Population Health Assessment, Surveillance, and Epidemiology (Smith), Island Health, Victoria, BC; Canadian Field Epidemiology Program (Smith), Public Health Agency of Canada, Ottawa, Ont.; Department of Public Health & Preventive Medicine (Enns), Island Health, Courtenay, BC; 'Namgis Health Centre (Cutfeet, James); 'Namgis First Nation (Alfred), Alert Bay, BC; Communicable Disease Program (Lindbeck), Island Health, Courtenay, BC; Public Health Laboratory (Russell), BC Centre for Disease Control, Vancouver, BC.
CMAJ Open. 2021 Nov 30;9(4):E1073-E1079. doi: 10.9778/cmajo.20210054. Print 2021 Oct-Dec.
In April 2020, British Columbia experienced its first outbreak of COVID-19 in a remote First Nations community. The objective of this paper was to describe the outbreak, including epidemiological and laboratory findings, and the public health response.
This report summarizes an outbreak of COVID-19 on Cormorant Island, British Columbia, in March and April 2020. Confirmed cases underwent investigation and contact tracing. Supports were provided to ensure successful isolation and quarantine for cases and contacts. Messaging to the community was circulated by trusted community members. Descriptive and social network analyses were conducted to describe the outbreak as it evolved. All case specimens underwent whole-genome sequencing.
Thirty cases of SARS-CoV-2 infection were identified. Those infected had a median age of 34 years (range 15-77), and the majority identified as female (19, 63%) and as First Nations (27, 90%). The most common symptoms included chills, cough, diarrhea, headache and fever. Five people were hospitalized (17%) and 1 died (3%). Percent positivity in the community was 18%. Transmission occurred primarily during evening social gatherings and within households. Two weeks after control measures were initiated, no further cases were identified. All cases were genetically related by 2 single nucleotide polymorphisms or fewer, and they belonged to the most dominant SARS-CoV-2 lineage present in British Columbia in April 2020.
A community-led response was essential for the effective containment of this outbreak that included 30 cases, preventing onward transmission of the virus. Lessons learned from the management of this outbreak can inform response to other similar outbreaks in First Nations communities across Canada.
2020 年 4 月，不列颠哥伦比亚省的一个偏远原住民社区首次爆发了 COVID-19。本文的目的是描述此次疫情，包括流行病学和实验室发现以及公共卫生应对措施。
本报告总结了不列颠哥伦比亚省科莫兰岛 2020 年 3 月和 4 月发生的 COVID-19 疫情。对确诊病例进行了调查和接触者追踪。为确保病例和接触者成功隔离和检疫提供了支持。通过受信任的社区成员传播了向社区传达的信息。对描述疫情演变的描述性和社交网络分析进行了描述。对所有病例标本进行了全基因组测序。
确定了 30 例 SARS-CoV-2 感染病例。感染者的中位年龄为 34 岁（范围 15-77 岁），大多数为女性（19 例，63％）和原住民（27 例，90％）。最常见的症状包括寒战，咳嗽，腹泻，头痛和发烧。有 5 人住院（17％），1 人死亡（3％）。社区内的阳性率为 18％。传播主要发生在晚上的社交聚会和家庭内部。在采取控制措施两周后，没有发现其他病例。所有病例通过 2 个或更少的单核苷酸多态性遗传相关，它们属于 2020 年 4 月不列颠哥伦比亚省最主要的 SARS-CoV-2 谱系。
社区主导的应对措施对于有效遏制此次包括 30 例病例的疫情至关重要，防止了病毒的进一步传播。从此次疫情管理中吸取的经验教训可为加拿大其他原住民社区类似疫情的应对提供参考。
