Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Equal contributors.
Eur Respir J. 2020 Jun 4;55(6). doi: 10.1183/13993003.00544-2020. Print 2020 Jun.
BACKGROUND: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members. METHODS: We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed. RESULTS: Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability. CONCLUSIONS: SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.
背景:新型冠状病毒(SARS-CoV-2)于 2020 年初在中国感染了超过 3300 名医护人员。关于医护人员在初期的医院感染,知之甚少。我们分析了来自武汉协和医院(中国武汉)感染医护人员及其家庭成员的感染数据。
方法:我们收集并分析了 2020 年 1 月 5 日至 2 月 12 日期间,25 名经实验室确诊为 2019 年冠状病毒病(COVID-19)的医护人员和 2 名高度疑似 COVID-19 的医护人员,以及他们 10 名 COVID-19 家庭成员的暴露史、疾病时间轴和流行病学特征。调查了 35 例实验室确诊病例的人口统计学和临床特征,并对 12 例的病毒 RNA 进行了测序和分析。
结果:在患者中发现了 9 个聚集群。所有患者均表现为轻至中度临床症状,并自行康复,无恶化。潜伏期平均为 4.5 天,平均±标准差临床发病间隔(COSI)为 5.2±3.2 天,中位病毒脱落时间为 18.5 天。12 种不同冠状病毒株的完整基因组序列表明,病毒结构稳定,在传播链中具有微小的无关突变,具有明显的传染性可追溯性特征。
结论:根据潜伏期和 COSI 较短的特点,SARS-CoV-2 可以在医院环境和社会活动中迅速在人与人之间传播,无论其是否有症状。公共卫生部门应采取切实可行的措施遏制传播,包括隔离病例、追踪密切接触者和控制严重疫区。此外,医护人员在疫情期间应保持警惕,如有自我怀疑感染,应进行自我隔离。
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