, 76 tests were performed on 52 contacts and all were negative, including all patient close contacts and six of the seven staff close contacts. The remaining contacts were asymptomatic throughout the surveillance period. CONCLUSION: Our findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/32259546/Risk_of_nosocomial_transmission_of_coronavirus_disease_2019:_an_experience_in_a_general_ward_setting_in_Hong_Kong_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0195-6701(20)30174-2 DB - PRIME DP - Unbound Medicine ER -