Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections

Illingworth, C. J.R. et al. (2021) Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections. eLife, 10, e67308. (doi: 10.7554/eLife.67308)

Abstract

SARS-CoV-2 is notable both for its rapid spread, and for the heterogeneity of its patterns of transmission, with multiple published incidences of superspreading behaviour. Here, we applied a novel network reconstruction algorithm to infer patterns of viral transmission occurring between patients and health care workers (HCWs) in the largest clusters of COVID-19 infection identified during the first wave of the epidemic at Cambridge University Hospitals NHS Foundation Trust, UK. Based upon dates of individuals reporting symptoms, recorded individual locations, and viral genome sequence data, we show an uneven pattern of transmission between individuals, with patients being much more likely to be infected by other patients than by HCWs. Further, the data were consistent with a pattern of superspreading, whereby 21% of individuals caused 80% of transmission events. Our study provides a detailed retrospective analysis of nosocomial SARS-CoV-2 transmission, and sheds light on the need for intensive and pervasive infection control procedures.

• Item Type: Articles
• Additional Information: This work was funded by COG-UK, which is supported by funding from the Medical Research Council (MRC) part of UK Research and Innovation (UKRI), the National Institute of Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute; We also acknowledge the support from the Wellcome (Senior Clinical Fellowship to MPW (ref: 108070/Z/15/ Z), Senior Research Fellowship to SB (ref: 215515/Z/19/Z), Senior Fellowship to IG (ref: 097997/Z/11/ Z); Collaborative Grant to CJH (ref: 204870/Z/16/Z)); the Academy of Medical Sciences and the Health Foundation (Clinician Scientist Fellowship to MET), the National Institute for Health Research Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust (to BW, MET); the NIHR Clinical Research Network Greenshoots award (to EGK); and MRC core funding (MC_UU_00002/11, for CJRI, DDA). CJRI acknowledges funding from Deutsche Forschungsgemeinschaft (DFG) Grant SFB 1310.
• Keywords: Hospital, nosocomial, SARS-CoV-2, superspreader, transmission, virus.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Illingworth, Dr Chris
• Authors: Illingworth, C. J.R., Hamilton, W. L., Warne, B., Routledge, M., Popay, A., Jackson, C., Fieldman, T., Meredith, L. W., Houldcroft, C. J., Hosmillo, M., Jahun, A. S., Caller, L. G., Caddy, S. L., Yakovleva, A., Hall, G., Khokhar, F. A., Feltwell, T., Pinckert, M. L., Georgana, I., Chaudhry, Y., Curran, M. D., Parmar, S., Sparkes, D., Rivett, L., Jones, N. K., Sridhar, S., Forrest, S., Dymond, T., Grainger, K., Workman, C., Ferris, M., Gkrania-Klotsas, E., Brown, N. M., Weekes, M. P., Baker, S., Peacock, S. J., Goodfellow, I. G., Gouliouris, T., De Angelis, D., and Török, M. E.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
• Journal Name: eLife
• Publisher: eLife Sciences Publications
• ISSN: 2050-084X
• ISSN (Online): 2050-084X
• Copyright Holders: Copyright © 2021 Illingworth et al.
• First Published: First published in eLife 10: e67308
• Publisher Policy: Reproduced under a Creative Commons License