Legrand Nicolas M, Bull Rowena A, Hajarizadeh Behzad, Lloyd Andrew R, Johnston Kirsty, Issa Katya, Harvey Christine, Arnott Alicia, Dwyer Dominic E, Sintchenko Vitali, Grant Luke, Dore Gregory J, Kaldor John, Martinello Marianne
Emerg Infect Dis. 2025 Aug;31(8):1527-1536. doi: 10.3201/eid3108.240571.
Limited surveillance data have hindered understanding of SARS-CoV-2 transmission within prisons. We integrated routine surveillance data with viral sequencing to investigate transmission dynamics and associated factors during a Delta variant outbreak in a maximum-security prison in Sydney, New South Wales, Australia. Infection incidence and associated factors were determined by using person-time and Cox regression. We generated transmission chains by integrating epidemiologic and viral sequencing data. Of 1,562 patients, SARS-CoV-2 infection was diagnosed in 169 (11%), predominantly acquired in prison and asymptomatic. Prisonwide testing identified substantial unrecognized transmission, and 4 subvariants indicated multiple viral introductions. Infection was associated with housing location, having a cellmate (regardless of infection status), and vaccination status. Our findings underscore the inadequacy of symptom-based testing and the efficacy of entry-quarantine, strategic housing, extensive testing, and vaccination in reducing transmission. This integrated approach to surveillance and genomic sequencing offers a valuable model for enhancing infectious disease surveillance in correctional settings.
有限的监测数据阻碍了对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在监狱内传播情况的了解。我们将常规监测数据与病毒测序相结合，以调查在澳大利亚新南威尔士州悉尼一所最高安全级别的监狱发生德尔塔变种疫情期间的传播动态及相关因素。采用人时和Cox回归确定感染发生率及相关因素。通过整合流行病学和病毒测序数据生成传播链。在1562名患者中，169人（11%）被诊断感染SARS-CoV-2，主要在监狱内感染且无症状。全监狱检测发现了大量未被识别的传播情况，4个亚变种表明有多次病毒传入。感染与居住位置、有同牢房人员（无论其感染状况如何）以及疫苗接种状况有关。我们的研究结果强调了基于症状检测的不足，以及入境检疫、合理安排住宿、广泛检测和疫苗接种在减少传播方面的有效性。这种监测与基因组测序相结合的方法为加强惩教机构的传染病监测提供了一个有价值的模式。
