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Published on: March 22, 2012
Nosocomial Outbreak of COVID-19 in a Hematologic Ward
Jiwon Jung1,2, Jungmin Lee3, Seongmin Jo4
1Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Insights
A hospital outbreak of COVID-19 rapidly spread in a hematologic ward, particularly in a multi-patient room and shared bathroom. Poor ventilation and unexpected airflow contributed to possible airborne transmission of SARS-CoV-2.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Airborne Transmission
Background:
- Coronavirus disease 2019 (COVID-19) outbreaks are a global concern in healthcare settings.
- Investigating potential airborne transmission routes within hospitals is crucial for infection control.
Purpose of the Study:
- To investigate a nosocomial outbreak of COVID-19 in a hospital hematologic ward.
- To identify transmission dynamics, including possible airborne spread of SARS-CoV-2.
Main Methods:
- Conducted contact tracing and CCTV monitoring to identify cases.
- Performed airflow simulations and whole-genome sequencing of SARS-CoV-2.
- Assessed ventilation in affected areas, including a shared bathroom.
Main Results:
- Eleven patients and guardians contracted COVID-19 within the hematologic ward.
- Rapid transmission occurred in a multi-patient room and shared bathroom.
- Airflow simulation indicated airborne spread from the bathroom to an adjacent room, linked to poor ventilation.
Conclusions:
- SARS-CoV-2 transmission was efficient in multi-patient rooms and shared bathrooms.
- A case of possible airborne transmission was identified, associated with ventilation deficiencies.
- Findings highlight the importance of addressing airflow and ventilation to prevent hospital-acquired infections.
Background:
Coronavirus disease 2019 (COVID-19) outbreaks occur in hospitals in many parts of the world. In hospital settings, the possibility of airborne transmission needs to be investigated thoroughly.
Materials And Methods:
There was a nosocomial outbreak of COVID-19 in a hematologic ward in a tertiary hospital, Seoul, Korea. We found 11 patients and guardians with COVID-19 through vigorous contact tracing and closed-circuit television monitoring. We found one patient who probably had acquired COVID-19 through airborne-transmission. We performed airflow investigation with simulation software, whole-genome sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Results:
Of the nine individuals with COVID-19 who had been in the hematologic ward, six stayed in one multi-patient room (Room 36), and other three stayed in different rooms (Room 1, 34, 35). Guardian in room 35 was close contact to cases in room 36, and patient in room 34 used the shared bathroom for teeth brushing 40 minutes after index used. Airflow simulation revealed that air was spread from the bathroom to the adjacent room 1 while patient in room 1 did not used the shared bathroom. Airflow was associated with poor ventilation in shared bathroom due to dysfunctioning air-exhaust, grill on the door of shared bathroom and the unintended negative pressure of adjacent room.
Conclusion:
Transmission of SARS-CoV-2 in the hematologic ward occurred rapidly in the multi-patient room and shared bathroom settings. In addition, there was a case of possible airborne transmission due to unexpected airflow.
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