Skip to main content
Top
Published in: Antimicrobial Resistance & Infection Control 1/2020

Open Access 01-12-2020 | Adenovirus | Research

Does respiratory co-infection facilitate dispersal of SARS-CoV-2? investigation of a super-spreading event in an open-space office

Authors: Dana Weissberg, Jürg Böni, Silvana K. Rampini, Verena Kufner, Maryam Zaheri, Peter W. Schreiber, Irene A. Abela, Michael Huber, Hugo Sax, Aline Wolfensberger

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2020

Login to get access

Abstract

Background

Super-spreaders are individuals infecting disproportionately large numbers of contacts. They probably play a crucial role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a super-spreading event within a team working in an open-space office and investigate factors potentially having facilitated SARS-CoV-2 transmission.

Methods

In this retrospective cohort study, semi-structured telephone interviews with all team members were carried out to identify symptoms, contacts, and adherence to basic hygiene measures. During site visits, we gathered information about workplace and seating arrangements. The secondary attack rate in office and households was calculated. Potential respiratory viral co-infections were assessed by multiplex PCR. SARS-CoV-2 whole-genome sequencing was performed using a tiled-amplicon sequencing approach.

Results

Of 13 team members, 11 fell ill with Coronavirus disease 2019 (COVID-19). Due to the sequence of events and full genome sequence data, one person was considered the index case for this outbreak, directly infecting 67 to 83% of the teammates. All team members reported repetitive close contacts among themselves during joint computer work, team meetings and a “Happy Birthday” serenade. Two individuals shared nuts and dates. The arrangement of the office and meeting rooms precluded sufficient adherence to physical distancing. The index case and a further individual were diagnosed with an adenovirus serotype 4 co-infection.

Conclusion

We identified several environmental and behavioral factors that probably have facilitated the transmission of SARS-CoV-2. The relevance of the adenovirus co-infection remains unclear and merits further investigation.
Appendix
Available only for authorised users
Literature
3.
go back to reference Wong SC, Kwong RT, Wu TC, Chan JWM, Chu MY, Lee SY, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect. 2020. Wong SC, Kwong RT, Wu TC, Chan JWM, Chu MY, Lee SY, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect. 2020.
5.
go back to reference Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schunemann HJ, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020. Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schunemann HJ, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020.
6.
go back to reference He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020;26(5):672–5.CrossRefPubMed He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020;26(5):672–5.CrossRefPubMed
7.
go back to reference Ferretti L, Wymant C, Kendall M, Zhao L, Nurtay A, Abeler-Dorner L, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science. 2020;368:6491.CrossRef Ferretti L, Wymant C, Kendall M, Zhao L, Nurtay A, Abeler-Dorner L, et al. Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science. 2020;368:6491.CrossRef
8.
go back to reference Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–207.CrossRefPubMedPubMedCentral Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–207.CrossRefPubMedPubMedCentral
9.
go back to reference Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Euro Surveill. 2020;25(4):2000058.CrossRefPubMedCentral Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Euro Surveill. 2020;25(4):2000058.CrossRefPubMedCentral
10.
go back to reference Wu JT, Leung K, Bushman M, Kishore N, Niehus R, de Salazar PM, et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med. 2020;26(4):506–10.CrossRefPubMedPubMedCentral Wu JT, Leung K, Bushman M, Kishore N, Niehus R, de Salazar PM, et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med. 2020;26(4):506–10.CrossRefPubMedPubMedCentral
11.
go back to reference Bi Q, Wu Y, Mei S, Ye C, Zou X, Zhang Z, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. Lancet Infect Dis. 2020;20(8):911–9.CrossRefPubMedPubMedCentral Bi Q, Wu Y, Mei S, Ye C, Zou X, Zhang Z, et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. Lancet Infect Dis. 2020;20(8):911–9.CrossRefPubMedPubMedCentral
12.
go back to reference Endo A, Abbott S, Kucharski AJ, Funk S, et al. Estimating the overdispersion in covid-19 transmission using outbreak sizes outside China. Wellcome Open Res. 2020;5:67.CrossRefPubMedPubMedCentral Endo A, Abbott S, Kucharski AJ, Funk S, et al. Estimating the overdispersion in covid-19 transmission using outbreak sizes outside China. Wellcome Open Res. 2020;5:67.CrossRefPubMedPubMedCentral
13.
go back to reference Woolhouse ME, Dye C, Etard JF, Smith T, Charlwood JD, Garnett GP, et al. Heterogeneities in the transmission of infectious agents: implications for the design of control programs. Proc Natl Acad Sci U S A. 1997;94(1):338–42.CrossRefPubMedPubMedCentral Woolhouse ME, Dye C, Etard JF, Smith T, Charlwood JD, Garnett GP, et al. Heterogeneities in the transmission of infectious agents: implications for the design of control programs. Proc Natl Acad Sci U S A. 1997;94(1):338–42.CrossRefPubMedPubMedCentral
15.
go back to reference Cho SY, Kang JM, Ha YE, Park GE, Lee JY, Ko JH, et al. MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study. Lancet. 2016;388(10048):994–1001.CrossRefPubMedPubMedCentral Cho SY, Kang JM, Ha YE, Park GE, Lee JY, Ko JH, et al. MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study. Lancet. 2016;388(10048):994–1001.CrossRefPubMedPubMedCentral
16.
go back to reference Severe acute respiratory syndrome--Taiwan, 2003. MMWR Morb Mortal Wkly Rep 2003;52(20):461–6. Severe acute respiratory syndrome--Taiwan, 2003. MMWR Morb Mortal Wkly Rep 2003;52(20):461–6.
17.
go back to reference Cluster of severe acute respiratory syndrome cases among protected health-care workers--Toronto, Canada, April 2003 MMWR Morbidity and mortality weekly report 2003;52(19):433–6. Cluster of severe acute respiratory syndrome cases among protected health-care workers--Toronto, Canada, April 2003 MMWR Morbidity and mortality weekly report 2003;52(19):433–6.
18.
go back to reference Severe acute respiratory syndrome--Singapore, 2003. MMWR Morb Mortal Wkly Rep 2003;52(18):405–11. Severe acute respiratory syndrome--Singapore, 2003. MMWR Morb Mortal Wkly Rep 2003;52(18):405–11.
19.
go back to reference Danis K, Epaulard O, Benet T, Gaymard A, Campoy S, Bothelo-Nevers E, et al. Cluster of coronavirus disease 2019 (Covid-19) in the French Alps, 2020. Clin Infect Dis. 2020;71(15):825–32.CrossRefPubMed Danis K, Epaulard O, Benet T, Gaymard A, Campoy S, Bothelo-Nevers E, et al. Cluster of coronavirus disease 2019 (Covid-19) in the French Alps, 2020. Clin Infect Dis. 2020;71(15):825–32.CrossRefPubMed
20.
go back to reference Huang R, Xia J, Chen Y, Shan C, Wu C. A family cluster of SARS-CoV-2 infection involving 11 patients in Nanjing, China. Lancet Infect Dis. 2020;20(5):534–5.CrossRefPubMedPubMedCentral Huang R, Xia J, Chen Y, Shan C, Wu C. A family cluster of SARS-CoV-2 infection involving 11 patients in Nanjing, China. Lancet Infect Dis. 2020;20(5):534–5.CrossRefPubMedPubMedCentral
22.
go back to reference Lu J, Gu J, Li K, Xu C, Su W, Lai Z, et al. COVID-19 outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020;26(7):1628.CrossRefPubMedPubMedCentral Lu J, Gu J, Li K, Xu C, Su W, Lai Z, et al. COVID-19 outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020;26(7):1628.CrossRefPubMedPubMedCentral
23.
go back to reference Hamner L, Dubbel P, Capron I, Ross A, Jordan A, Lee J, et al. High SARS-CoV-2 attack rate following exposure at a choir practice - Skagit County, Washington, march 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):606–10.CrossRefPubMed Hamner L, Dubbel P, Capron I, Ross A, Jordan A, Lee J, et al. High SARS-CoV-2 attack rate following exposure at a choir practice - Skagit County, Washington, march 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):606–10.CrossRefPubMed
25.
go back to reference Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045.CrossRefPubMedCentral Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045.CrossRefPubMedCentral
26.
go back to reference Rockett RJ, Arnott A, Lam C, Sadsad R, Timms V, Gray KA, et al. Revealing COVID-19 transmission in Australia by SARS-CoV-2 genome sequencing and agent-based modeling. Nat Med. 2020;26(9):1398–404.CrossRefPubMed Rockett RJ, Arnott A, Lam C, Sadsad R, Timms V, Gray KA, et al. Revealing COVID-19 transmission in Australia by SARS-CoV-2 genome sequencing and agent-based modeling. Nat Med. 2020;26(9):1398–404.CrossRefPubMed
27.
go back to reference Eden JS. SARS-CoV-2 Genome Sequencing Using Long Pooled Amplicons on Illumina Platforms protocols.io2020 Eden JS. SARS-CoV-2 Genome Sequencing Using Long Pooled Amplicons on Illumina Platforms protocols.io2020
28.
go back to reference Kufner V, Plate A, Schmutz S, Braun DL, Gunthard HF, Capaul R, et al. Two years of viral metagenomics in a tertiary diagnostics unit: evaluation of the first 105 cases. Genes (Basel). 2019;10(9):661.CrossRefPubMedCentral Kufner V, Plate A, Schmutz S, Braun DL, Gunthard HF, Capaul R, et al. Two years of viral metagenomics in a tertiary diagnostics unit: evaluation of the first 105 cases. Genes (Basel). 2019;10(9):661.CrossRefPubMedCentral
29.
go back to reference Katoh K, Standley DM. MAFFT multiple sequence alignment software version 7: improvements in performance and usability. Mol Biol Evol. 2013;30(4):772–80.CrossRefPubMedPubMedCentral Katoh K, Standley DM. MAFFT multiple sequence alignment software version 7: improvements in performance and usability. Mol Biol Evol. 2013;30(4):772–80.CrossRefPubMedPubMedCentral
30.
go back to reference Kozlov AM, Darriba D, Flouri T, Morel B, Stamatakis A. RAxML-NG: a fast, scalable and user-friendly tool for maximum likelihood phylogenetic inference. Bioinformatics. 2019;35(21):4453–5.CrossRefPubMedPubMedCentral Kozlov AM, Darriba D, Flouri T, Morel B, Stamatakis A. RAxML-NG: a fast, scalable and user-friendly tool for maximum likelihood phylogenetic inference. Bioinformatics. 2019;35(21):4453–5.CrossRefPubMedPubMedCentral
31.
go back to reference Alm E, Broberg EK, Connor T, Hodcroft EB, Komissarov AB, Maurer-Stroh S, et al. Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European region, January to June 2020. Euro Surveill. 2020;25(32):2001410.CrossRefPubMedCentral Alm E, Broberg EK, Connor T, Hodcroft EB, Komissarov AB, Maurer-Stroh S, et al. Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European region, January to June 2020. Euro Surveill. 2020;25(32):2001410.CrossRefPubMedCentral
32.
go back to reference Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. 2020;172(9):577–82.CrossRefPubMed Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. 2020;172(9):577–82.CrossRefPubMed
33.
go back to reference Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20–28 January 2020. Euro Surveill. 2020;25(5). Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20–28 January 2020. Euro Surveill. 2020;25(5).
34.
go back to reference Cheng HY, Jian SW, Liu DP, Ng TC, Huang WT, Lin HH, et al. Contact tracing assessment of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods before and after symptom onset. JAMA Intern Med. 2020;180(9):1156–63.CrossRefPubMedPubMedCentral Cheng HY, Jian SW, Liu DP, Ng TC, Huang WT, Lin HH, et al. Contact tracing assessment of COVID-19 transmission dynamics in Taiwan and risk at different exposure periods before and after symptom onset. JAMA Intern Med. 2020;180(9):1156–63.CrossRefPubMedPubMedCentral
35.
go back to reference Burke RM, Midgley CM, Dratch A, Fenstersheib M, Haupt T, Holshue M, et al. Active monitoring of persons exposed to patients with confirmed COVID-19 - United States, January-February 2020. MMWR Morb Mortal Wkly Rep. 2020;69(9):245–6.CrossRefPubMedPubMedCentral Burke RM, Midgley CM, Dratch A, Fenstersheib M, Haupt T, Holshue M, et al. Active monitoring of persons exposed to patients with confirmed COVID-19 - United States, January-February 2020. MMWR Morb Mortal Wkly Rep. 2020;69(9):245–6.CrossRefPubMedPubMedCentral
36.
go back to reference Park SH, Kim WJ, Yoo JH, Choi JH. Epidemiologic parameters of the Middle East respiratory syndrome outbreak in Korea, 2015. Infect Chemother. 2016;48(2):108–17.CrossRefPubMedPubMedCentral Park SH, Kim WJ, Yoo JH, Choi JH. Epidemiologic parameters of the Middle East respiratory syndrome outbreak in Korea, 2015. Infect Chemother. 2016;48(2):108–17.CrossRefPubMedPubMedCentral
37.
go back to reference Jing QL, Li YG, Ma MM, Gu YZ, Li K, Ma Y, et al. Contagiousness and secondary attack rate of 2019 novel coronavirus based on cluster epidemics of COVID-19 in Guangzhou. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(0):E058. Jing QL, Li YG, Ma MM, Gu YZ, Li K, Ma Y, et al. Contagiousness and secondary attack rate of 2019 novel coronavirus based on cluster epidemics of COVID-19 in Guangzhou. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(0):E058.
38.
go back to reference Frieden TR, Lee CT. Identifying and interrupting Superspreading events-implications for control of severe acute respiratory syndrome coronavirus 2. Emerg Infect Dis. 2020;26(6):1059–66.CrossRefPubMedPubMedCentral Frieden TR, Lee CT. Identifying and interrupting Superspreading events-implications for control of severe acute respiratory syndrome coronavirus 2. Emerg Infect Dis. 2020;26(6):1059–66.CrossRefPubMedPubMedCentral
39.
go back to reference Asadi S, Wexler AS, Cappa CD, Barreda S, Bouvier NM, Ristenpart WD. Aerosol emission and superemission during human speech increase with voice loudness. Sci Rep. 2019;9(1):2348.CrossRefPubMedPubMedCentral Asadi S, Wexler AS, Cappa CD, Barreda S, Bouvier NM, Ristenpart WD. Aerosol emission and superemission during human speech increase with voice loudness. Sci Rep. 2019;9(1):2348.CrossRefPubMedPubMedCentral
40.
go back to reference Ghinai I, Woods S, Ritger KA, McPherson TD, Black SR, Sparrow L, et al. Community transmission of SARS-CoV-2 at two family gatherings - Chicago, Illinois, February-march 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):446–50.CrossRefPubMedPubMedCentral Ghinai I, Woods S, Ritger KA, McPherson TD, Black SR, Sparrow L, et al. Community transmission of SARS-CoV-2 at two family gatherings - Chicago, Illinois, February-march 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):446–50.CrossRefPubMedPubMedCentral
41.
go back to reference Yong SEF, Anderson DE, Wei WE, Pang J, Chia WN, Tan CW, et al. Connecting clusters of COVID-19: an epidemiological and serological investigation. Lancet Infect Dis. 2020;20(7):809–15.CrossRefPubMedPubMedCentral Yong SEF, Anderson DE, Wei WE, Pang J, Chia WN, Tan CW, et al. Connecting clusters of COVID-19: an epidemiological and serological investigation. Lancet Infect Dis. 2020;20(7):809–15.CrossRefPubMedPubMedCentral
42.
go back to reference Lynch JP 3rd, Kajon AE. Adenovirus: epidemiology, global spread of novel serotypes, and advances in treatment and prevention. Semin Respir Crit Care Med. 2016;37(4):586–602.CrossRefPubMedPubMedCentral Lynch JP 3rd, Kajon AE. Adenovirus: epidemiology, global spread of novel serotypes, and advances in treatment and prevention. Semin Respir Crit Care Med. 2016;37(4):586–602.CrossRefPubMedPubMedCentral
44.
go back to reference Sherertz RJ, Reagan DR, Hampton KD, Robertson KL, Streed SA, Hoen HM, et al. A cloud adult: the Staphylococcus aureus-virus interaction revisited. Ann Intern Med. 1996;124(6):539–47.CrossRefPubMed Sherertz RJ, Reagan DR, Hampton KD, Robertson KL, Streed SA, Hoen HM, et al. A cloud adult: the Staphylococcus aureus-virus interaction revisited. Ann Intern Med. 1996;124(6):539–47.CrossRefPubMed
Metadata
Title
Does respiratory co-infection facilitate dispersal of SARS-CoV-2? investigation of a super-spreading event in an open-space office
Authors
Dana Weissberg
Jürg Böni
Silvana K. Rampini
Verena Kufner
Maryam Zaheri
Peter W. Schreiber
Irene A. Abela
Michael Huber
Hugo Sax
Aline Wolfensberger
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2020
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-020-00861-z

Other articles of this Issue 1/2020

Antimicrobial Resistance & Infection Control 1/2020 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.