Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Intercollegiate Athletics Not Fully Mitigated With Daily Antigen Testing.
Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Intercollegiate Athletics Not Fully Mitigated With Daily Antigen Testing.
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DOI：
10.1093/cid/ciab343
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发表时间：
2021-07-15
期刊：
影响因子：
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通讯作者：
O'Connor DH
中科院分区：
文献类型：
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作者：
Moreno GK;Braun KM;Pray IW;Segaloff HE;Lim A;Poulsen K;Meiman J;Borcher J;Westergaard RP;Moll MK;Friedrich TC;O'Connor DH
人们继续提议进行高频率、快速周转的严重急性呼吸系统综合征冠状病毒2型（SARS-CoV-2）检测，作为有效识别和减轻聚集环境中传播的一种方式。然而，2020年秋季学期，尽管强制性的直接观察每日抗原检测，但在校际大学体育项目中发生了2起SARS-CoV-2疫情。在2020年秋季学期，两个项目的运动员和工作人员每天都使用Quidel的索菲亚SARS抗原荧光免疫分析法进行检测，抗原阳性结果需要实时逆转录聚合酶链反应进行确证性检测。我们使用基因组测序来调查这两次暴发的传播动态。在第一次疫情中，尽管会议当天的抗原检测结果为阴性，但在指示患者参加了具有传染性的会议后，在一所大学的体育项目中发生了32例确诊病例。在从该爆发中测序的分离株中，26株中有24株（92%）密切相关，表明在最初的引入事件后持续传播。在第二次疫情中，12例确诊病例发生在两个大学项目的运动员中，他们在一场体育比赛中面对面，尽管在比赛当天收到了阴性抗原检测结果。来自两个团队的序列密切相关，并与团队1在社区中传播的病毒不同，这表明团队2在社区中的校际竞争期间传播。这些发现表明，单独的抗原检测，即使是强制性的和直接观察的，可能不足以作为预防聚集环境中SARS-CoV-2爆发的干预措施，并且它们强调了疫苗接种对预防聚集环境中SARS-CoV-2爆发的重要性。
High-frequency, rapid-turnaround severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing continues to be proposed as a way of efficiently identifying and mitigating transmission in congregate settings. However, 2 SARS-CoV-2 outbreaks occurred among intercollegiate university athletic programs during the fall 2020 semester, despite mandatory directly observed daily antigen testing. During the fall 2020 semester, athletes and staff in both programs were tested daily using Quidel’s Sofia SARS Antigen Fluorescent Immunoassay, with positive antigen results requiring confirmatory testing with real-time reverse-transcription polymerase chain reaction. We used genomic sequencing to investigate transmission dynamics in these 2 outbreaks. In the first outbreak, 32 confirmed cases occurred within a university athletics program after the index patient attended a meeting while infectious, despite a negative antigen test on the day of the meeting. Among isolates sequenced from that outbreak, 24 (92%) of 26 were closely related, suggesting sustained transmission following an initial introduction event. In the second outbreak, 12 confirmed cases occurred among athletes from 2 university programs that faced each other in an athletic competition, despite receipt of negative antigen test results on the day of the competition. Sequences from both teams were closely related and distinct from viruses circulating in the community for team 1, suggesting transmission during intercollegiate competition in the community for team 2. These findings suggest that antigen testing alone, even when mandated and directly observed, may not be sufficient as an intervention to prevent SARS-CoV-2 outbreaks in congregate settings, and they highlight the importance of vaccination to prevent SARS-CoV-2 outbreak in congregate settings.