Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong
Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong
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DOI：
10.1017/ice.2020.58
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发表时间：
2020-05-01
影响因子：
4.5
通讯作者：
Yuen, Kwok-Yung
中科院分区：
文献类型：
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作者：
Cheng, Vincent C. C.;Wong, Shuk-Ching;Yuen, Kwok-Yung
目的：描述2019年12月31日（第1天）中国香港宣布发生聚集性肺炎后的头42天内，对SARS-CoV-2（以前称为2019年新型冠状病毒）引起的冠状病毒病（COVID-19）的感染控制准备措施。方法：对在医院无保护暴露的卫生保健工作者（HCWs）实施积极和加强实验室监测、早期空气传播感染隔离、快速分子诊断检测和接触者追踪的捆绑方法。收集并分析确诊病例、环境样本和空气样本的流行病学特征。结果：从第1天到第42天，1275例患者中有42例（3.3%）（n = 29）和加强实验室监测（n = 13）确诊为SARS-CoV-2感染。本地获得性病例数从13例确诊病例中的1例（7.7%，第22天至第32天）显著增加到29例确诊病例中的27例（93.1%，第33天至第42天），P < 0.001。其中28例（66.6%）来自8个家庭聚集。在照顾这些确诊病例的413名卫生保健员中，11名（2.7%）有未受保护的接触，需要隔离14天。这些患者均未被感染，未观察到SARS-CoV-2的医院传播。在患者房间进行环境监测，病毒载量分别为3.3 × 10(6)拷贝/mL（合并鼻咽和咽拭子）和5.9 × 10(6)拷贝/mL（唾液）。在13份环境样本中有1份（7.7%）检测到SARS-CoV-2，但在距离患者下巴10厘米处采集的8份空气样本中未检测到SARS-CoV-2，无论是否佩戴外科口罩。结论：采取适当的医院感染控制措施可以有效预防SARS-CoV-2的医院传播。
Objective: To describe the infection control preparedness measures undertaken for coronavirus disease (COVID-19) due to SARS-CoV-2 (previously known as 2019 novel coronavirus) in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019 (day 1) in Hong Kong. Methods: A bundled approach of active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers (HCWs) with unprotected exposure in the hospitals was implemented. Epidemiological characteristics of confirmed cases, environmental samples, and air samples were collected and analyzed. Results: From day 1 to day 42, 42 of 1,275 patients (3.3%) fulfilling active (n = 29) and enhanced laboratory surveillance (n = 13) were confirmed to have the SARS-CoV-2 infection. The number of locally acquired case significantly increased from 1 of 13 confirmed cases (7.7%, day 22 to day 32) to 27 of 29 confirmed cases (93.1%, day 33 to day 42; P < .001). Among them, 28 patients (66.6%) came from 8 family clusters. Of 413 HCWs caring for these confirmed cases, 11 (2.7%) had unprotected exposure requiring quarantine for 14 days. None of these was infected, and nosocomial transmission of SARS-CoV-2 was not observed. Environmental surveillance was performed in the room of a patient with viral load of 3.3 x 10(6) copies/mL (pooled nasopharyngeal and throat swabs) and 5.9 x 10(6) copies/mL (saliva), respectively. SARS-CoV-2 was identified in 1 of 13 environmental samples (7.7%) but not in 8 air samples collected at a distance of 10 cm from the patient's chin with or without wearing a surgical mask. Conclusion: Appropriate hospital infection control measures was able to prevent nosocomial transmission of SARS-CoV-2.