• S Paltansing, R S Sikkema, S J de Man, KoopmansM P GMPGErasmusMC, Department of Viroscience, WHO Collaborating Centre for Arbovirus and Viral Haemorrhagic Fever Reference and Research, Rotterdam, the Netherlands., B B Oude Munnink, and P de Man.
• Department of Medical Microbiology and Infection Control, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, the Netherlands. Electronic address: s.paltansing@franciscus.nl.
• J. Hosp. Infect. 2021 Apr 1; 110: 178-183.

AimTo investigate the sources of infection among healthcare workers (HCWs) and patients in a teaching hospital in the Netherlands during the early stages of the coronavirus disease 2019 (COVID-19) pandemic using epidemiological and whole-genome sequencing data.MethodsFrom 3rd April to 11th May 2020, 88 HCWs and 215 patients were diagnosed with COVID-19. Whole-genome sequences were obtained for 30 HCWs and 20 patients.ResultsSeven and 11 sequence types were identified in HCWs and patients, respectively. Cluster A was the most common sequence type, detected in 23 (77%) HCWs; of these, 14 (61%) had direct patient contact and nine (39%) had indirect patient contact. In addition, seven patients who were not hospitalized in the COVID-19 cohort isolation ward who became positive during their admission were infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cluster A. Following universal masking of all HCWs and emphasis on physical distancing during meals and breaks, no further evidence was found for patient-to-HCW or HCW-to-HCW transmission or vice versa.ConclusionThe finding that patients and HCWs were infected with SARS-CoV-2 cluster A suggests both HCW-to-HCW and HCW-to-patient transmission.Copyright © 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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