Adrien Contejean1,2, Jérémie Leporrier3, Etienne Canouï2, Fanny Alby-Laurent1,3, Emmanuel Lafont1,3, Lauren Beaudeau2, Perrine Parize3, Fabienne Lecieux4, Agnès Greffet5, Gérard Chéron1,6, Rémy Gauzit2, Jacques Fourgeaud7,8, Anne-Sophie L'Honneur9, Jean-Marc Tréluyer10,11,12, Caroline Charlier1,3, Anne Casetta13, Pierre Frange8,14, Marianne Leruez-Ville7,8, Flore Rozenberg1,9, Olivier Lortholary1,3,15, Solen Kernéis2,16,17. 1. Université de Paris, Faculté de Médecine, Paris, France. 2. Equipe Mobile d'Infectiologie, Assistance Publique-Hôpitaux de Paris, APHP.CUP, Hôpital Cochin, Paris, France. 3. Service de maladies infectieuses et tropicales, Assistance Publique-Hôpitaux de Paris, IHU Imagine, Hôpital Necker-Enfants malades, Paris, France. 4. Service de santé au travail, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France. 5. Service de santé au travail, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, Paris, France. 6. Service d'urgences pédiatriques, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, Paris, France. 7. Laboratoire de virologie, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, Paris, France. 8. EHU 7328 PACT, Institut Imagine, Université de Paris, Faculté de Médecine, Paris, France. 9. Service de virologie, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France. 10. Département de soins intensifs pédiatriques, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, Paris, France. 11. Pharmacology and Drug Evaluation in Children and Pregnant Women EA7323, Université de Paris, Faculté de Médecine, Paris, France. 12. Département de pharmacologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France. 13. Equipe opérationnelle d'hygiène hospitalière, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France. 14. Laboratoire de microbiologie clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants malades, Paris, France. 15. Institut Pasteur, Molecular Mycology Unit, National Reference Centre for Invasive Mycoses and Antifungals, CNRS UMR 2000, Paris, France. 16. Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France. 17. Université de Paris, INSERM, IAME, Paris, France.
Abstract
BACKGROUND: Healthcare workers (HCWs) have paid a heavy toll during the coronavirus disease 2019 (COVID-19) outbreak. Routes of transmission remain to be fully understood. METHODS: This prospective study compared a 1500-bed adult and 600-bed pediatric setting of a tertiary-care university hospital located in central Paris. From 24 February until 10 April 2020, all symptomatic HCWs were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on a nasopharyngeal swab. HCWs screened positive were questioned on their profession, symptoms, and occupational and nonoccupational exposures to SARS-CoV-2. RESULTS: Among 1344 HCWs tested, 373 were positive (28%) and 336 (90%) corresponding questionnaires were completed. Three hospitalizations and no deaths were reported. Most HCWs (70%) had patient-facing occupational activities (22% in COVID-19 dedicated units). The total number of HCW cases peaked on 23 March, then decreased slowly, concomitantly with a continuous increase of compliance to preventive measures (including universal medical masking and personal protective equipment [PPE] for direct care to COVID-19 patients). Attack rates were of 3.2% and 2.3% in the adult and pediatric settings, respectively (P = .0022). In the adult setting, HCWs more frequently reported exposure to COVID-19 patients without PPE (25% vs 15%, P = .046). Report of contacts with children attending out-of-home care facilities dramatically decreased over the study period. CONCLUSIONS: Universal masking, reinforcement of hand hygiene, and PPE with medical masks for patients' care allowed protection of HCWs and containment of the outbreak. Residual transmissions were related to persistent exposures with undiagnosed patients or colleagues and not to contacts with children attending out-of-home care facilities.
BACKGROUND: Healthcare workers (HCWs) have paid a heavy toll during the coronavirus disease 2019 (COVID-19) outbreak. Routes of transmission remain to be fully understood. METHODS: This prospective study compared a 1500-bed adult and 600-bed pediatric setting of a tertiary-care university hospital located in central Paris. From 24 February until 10 April 2020, all symptomatic HCWs were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on a nasopharyngeal swab. HCWs screened positive were questioned on their profession, symptoms, and occupational and nonoccupational exposures to SARS-CoV-2. RESULTS: Among 1344 HCWs tested, 373 were positive (28%) and 336 (90%) corresponding questionnaires were completed. Three hospitalizations and no deaths were reported. Most HCWs (70%) had patient-facing occupational activities (22% in COVID-19 dedicated units). The total number of HCW cases peaked on 23 March, then decreased slowly, concomitantly with a continuous increase of compliance to preventive measures (including universal medical masking and personal protective equipment [PPE] for direct care to COVID-19 patients). Attack rates were of 3.2% and 2.3% in the adult and pediatric settings, respectively (P = .0022). In the adult setting, HCWs more frequently reported exposure to COVID-19 patients without PPE (25% vs 15%, P = .046). Report of contacts with children attending out-of-home care facilities dramatically decreased over the study period. CONCLUSIONS: Universal masking, reinforcement of hand hygiene, and PPE with medical masks for patients' care allowed protection of HCWs and containment of the outbreak. Residual transmissions were related to persistent exposures with undiagnosed patients or colleagues and not to contacts with children attending out-of-home care facilities.
Authors: Roger Chou; Tracy Dana; David I Buckley; Shelley Selph; Rongwei Fu; Annette M Totten Journal: Ann Intern Med Date: 2020-10-20 Impact factor: 25.391
Authors: Beata Kasztelewicz; Katarzyna Janiszewska; Julia Burzyńska; Emilia Szydłowska; Marek Migdał; Katarzyna Dzierżanowska-Fangrat Journal: PLoS One Date: 2021-04-01 Impact factor: 3.240
Authors: Nishanth Dev; Ramesh Chand Meena; D K Gupta; Nitesh Gupta; Jhuma Sankar Journal: Trans R Soc Trop Med Hyg Date: 2021-03-24 Impact factor: 2.184
Authors: Barbara Clyne; Karen Jordan; Susan Ahern; Kieran A Walsh; Paula Byrne; Paul G Carty; Linda Drummond; Kirsty K O'Brien; Susan M Smith; Patricia Harrington; Máirín Ryan; Michelle O'Neill Journal: Euro Surveill Date: 2022-02