COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

BMC Infectious Diseases

Petra Wolffs¹  Edou R. Heddema²  Henriëtte L. G. ter Waarbeek³  Volker Hackert³  Mitch van Hensbergen⁴  Casper D. J. den Heijer⁵  Christian J. P. A. Hoebe⁵  Reina S. Sikkema⁶  Bas B. Oude Munnink⁶ 

[1] Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), PO-Box 5800, 6202 AZ, Maastricht, The Netherlands;Department of Medical Microbiology, Zuyderland Medical Center Heerlen/Sittard-Geleen, 6162 BG, Geleen, The Netherlands;Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, PO-Box 33, 6400 AA, Heerlen, The Netherlands;Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, PO-Box 33, 6400 AA, Heerlen, The Netherlands;Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO-Box 616, 6200 MD, Maastricht, The Netherlands;Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, PO-Box 33, 6400 AA, Heerlen, The Netherlands;Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, PO-Box 616, 6200 MD, Maastricht, The Netherlands;Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), PO-Box 5800, 6202 AZ, Maastricht, The Netherlands;Department of Viroscience, Erasmus MC - University Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands;

关键词: Coronavirus;    SARS-CoV-2;    Whole genome sequencing;    Cross-sectional;    Observational;    Nursing home;    Infection control;   

DOI  :  10.1186/s12879-021-06093-9

来源: Springer

【 摘 要 】

BackgroundThe Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically.MethodsSurveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections.ResultsOut of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany.ConclusionsSequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

【 授权许可】

CC BY