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- Reina S Sikkema, Suzan D Pas, David F Nieuwenhuijse, Áine O'Toole, Jaco Verweij, Anne van der Linden, Irina Chestakova, Claudia Schapendonk, Mark Pronk, Pascal Lexmond, Theo Bestebroer, Ronald J Overmars, Stefan van Nieuwkoop, Wouter van den Bijllaardt, Robbert G Bentvelsen, van Rijen Miranda M L MML Microvida Laboratory for Microbiology, Amphia Hospital, Breda, Netherlands., Buiting Anton G M AGM Laboratory for Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands; Department of Infection Control, Elisabeth-, Anne J G van Oudheusden, Bram M Diederen, Anneke M C Bergmans, Annemiek van der Eijk, Richard Molenkamp, Andrew Rambaut, Aura Timen, Kluytmans Jan A J W JAJW Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Microvida Laboratory for Microbiolog, Bas B Oude Munnink, Marjolein F Q Kluytmans van den Bergh, and Koopmans Marion P G MPG Viroscience, Erasmus MC, Rotterdam, Netherlands..
- Viroscience, Erasmus MC, Rotterdam, Netherlands. Electronic address: r.sikkema@erasmusmc.nl.
- Lancet Infect Dis. 2020 Nov 1; 20 (11): 1273-1280.
Background10 days after the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Netherlands (on Feb 27, 2020), 55 (4%) of 1497 health-care workers in nine hospitals located in the south of the Netherlands had tested positive for SARS-CoV-2 RNA. We aimed to gain insight in possible sources of infection in health-care workers.MethodsWe did a cross-sectional study at three of the nine hospitals located in the south of the Netherlands. We screened health-care workers at the participating hospitals for SARS-CoV-2 infection, based on clinical symptoms (fever or mild respiratory symptoms) in the 10 days before screening. We obtained epidemiological data through structured interviews with health-care workers and combined this information with data from whole-genome sequencing of SARS-CoV-2 in clinical samples taken from health-care workers and patients. We did an in-depth analysis of sources and modes of transmission of SARS-CoV-2 in health-care workers and patients.FindingsBetween March 2 and March 12, 2020, 1796 (15%) of 12 022 health-care workers were screened, of whom 96 (5%) tested positive for SARS-CoV-2. We obtained complete and near-complete genome sequences from 50 health-care workers and ten patients. Most sequences were grouped in three clusters, with two clusters showing local circulation within the region. The noted patterns were consistent with multiple introductions into the hospitals through community-acquired infections and local amplification in the community.InterpretationAlthough direct transmission in the hospitals cannot be ruled out, our data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers.FundingEU Horizon 2020 (RECoVer, VEO, and the European Joint Programme One Health METASTAVA), and the National Institute of Allergy and Infectious Diseases, National Institutes of Health.Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.
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