Centre for Disease Surveillance and Control, Public Health Wales, Cardiff, Wales, UK.
UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK.
Epidemiol Infect. 2022 May 30;150:e134. doi: 10.1017/S0950268822000991.
Prisons are susceptible to outbreaks. Control measures focusing on isolation and cohorting negatively affect wellbeing. We present an outbreak of coronavirus disease 2019 (COVID-19) in a large male prison in Wales, UK, October 2020 to April 2021, and discuss control measures.We gathered case-information, including demographics, staff-residence postcode, resident cell number, work areas/dates, test results, staff interview dates/notes and resident prison-transfer dates. Epidemiological curves were mapped by prison location. Control measures included isolation (exclusion from work or cell-isolation), cohorting (new admissions and work-area groups), asymptomatic testing (case-finding), removal of communal dining and movement restrictions. Facemask use and enhanced hygiene were already in place. Whole-genome sequencing (WGS) and interviews determined the genetic relationship between cases plausibility of transmission.Of 453 cases, 53% ( = 242) were staff, most aged 25-34 years (11.5% females, 27.15% males) and symptomatic (64%). Crude attack-rate was higher in staff (29%, 95% CI 26-64%) than in residents (12%, 95% CI 9-15%).Whole-genome sequencing can help differentiate multiple introductions from person-to-person transmission in prisons. It should be introduced alongside asymptomatic testing as soon as possible to control prison outbreaks. Timely epidemiological investigation, including data visualisation, allowed dynamic risk assessment and proportionate control measures, minimising the reduction in resident welfare.
监狱容易爆发疫情。以隔离和群体为重点的控制措施会对福利产生负面影响。我们报告了 2020 年 10 月至 2021 年 4 月期间在英国威尔士的一家大型男性监狱中爆发的 2019 年冠状病毒病（COVID-19）疫情，并讨论了控制措施。我们收集了病例信息，包括人口统计学特征、员工居住地邮政编码、居民牢房号码、工作区域/日期、检测结果、员工访谈日期/记录和居民监狱转移日期。根据监狱位置绘制了流行病学曲线。控制措施包括隔离（排除工作或牢房隔离）、群体（新入院和工作区域群体）、无症状检测（病例发现）、取消公共用餐和限制行动。当时已经在使用口罩和加强卫生。全基因组测序（WGS）和访谈确定了病例之间的遗传关系以及传播的可能性。在 453 例病例中，53%（=242 例）为工作人员，大多数年龄在 25-34 岁（女性 11.5%，男性 27.15%），有症状（64%）。工作人员的粗发病率较高（29%，95%CI 26-64%），高于居民（12%，95%CI 9-15%）。全基因组测序有助于区分监狱中多人感染和人际传播。应尽快与无症状检测一起引入，以控制监狱疫情。及时进行流行病学调查，包括数据可视化，允许进行动态风险评估和采取相应的控制措施，将对居民福利的影响降到最低。
