Department of Anaesthesiology, Kantonsspital Winterthur, Winterthur, Switzerland.
Military Medical Services, Swiss Armed Forces, Bern, Switzerland.
BMJ Mil Health. 2021 Aug;167(4):251-254. doi: 10.1136/bmjmilitary-2020-001482. Epub 2020 Apr 16.
A new coronavirus, called Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), has emerged from China in late 2019 and has now caused a worldwide pandemic. The impact of COVID-19 has not been described so far in a military setting. We therefore report a case series of infected patients in a recruit school in Switzerland and the herein associated challenges.
Retrospective review of COVID-19 cases among Swiss Armed Forces recruits in the early weeks of SARS-CoV-2 pandemic in the canton of Ticino, the southernmost canton of Switzerland. Positive cases were defined with two positive PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Serological testing was performed with a commercially available kit according to manufacturers' instructions.
The first case was likely contaminated while skiing during weekend permission. He became symptomatic 4 days later, tested positive for SARS-CoV-2 and was put into isolation. He showed complete symptom resolution after 48 hours. Quarantine was ordered for all recruits with close contact in the past 2 days, a total of 55 persons out of 140 in the company. Seven out of nine recruits in one particular quarantine room became mildly symptomatic. SARS-CoV-2 PCR was positive in one of them. Seven days after initial diagnosis, the index patient and the other one from the quarantine retested positive for SARS-CoV-2, although they had been completely asymptomatic for over 96 hours. Serological testing revealed positive for both patients. All others showed negative IgM and IgG.
Young healthy recruits often showed a mild course of COVID-19 with rapid symptom decline but were persistent SARS-CoV-2 carriers. This illustrates how asymptomatic patients may be responsible for covert viral transmission. An early and prolonged establishment of isolation and quarantine for patients and close contacts is essential to slow down the spread of SARS-CoV-2, especially in the confined space of a military environment.
一种新型冠状病毒，称为严重急性呼吸系统综合症冠状病毒 2 型（SARS-CoV-2），于 2019 年末在中国出现，现已在全球范围内引发大流行。迄今为止，尚无关于 COVID-19 在军事环境中影响的报道。因此，我们报告了瑞士一所新兵学校中感染患者的病例系列以及相关挑战。
回顾性分析瑞士提契诺州 SARS-CoV-2 大流行早期瑞士武装部队新兵中的 COVID-19 病例。通过鼻咽拭子的两次 SARS-CoV-2 阳性 PCR 检测来定义阳性病例。根据制造商的说明，使用市售试剂盒进行血清学检测。
首例病例可能是在周末休假滑雪时被污染的。他在 4 天后出现症状，对 SARS-CoV-2 检测呈阳性，并被隔离。他在 48 小时后完全缓解症状。对过去 2 天内有密切接触的所有新兵进行了隔离，共有 140 名新兵中的 55 人被隔离。9 名新兵中有 7 名在一个特定的隔离房间中出现轻微症状。其中一人的 SARS-CoV-2 PCR 检测呈阳性。在最初诊断后 7 天，索引病例和另一名来自隔离区的新兵对 SARS-CoV-2 检测再次呈阳性，尽管他们已经完全无症状超过 96 小时。血清学检测显示两名患者均呈阳性。其他所有人的 IgM 和 IgG 均为阴性。
年轻健康的新兵通常表现出 COVID-19 的轻度病程，症状迅速消退，但持续为 SARS-CoV-2 的携带者。这说明了无症状患者可能是隐匿性病毒传播的原因。早期并长期对患者和密切接触者进行隔离和检疫对于减缓 SARS-CoV-2 的传播至关重要，尤其是在军事环境这种封闭空间中。
