Does respiratory co-infection facilitate dispersal of SARS-CoV-2? investigation of a super-spreading event in an open-sp
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RESEARCH
Does respiratory co-infection facilitate dispersal of SARS-CoV-2? investigation of a super-spreading event in an open-space office Dana Weissberg1*, Jürg Böni2, Silvana K. Rampini3, Verena Kufner2, Maryam Zaheri2, Peter W. Schreiber1, Irene A. Abela1,2, Michael Huber2, Hugo Sax1 and Aline Wolfensberger1
Abstract Background: Super-spreaders are individuals infecting disproportionately large numbers of contacts. They probably play a crucial role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a super-spreading event within a team working in an open-space office and investigate factors potentially having facilitated SARS-CoV-2 transmission. Methods: In this retrospective cohort study, semi-structured telephone interviews with all team members were carried out to identify symptoms, contacts, and adherence to basic hygiene measures. During site visits, we gathered information about workplace and seating arrangements. The secondary attack rate in office and households was calculated. Potential respiratory viral co-infections were assessed by multiplex PCR. SARS-CoV-2 whole-genome sequencing was performed using a tiled-amplicon sequencing approach. Results: Of 13 team members, 11 fell ill with Coronavirus disease 2019 (COVID-19). Due to the sequence of events and full genome sequence data, one person was considered the index case for this outbreak, directly infecting 67 to 83% of the teammates. All team members reported repetitive close contacts among themselves during joint computer work, team meetings and a “Happy Birthday” serenade. Two individuals shared nuts and dates. The arrangement of the office and meeting rooms precluded sufficient adherence to physical distancing. The index case and a further individual were diagnosed with an adenovirus serotype 4 co-infection. Conclusion: We identified several environmental and behavioral factors that probably have facilitated the transmission of SARS-CoV-2. The relevance of the adenovirus co-infection remains unclear and merits further investigation. Keywords: COVID-19, SARS-CoV-2, Super-spreading, Co-infection, Adenovirus, Transmission, Secondary attack rate, Outbreak investigation
*Correspondence: [email protected] 1 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland Full list of author information is available at the end of the article
Background The Coronavirus disease 2019 (COVID-19) emerged in late December 2019 in Wuhan, China. The causative agent is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a betacoronavirus, related to SARS-CoV and Middle Eastern respiratory syndrome coronavirus (MERS-CoV). COVID-19 was declared a pandemic in March 2020 [1]. As of November 13, more
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as lo
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