Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections-Reference-Cited by-同舟云学术

Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections

Published:2021-08-24 Issue: Volume:10 Page:
ISSN:2050-084X
Container-title:eLife
language:en
Short-container-title:

Author:

Illingworth Christopher JR¹²³^ORCID,Hamilton William L⁴⁵^ORCID,Warne Ben⁴⁵,Routledge Matthew⁵⁶,Popay Ashley⁷,Jackson Chris¹,Fieldman Tom⁴⁵,Meredith Luke W⁸,Houldcroft Charlotte J⁴^ORCID,Hosmillo Myra⁸^ORCID,Jahun Aminu S⁸^ORCID,Caller Laura G⁸,Caddy Sarah L⁹^ORCID,Yakovleva Anna⁸,Hall Grant⁸^ORCID,Khokhar Fahad A⁴⁹,Feltwell Theresa⁴,Pinckert Malte L⁸,Georgana Iliana⁸^ORCID,Chaudhry Yasmin⁸,Curran Martin D⁶,Parmar Surendra⁶,Sparkes Dominic⁵⁶,Rivett Lucy⁵⁶^ORCID,Jones Nick K⁵⁶^ORCID,Sridhar Sushmita⁴⁹¹⁰^ORCID,Forrest Sally⁹,Dymond Tom⁵,Grainger Kayleigh⁵,Workman Chris⁵,Ferris Mark⁵^ORCID,Gkrania-Klotsas Effrossyni⁵¹¹¹²^ORCID,Brown Nicholas M⁵^ORCID,Weekes Michael P⁴⁹^ORCID,Baker Stephen⁴⁹^ORCID,Peacock Sharon J⁴¹⁰¹³^ORCID,Goodfellow Ian G⁸^ORCID,Gouliouris Theodore⁴⁵⁶,de Angelis Daniela²¹³,Török M Estée⁴⁵^ORCID

Affiliation:

1. MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Forvie Site, Robinson Way, Cambridge, United Kingdom

2. Institut für Biologische Physik, Universität zu Köln, Köln, Germany

3. Department of Applied Mathematics and Theoretical Physics, Centre for Mathematical Sciences, Cambridge, United States

4. University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom

5. Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom

6. Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United Kingdom

7. Public Health England Field Epidemiology Unit, Cambridge Institute of Public Health, Forvie Site, Cambridge Biomedical Campus, Cambridge, United Kingdom

8. University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom

9. Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom

10. Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom

11. MRC Epidemiology Unit, University of Cambridge, Level 3 Institute of Metabolic Science, Cambridge, United Kingdom

12. University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom

13. Public Health England, National Infection Service, London, United Kingdom

Abstract

SARS-CoV-2 is notable both for its rapid spread, and for the heterogeneity of its patterns of transmission, with multiple published incidences of superspreading behaviour. Here, we applied a novel network reconstruction algorithm to infer patterns of viral transmission occurring between patients and health care workers (HCWs) in the largest clusters of COVID-19 infection identified during the first wave of the epidemic at Cambridge University Hospitals NHS Foundation Trust, UK. Based upon dates of individuals reporting symptoms, recorded individual locations, and viral genome sequence data, we show an uneven pattern of transmission between individuals, with patients being much more likely to be infected by other patients than by HCWs. Further, the data were consistent with a pattern of superspreading, whereby 21% of individuals caused 80% of transmission events. Our study provides a detailed retrospective analysis of nosocomial SARS-CoV-2 transmission, and sheds light on the need for intensive and pervasive infection control procedures.

Funder

Wellcome Trust

Academy of Medical Sciences

NIHR

National Institute for Health Research

Medical Research Council

Deutsche Forschungsgemeinschaft

The Health Foundation

Publisher

eLife Sciences Publications, Ltd

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience