Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections
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...
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| Format: | Article |
| Language: | English |
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eLife Sciences Publications Ltd
2021-08-01
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| Series: | eLife |
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| Online Access: | https://elifesciences.org/articles/67308 |
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Article |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Christopher JR Illingworth William L Hamilton Ben Warne Matthew Routledge Ashley Popay Chris Jackson Tom Fieldman Luke W Meredith Charlotte J Houldcroft Myra Hosmillo Aminu S Jahun Laura G Caller Sarah L Caddy Anna Yakovleva Grant Hall Fahad A Khokhar Theresa Feltwell Malte L Pinckert Iliana Georgana Yasmin Chaudhry Martin D Curran Surendra Parmar Dominic Sparkes Lucy Rivett Nick K Jones Sushmita Sridhar Sally Forrest Tom Dymond Kayleigh Grainger Chris Workman Mark Ferris Effrossyni Gkrania-Klotsas Nicholas M Brown Michael P Weekes Stephen Baker Sharon J Peacock Ian G Goodfellow Theodore Gouliouris Daniela de Angelis M Estée Török |
| spellingShingle |
Christopher JR Illingworth William L Hamilton Ben Warne Matthew Routledge Ashley Popay Chris Jackson Tom Fieldman Luke W Meredith Charlotte J Houldcroft Myra Hosmillo Aminu S Jahun Laura G Caller Sarah L Caddy Anna Yakovleva Grant Hall Fahad A Khokhar Theresa Feltwell Malte L Pinckert Iliana Georgana Yasmin Chaudhry Martin D Curran Surendra Parmar Dominic Sparkes Lucy Rivett Nick K Jones Sushmita Sridhar Sally Forrest Tom Dymond Kayleigh Grainger Chris Workman Mark Ferris Effrossyni Gkrania-Klotsas Nicholas M Brown Michael P Weekes Stephen Baker Sharon J Peacock Ian G Goodfellow Theodore Gouliouris Daniela de Angelis M Estée Török Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections eLife SARS-CoV-2 nosocomial transmission superspreader hospital |
| author_facet |
Christopher JR Illingworth William L Hamilton Ben Warne Matthew Routledge Ashley Popay Chris Jackson Tom Fieldman Luke W Meredith Charlotte J Houldcroft Myra Hosmillo Aminu S Jahun Laura G Caller Sarah L Caddy Anna Yakovleva Grant Hall Fahad A Khokhar Theresa Feltwell Malte L Pinckert Iliana Georgana Yasmin Chaudhry Martin D Curran Surendra Parmar Dominic Sparkes Lucy Rivett Nick K Jones Sushmita Sridhar Sally Forrest Tom Dymond Kayleigh Grainger Chris Workman Mark Ferris Effrossyni Gkrania-Klotsas Nicholas M Brown Michael P Weekes Stephen Baker Sharon J Peacock Ian G Goodfellow Theodore Gouliouris Daniela de Angelis M Estée Török |
| author_sort |
Christopher JR Illingworth |
| title |
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections |
| title_short |
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections |
| title_full |
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections |
| title_fullStr |
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections |
| title_full_unstemmed |
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections |
| title_sort |
superspreaders drive the largest outbreaks of hospital onset covid-19 infections |
| publisher |
eLife Sciences Publications Ltd |
| series |
eLife |
| issn |
2050-084X |
| publishDate |
2021-08-01 |
| description |
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. |
| topic |
SARS-CoV-2 nosocomial transmission superspreader hospital |
| url |
https://elifesciences.org/articles/67308 |
| work_keys_str_mv |
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1721174220505874432 |
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doaj-10ef2e455581422cb454523aa83c14562021-09-02T14:52:30ZengeLife Sciences Publications LtdeLife2050-084X2021-08-011010.7554/eLife.67308Superspreaders drive the largest outbreaks of hospital onset COVID-19 infectionsChristopher JR Illingworth0https://orcid.org/0000-0002-0030-2784William L Hamilton1https://orcid.org/0000-0002-3330-353XBen Warne2Matthew Routledge3Ashley Popay4Chris Jackson5Tom Fieldman6Luke W Meredith7Charlotte J Houldcroft8https://orcid.org/0000-0002-1833-5285Myra Hosmillo9https://orcid.org/0000-0002-3514-7681Aminu S Jahun10https://orcid.org/0000-0002-4585-1701Laura G Caller11Sarah L Caddy12https://orcid.org/0000-0002-9790-7420Anna Yakovleva13Grant Hall14https://orcid.org/0000-0003-3928-3979Fahad A Khokhar15Theresa Feltwell16Malte L Pinckert17Iliana Georgana18https://orcid.org/0000-0002-8976-1177Yasmin Chaudhry19Martin D Curran20Surendra Parmar21Dominic Sparkes22Lucy Rivett23https://orcid.org/0000-0002-2781-9345Nick K Jones24https://orcid.org/0000-0003-4475-7761Sushmita Sridhar25https://orcid.org/0000-0001-7453-7482Sally Forrest26Tom Dymond27Kayleigh Grainger28Chris Workman29Mark Ferris30https://orcid.org/0000-0001-5040-4263Effrossyni Gkrania-Klotsas31https://orcid.org/0000-0002-0930-8330Nicholas M Brown32https://orcid.org/0000-0002-6657-300XMichael P Weekes33https://orcid.org/0000-0003-3196-5545Stephen Baker34https://orcid.org/0000-0003-1308-5755Sharon J Peacock35https://orcid.org/0000-0002-1718-2782Ian G Goodfellow36https://orcid.org/0000-0002-9483-510XTheodore Gouliouris37Daniela de Angelis38M Estée Török39https://orcid.org/0000-0001-9098-8590MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Forvie Site, Robinson Way, Cambridge, United Kingdom; Institut für Biologische Physik, Universität zu Köln, Köln, Germany; Department of Applied Mathematics and Theoretical Physics, Centre for Mathematical Sciences, Cambridge, United StatesUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom; Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomPublic Health England Field Epidemiology Unit, Cambridge Institute of Public Health, Forvie Site, Cambridge Biomedical Campus, Cambridge, United KingdomMRC Biostatistics Unit, University of Cambridge, East Forvie Building, Forvie Site, Robinson Way, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomPublic Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomPublic Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom; Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom; Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom; Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom; Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United KingdomCambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom; MRC Epidemiology Unit, University of Cambridge, Level 3 Institute of Metabolic Science, Cambridge, United Kingdom; University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United KingdomCambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; Public Health England, National Infection Service, London, United KingdomUniversity of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom; Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United KingdomInstitut für Biologische Physik, Universität zu Köln, Köln, Germany; Public Health England, National Infection Service, London, United KingdomUniversity of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United KingdomSARS-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.https://elifesciences.org/articles/67308SARS-CoV-2nosocomial transmissionsuperspreaderhospital |