Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel-Hashomer, P.O. Box 5265601, Ramat-Gan, Israel.
The Israel Center for Disease Control, Israel Ministry of Health, P.O. Box 5265601, Tel-Hashomer, Israel.
Viruses. 2020 Aug 5;12(8):854. doi: 10.3390/v12080854.
SARS-CoV-2 has become a major global concern as of December 2019, particularly affecting healthcare workers. As person-to-person transmission is airborne, crowded closed spaces have high potential for rapid virus spread, especially early in the pandemic when social distancing and mask wearing were not mandatory. This retrospective study thoroughly investigates a small-scale SARS-CoV-2 outbreak in Israel's central virology laboratory (ICVL) in mid-March 2020, in which six staff members and two related family members were infected. Suspicions regarding infection by contaminated surfaces in ICVL facilities were nullified by SARS-CoV-2 negative real time polymerase chain reaction (PCR) of work surfaces swipe tests. Complete SARS-CoV-2 genomes were sequenced and mutation analyses showed inclusion of all samples to clades 20B and 20C, possessing the spike mutation D614G. Phylogenetic analysis clarified transmission events, confirming S1 as having infected at least three other staff members and refuting the association of a staff member's infected spouse with the ICVL transmission cluster. Finally, serology tests exhibited IgG and IgA antibodies in all infected individuals and revealed the occurrence of asymptomatic infections in additional staff members. This study demonstrates the advantages of molecular epidemiology in elucidating transmission events and exemplifies the importance of good laboratory practice, distancing and mask wearing in preventing SARS-CoV-2 spread, specifically in healthcare facilities.
截至 2019 年 12 月，SARS-CoV-2 已成为全球关注的主要问题，尤其是对医护人员的影响。由于人与人之间的传播是空气传播的，拥挤的封闭空间具有快速传播病毒的高潜力，尤其是在大流行早期，当时社交距离和戴口罩并不是强制性的。本回顾性研究深入调查了 2020 年 3 月中旬以色列中央病毒学实验室（ICVL）的小规模 SARS-CoV-2 爆发，该实验室有 6 名工作人员和 2 名相关家属感染。通过对 ICVL 设施表面的实时聚合酶链反应（PCR）检测，排除了受污染表面感染的嫌疑。对完整的 SARS-CoV-2 基因组进行测序和突变分析表明，所有样本均包含在 20B 和 20C 分支中，具有 D614G 刺突突变。系统发育分析阐明了传播事件，证实 S1 至少感染了其他 3 名工作人员，驳斥了一名工作人员感染的配偶与 ICVL 传播群集有关的说法。最后，血清学检测显示所有感染个体均存在 IgG 和 IgA 抗体，并表明其他工作人员发生了无症状感染。本研究证明了分子流行病学在阐明传播事件方面的优势，并说明了良好的实验室实践、保持距离和戴口罩在防止 SARS-CoV-2 传播方面的重要性，尤其是在医疗保健设施中。
