{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:48:22Z","timestamp":1747172902770,"version":"3.40.5"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X23001721_as1\"><jats:title>Background:<\/jats:title><jats:p>Despite infection control guidance, sporadic nosocomial coronavirus disease 2019 (COVID-19) outbreaks occur. We describe a complex severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cluster with interfacility spread during the SARS-CoV-2 \u03b4 (delta) pandemic surge in the Midwest.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23001721_as2\"><jats:title>Setting:<\/jats:title><jats:p>This study was conducted in (1) a hematology-oncology ward in a regional academic medical center and (2) a geographically distant acute rehabilitation hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23001721_as3\"><jats:title>Methods:<\/jats:title><jats:p>We conducted contact tracing for each COVID-19 case to identify healthcare exposures within 14 days prior to diagnosis. Liberal testing was performed for asymptomatic carriage for patients and staff. Whole-genome sequencing was conducted for all available clinical isolates from patients and healthcare workers (HCWs) to identify transmission clusters.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23001721_as4\"><jats:title>Results:<\/jats:title><jats:p>In the immunosuppressed ward, 19 cases (4 patients, 15 HCWs) shared a genetically related SARS-CoV-2 isolate. Of these 4 patients, 3 died in the hospital or within 1 week of discharge. The suspected index case was a patient with new dyspnea, diagnosed during preprocedure screening. In the rehabilitation hospital, 20 cases (5 patients and 15 HCWs) positive for COVID-19, of whom 2 patients and 3 HCWs had an isolate genetically related to the above cluster. The suspected index case was a patient from the immune suppressed ward whose positive status was not detected at admission to the rehabilitation facility. Our response to this cluster included the following interventions in both settings: restricting visitors, restricting learners, restricting overflow admissions, enforcing strict compliance with escalated PPE, access to on-site free and frequent testing for staff, and testing all patients prior to hospital discharge and transfer to other facilities.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X23001721_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Stringent infection control measures can prevent nosocomial COVID-19 transmission in healthcare facilities with high-risk patients during pandemic surges. These interventions were successful in ending these outbreaks.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2023.172","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T07:59:46Z","timestamp":1704355186000},"page":"635-643","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["A severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nosocomial cluster with inter-facility spread: Lessons learned"],"prefix":"10.1017","volume":"45","author":[{"given":"Aurora E.","family":"Pop-Vicas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Hatas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Buys","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"O\u2019Connor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasen","family":"Riemersma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis A","family":"Haddock Soto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abby","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Clemens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennylynde","family":"Packham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7901-7512","authenticated-orcid":false,"given":"Daniel","family":"Shirley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasia","family":"Safdar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"S0899823X23001721_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31187-9"},{"key":"S0899823X23001721_ref3","unstructured":"3. Interim Infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/infection-control-recommendations.html. Accessed February 7, 2022."},{"key":"S0899823X23001721_ref23","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2022.295"},{"key":"S0899823X23001721_ref24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2031670"},{"key":"S0899823X23001721_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2021.08.006"},{"key":"S0899823X23001721_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.06.021"},{"key":"S0899823X23001721_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2021.05.002"},{"key":"S0899823X23001721_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.06.007"},{"key":"S0899823X23001721_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.5437"},{"key":"S0899823X23001721_ref18","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001887"},{"key":"S0899823X23001721_ref4","doi-asserted-by":"publisher","DOI":"10.7326\/M20-7567"},{"key":"S0899823X23001721_ref12","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-20-0516"},{"key":"S0899823X23001721_ref2","unstructured":"2. Annex to infection prevention and control during health care when coronavirus disease (COVID-19) is suspected or confirmed. World Health Organization website. https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-IPC-Annex-2021.1. Accessed February 6, 2022."},{"key":"S0899823X23001721_ref19","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001686"},{"key":"S0899823X23001721_ref1","unstructured":"1. Infection prevention and control during health care when coronavirus disease (COVID-19) is suspected or confirmed. World Health Organization website. https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-IPC-2021.1. 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Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}