Skip to main content
Top
Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | SARS-CoV-2 | Research article

High impact of COVID-19 outbreak in a nursing home in the Nouvelle-Aquitaine region, France, March to April 2020

Authors: A. Bernadou, S. Bouges, M. Catroux, J. C. Rigaux, C. Laland, N. Levêque, U. Noury, S. Larrieu, S. Acef, D. Habold, F. Cazenave-Roblot, L. Filleul

Published in: BMC Infectious Diseases | Issue 1/2021

Login to get access

Abstract

Background

Elderly people in nursing homes are particularly vulnerable to COVID-19 due to their age, the presence of comorbidities, and community living. On March 14, 2020, at the beginning of the first epidemic wave of COVID-19 in France, a cluster was reported in a nursing home in the Nouvelle-Aquitaine region. We monitored the outbreak as well as the infection prevention and control (IPC) measures implemented.

Methods

A confirmed case was defined as laboratory-confirmed COVID-19 in a resident or staff member present in the nursing home between March 7 and May 1, 2020; and a probable case as a person presenting an acute respiratory illness after contact with a confirmed case. Symptomatic inpatient residents and symptomatic staff members were systematically tested for SARS-CoV-2. In addition, two screening sessions were held on site.

Results

We identified 109 cases (98 confirmed, 11 probable). The attack rate was 66% among residents and 45% among staff. Half of all cases were identified during the screening sessions. One-quarter of cases had minor symptoms or were asymptomatic. The case fatality rate among residents was 29%. IPC measures were rapidly implemented such as the quarantine of residents, the reinforcement of staff personal protective equipment, and home quarantine of staff testing positive, which were supplemented in April by systematic controls at the entrance of the nursing home and the creation of additional staff break rooms.

Conclusions

This outbreak confirmed the considerable health impact of SARS-CoV-2 transmission in a nursing home. In addition to the implementation of IPC measures, the early detection of cases through the screening of residents and staff is essential to identify asymptomatic and pre-symptomatic cases and limit the spread of the virus.
Literature
1.
go back to reference Bernard Stoecklin S, Rolland P, Silue Y, Mailles A, Campese C, Simondon A, et al. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020. Eurosurveillance. 2020;25(6):2000094.CrossRef Bernard Stoecklin S, Rolland P, Silue Y, Mailles A, Campese C, Simondon A, et al. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020. Eurosurveillance. 2020;25(6):2000094.CrossRef
3.
go back to reference Haut Conseil de la santé publique. Conduite à tenir devant une ou plusieurs infections respiratoires aiguës en Ehpad. Paris: HCSP; 2012. p. 59. Haut Conseil de la santé publique. Conduite à tenir devant une ou plusieurs infections respiratoires aiguës en Ehpad. Paris: HCSP; 2012. p. 59.
4.
go back to reference Bouza E, Pérez-Granda MJ, Escribano P, Fernández-Del-Rey R, Pastor I, Moure Z, et al. Outbreak of COVID-19 in a nursing home in Madrid. J Inf Secur. 2020;81(4):647–79. Bouza E, Pérez-Granda MJ, Escribano P, Fernández-Del-Rey R, Pastor I, Moure Z, et al. Outbreak of COVID-19 in a nursing home in Madrid. J Inf Secur. 2020;81(4):647–79.
5.
go back to reference McMichael TM, Currie DW, Clark S, Pogosjans S, Kay M, Schwartz NG, et al. Epidemiology of Covid-19 in a long-term Care Facility in King County, Washington. N Engl J Med. 2020;382(21):2005–11.CrossRef McMichael TM, Currie DW, Clark S, Pogosjans S, Kay M, Schwartz NG, et al. Epidemiology of Covid-19 in a long-term Care Facility in King County, Washington. N Engl J Med. 2020;382(21):2005–11.CrossRef
6.
go back to reference Heudorf U, Müller M, Schmehl C, Gasteyer S, Steul K. COVID-19 in long-term care facilities in Frankfurt am Main, Germany: incidence, case reports, and lessons learned. GMS Hyg Infect Control. 2020;15:Doc26.PubMedPubMedCentral Heudorf U, Müller M, Schmehl C, Gasteyer S, Steul K. COVID-19 in long-term care facilities in Frankfurt am Main, Germany: incidence, case reports, and lessons learned. GMS Hyg Infect Control. 2020;15:Doc26.PubMedPubMedCentral
7.
go back to reference Graham NSN, Junghans C, Downes R, Sendall C, Lai H, McKirdy A, et al. SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes. J Infect. 2020;81(3):411–9.CrossRef Graham NSN, Junghans C, Downes R, Sendall C, Lai H, McKirdy A, et al. SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes. J Infect. 2020;81(3):411–9.CrossRef
8.
go back to reference Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020;382(22):2081–90.CrossRef Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med. 2020;382(22):2081–90.CrossRef
9.
go back to reference Huff HV, Singh A. Asymptomatic transmission during the coronavirus disease 2019 pandemic and Implications for public health strategies. Clin Infect Dis. 2020;71(10):2752–6.CrossRef Huff HV, Singh A. Asymptomatic transmission during the coronavirus disease 2019 pandemic and Implications for public health strategies. Clin Infect Dis. 2020;71(10):2752–6.CrossRef
10.
go back to reference Klinkenberg D, Fraser C, Heesterbeek H. The effectiveness of contact tracing in emerging epidemics. PloS One. 2006;1(1):e12–e.CrossRef Klinkenberg D, Fraser C, Heesterbeek H. The effectiveness of contact tracing in emerging epidemics. PloS One. 2006;1(1):e12–e.CrossRef
11.
go back to reference Peak CM, Childs LM, Grad YH, Buckee CO. Comparing nonpharmaceutical interventions for containing emerging epidemics. Proc Natl Acad Sci U S A. 2017;114(15):4023–8.CrossRef Peak CM, Childs LM, Grad YH, Buckee CO. Comparing nonpharmaceutical interventions for containing emerging epidemics. Proc Natl Acad Sci U S A. 2017;114(15):4023–8.CrossRef
12.
go back to reference Xu H, Intrator O, Bowblis JR. Shortages of staff in nursing homes during the COVID-19 pandemic: what are the driving factors? J Am Med Dir Assoc. 2020;21(10):1371–7.CrossRef Xu H, Intrator O, Bowblis JR. Shortages of staff in nursing homes during the COVID-19 pandemic: what are the driving factors? J Am Med Dir Assoc. 2020;21(10):1371–7.CrossRef
13.
go back to reference Zabarsky TF, Bhullar D, Silva SY, Mana TSC, Ertle MT, Navas ME, et al. What are the sources of exposure in healthcare personnel with coronavirus disease 2019 infection? Am J Infect Control. 2020:S0196-6553(20)30769-0. Zabarsky TF, Bhullar D, Silva SY, Mana TSC, Ertle MT, Navas ME, et al. What are the sources of exposure in healthcare personnel with coronavirus disease 2019 infection? Am J Infect Control. 2020:S0196-6553(20)30769-0.
14.
go back to reference Pascual FB, McCall CL, McMurtray A, Payton T, Smith F, Bisgard KM. Outbreak of pertussis among healthcare workers in a hospital surgical unit. Infect Control Hosp Epidemiol. 2006;27(6):546–52.CrossRef Pascual FB, McCall CL, McMurtray A, Payton T, Smith F, Bisgard KM. Outbreak of pertussis among healthcare workers in a hospital surgical unit. Infect Control Hosp Epidemiol. 2006;27(6):546–52.CrossRef
15.
go back to reference Team EPHE, Danis K, Fonteneau L, Georges S, Daniau C, Bernard-Stoecklin S, et al. High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA, may 2020. Eurosurveillance. 2020;25(22):2000956. Team EPHE, Danis K, Fonteneau L, Georges S, Daniau C, Bernard-Stoecklin S, et al. High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA, may 2020. Eurosurveillance. 2020;25(22):2000956.
16.
go back to reference Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility — King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):377–81.CrossRef Kimball A, Hatfield KM, Arons M, James A, Taylor J, Spicer K, et al. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility — King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):377–81.CrossRef
17.
go back to reference Taylor J, Carter RJ, Lehnertz N, Kazazian L, Sullivan M, Wang X, et al. Serial testing for SARS-CoV-2 and virus whole genome sequencing inform infection risk at two skilled nursing facilities with COVID-19 outbreaks - Minnesota, April-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(37):1288–95.CrossRef Taylor J, Carter RJ, Lehnertz N, Kazazian L, Sullivan M, Wang X, et al. Serial testing for SARS-CoV-2 and virus whole genome sequencing inform infection risk at two skilled nursing facilities with COVID-19 outbreaks - Minnesota, April-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(37):1288–95.CrossRef
18.
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.CrossRef 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.CrossRef
19.
go back to reference Birgand G, Blanckaert K, Deschanvres C, Vaudron A, Loury P, King L. Testing strategies for the control of COVID-19 in nursing homes: universal or targeted screening? J Infect. 2020;82(1). Birgand G, Blanckaert K, Deschanvres C, Vaudron A, Loury P, King L. Testing strategies for the control of COVID-19 in nursing homes: universal or targeted screening? J Infect. 2020;82(1).
20.
go back to reference Santé publique France. Protocole de la surveillance active des cas de COVID-19 en EHPAD et EMS. Saint-Maurice: Santé publique France; 2020. p. 9. [cited 31/03/2020] Santé publique France. Protocole de la surveillance active des cas de COVID-19 en EHPAD et EMS. Saint-Maurice: Santé publique France; 2020. p. 9. [cited 31/03/2020]
Metadata
Title
High impact of COVID-19 outbreak in a nursing home in the Nouvelle-Aquitaine region, France, March to April 2020
Authors
A. Bernadou
S. Bouges
M. Catroux
J. C. Rigaux
C. Laland
N. Levêque
U. Noury
S. Larrieu
S. Acef
D. Habold
F. Cazenave-Roblot
L. Filleul
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-021-05890-6

Other articles of this Issue 1/2021

BMC Infectious Diseases 1/2021 Go to the issue