Cutaneous Anthrax Outbreak Associated with Handling Dead Animals, Rhino Camp Sub-county: Arua District, Uganda, January-May 2018

Abstract Background: On the 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. About 9 persons fell ill after reported contact with livestock that died suddenly. We investigated to determine the scope, mode of transmission and exposures associated with identified anthrax, to guide control and prevention measures.Methods: We defined a suspected cutaneous anthrax case as onset of skin lesions (e.g., papule, vesicle, or eschar) in a person residing in Rhino Camp sub-county, Arua District from 25 December, 2017 to 31 May, 2018. A confirmed case was a suspected case with PCR-positivity for Bacillus anthracis from a clinical sample. We identified cases by reviewing medical records at Rhino Camp Health Centre. We also conducted additional case searches in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all members of households in which at least one person had contact with the carcasses of or meat from animals suspected to have died of anthrax. We collected and tested hides of implicated animals using an anthrax rapid diagnostic test.Results: We identified 14 case-patients (1 confirmed, 13 suspected); none died. Only males were affected (AR: 12/10,000). Mean age of case-persons was 33years (SD: 22).The epidemic curve shows that the outbreak lasted for 5 months, from January 2018-May 2018, peaking in February.Skinning(RR=2.7, 95%CI=1.1-6.7), dissecting (RR=3.0, 95%CI=1.2-7.6), and carrying the dead animals (RR=2.7, 95%CI=1.1-6.7) were associated with increased risk of illness, as were carrying dissected parts of the animal (RR=2.9, 95%CI 1.3-6.5) and preparing and cooking the meat (RR=2.3, 95%CI 2.7-8.1). We found evidence of animal remains on pastureland.Conclusion: Multiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of livestock that die suddenly.

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Cutaneous Anthrax Outbreak Associated with Handling Dead Animals, Rhino Camp Sub-county: Arua District, Uganda, January-May 2018

10.21203/rs.3.rs-38244/v1 ◽

2020 ◽

Author(s):

Vivian Ntono ◽

Daniel Eurien ◽

Lilian Bulage ◽

Daniel Kadobera ◽

Julie Harris ◽

...

Keyword(s):

Health Workers ◽

Clinical Sample ◽

Health Centre ◽

Skin Lesions ◽

Suspected Case ◽

Prevention Measures ◽

Epidemic Curve ◽

Multiple Exposures ◽

Increased Risk ◽

Cutaneous Anthrax

Abstract BackgroundOn the 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. Many persons fell ill after reported contact with livestock that died suddenly. We investigated to determine the scope, mode of transmission and exposures associated with identified anthrax, to guide control and prevention measures.MethodsWe defined a suspected cutaneous anthrax case as onset of skin lesions (e.g., papule, vesicle, or eschar) in a person residing in Rhino Camp sub-county, Arua District from 25 December, 2017 to 31 May, 2018. A confirmed case was a suspected case with PCR-positivity for Bacillus anthracis from a clinical sample. We identified cases by reviewing medical records at Rhino Camp Health Centre. We also conducted additional case searches in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all members of households in which at least one person had contact with the carcasses of or meat from animals suspected to have died of anthrax. We collected and tested hides of implicated animals using an anthrax rapid diagnostic test.ResultsWe identified 14 case-patients (1 confirmed, 13 suspected); none died. Only males were affected (AR: 12/10,000). Mean age of case-persons was 33 years (SD: 22).The epidemic curve shows that the outbreak lasted for 5 months, from January 2018-May 2018, peaking in February.Skinning(RR = 2.7, 95%CI = 1.1–6.7), dissecting (RR = 3.0, 95%CI = 1.2–7.6), and carrying the dead animals (RR = 2.7, 95%CI = 1.1–6.7) were associated with increased risk of illness, as were carrying dissected parts of the animal (RR = 2.9, 95%CI 1.3–6.5) and preparing and cooking the meat (RR = 2.3, 95%CI 2.7–8.1). We found evidence of animal remains on pastureland.ConclusionMultiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of livestock that die suddenly.

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Cutaneous Anthrax Outbreak Associated with Handling Dead Animals, Rhino Camp Sub-county: Arua District, Uganda, January-May2018

10.21203/rs.3.rs-38244/v2 ◽

2020 ◽

Author(s):

Vivian Ntono ◽

Daniel Eurien ◽

Lilian Bulage ◽

Daniel Kadobera ◽

Julie Harris ◽

...

Keyword(s):

Health Workers ◽

Clinical Sample ◽

Health Centre ◽

Skin Lesions ◽

Suspected Case ◽

Prevention Measures ◽

Epidemic Curve ◽

Multiple Exposures ◽

Increased Risk ◽

Cutaneous Anthrax

Abstract Background: On the 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. Many persons fell ill after reported contact with livestock that died suddenly. We investigated to determine the scope, mode of transmission and exposures associated with identified anthrax, to guide control and prevention measures. Methods: We defined a suspected cutaneous anthrax case as onset of skin lesions (e.g., papule, vesicle, or eschar) in a person residing in Rhino Camp sub-county, Arua District from 25 December, 2017 to 31 May, 2018. A confirmed case was a suspected case with PCR-positivity for Bacillus anthracis from a clinical sample. We identified cases by reviewing medical records at Rhino Camp Health Centre. We also conducted additional case searches in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all members of households in which at least one person had contact with the carcasses of or meat from animals suspected to have died of anthrax. We collected and tested hides of implicated animals using an anthrax rapid diagnostic test.Results: We identified 14 case-patients (1 confirmed, 13 suspected); none died. Only males were affected (AR: 12/10,000). Mean age of case-persons was 33years (SD: 22).The epidemic curve shows that the outbreak lasted for 5 months, from January 2018-May 2018, peaking in February.Skinning(RR=2.7, 95%CI=1.1-6.7), dissecting (RR=3.0, 95%CI=1.2-7.6), and carrying the dead animals (RR=2.7, 95%CI=1.1-6.7) were associated with increased risk of illness, as were carrying dissected parts of the animal (RR=2.9, 95%CI 1.3-6.5) and preparing and cooking the meat (RR=2.3, 95%CI 2.7-8.1). We found evidence of animal remains on pastureland.Conclusion: Multiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of livestock that die suddenly.

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Cutaneous anthrax outbreak associated with handling dead animals, Rhino Camp sub-county: Arua District, Uganda, January–May 2018

One Health Outlook ◽

10.1186/s42522-021-00040-z ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Vivian Ntono ◽

Daniel Eurien ◽

Lilian Bulage ◽

Daniel Kadobera ◽

Julie Harris ◽

...

Keyword(s):

Health Workers ◽

Clinical Sample ◽

Health Centre ◽

Skin Lesions ◽

Suspected Case ◽

Prevention Measures ◽

Multiple Exposures ◽

Increased Risk ◽

Control And Prevention ◽

Cutaneous Anthrax

Abstract Background On 18 January 2018 a 40 year old man presented with skin lesions at Rhino Camp Health Centre. A skin lesion swab was collected on 20 January 2018 and was confirmed by PCR at Uganda Virus Research Institute on 21 January 2018. Subsequently, about 9 persons were reported to have fallen ill after reporting contact with livestock that died suddenly. On 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. We investigated to determine the scope and mode of transmission and exposures associated with identified anthrax to guide control and prevention measures. Methods We defined a suspected cutaneous anthrax case as onset of skin lesions (e.g., papule, vesicle, or eschar) in a person residing in Rhino Camp sub-county, Arua District from 25 December 2017 to 31 May 2018. A confirmed case was a suspected case with PCR-positivity for Bacillus anthracis from a clinical sample. We identified cases by reviewing medical records at Rhino Camp Health Centre. We also conducted additional case searches in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all members of households in which at least one person had contact with the carcasses of or meat from animals suspected to have died of anthrax. We collected and tested hides of implicated animals using an anthrax rapid diagnostic test. Results We identified 14 case-patients (1 confirmed, 13 suspected); none died. Only males were affected (affected proportion: 12/10,000). Mean age of case-persons was 33 years (SD: 22). The outbreak lasted for 5 months, from January 2018–May 2018, peaking in February. Skinning (risk ratio = 2.7, 95% CI = 1.1–6.7), dissecting (RR = 3.0, 95% CI = 1.2–7.6), and carrying dead animals (RR = 2.7, 95% CI = 1.1–6.7) were associated with increased risk of illness, as were carrying dissected parts of animals (RR = 2.9, 95% CI 1.3–6.5) and preparing and cooking the meat (RR = 2.3, 95% CI 0.9–5.9). We found evidence of animal remains on pastureland. Conclusion Multiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of livestock that die suddenly.

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Outbreak of cutaneous anthrax in Musalimadugu village, Chittoor district, Andhra Pradesh, India, July-August 2011

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2635 ◽

2012 ◽

Vol 6 (10) ◽

pp. 695-699 ◽

Cited By ~ 9

Author(s):

Ramesh Reddy ◽

Geetha Parasadini ◽

Prasada Rao ◽

Chengappa K Uthappa ◽

Manoj V Murhekar

Keyword(s):

Risk Factors ◽

Attack Rate ◽

Andhra Pradesh ◽

Community Education ◽

Population Attributable Fraction ◽

Skin Lesions ◽

Suspected Case ◽

Gram Staining ◽

Potential Risk Factors ◽

Cutaneous Anthrax

Background: In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases, to Andhra Pradesh state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk-factors and make recommendations for preventing similar outbreaks in future. Methods: We searched for suspected cutaneous anthrax cases defined as a painless skin lesion (papule, vesicle or eschar) that appeared between July-August 2011 in resident of Musalimadugu. We collected information about clinical details as well as smears from skin lesions from suspected case-patients and described the outbreak by time, place and person.We conducted a retrospective cohort study among villagers aged ≥ 15 years to identify risk factors for acquiring the infection. Results: During 24 June-7August 2011, 16 livestock in the village died. Smears from 5 animals showed gram positive, spore bearing, bacillus characteristic of Bacillus anthracis. Villagers butchered and skinned the dead animals, sold the skin and consumed the meat after boiling it for 2 hours. The outbreak in humans started on 30 July, and 9 suspected cases of cutaneous anthrax (attack rate: 2%, no deaths) occurred till 7 August. The attack rate was higher among those aged 15 years or more. All the smears were negative on gram staining. Persons who had handled [Relative risk (RR): 56, 95% confidence interval (CI): 8.4 -571.8, population attributable fraction (PAF): 87%)], skinned (RR: 28, 95% CI: 8.4-93, PAF=54%) and slaughtered (RR: 21, 95% CI: 6.5-68.4, PAF: 42%) dead animals were at higher risk. Conclusions: We recommended ciprofloxacin prophylaxis to close family contacts, community education to avoid slaughtering of dead/ ill livestock and vaccination of the livestock in the area.

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COVID-19 and Its Symptoms’ Panoply: A Case-Control Study of 919 Suspected Cases in Locked-Down Ovar, Portugal

Portuguese Journal of Public Health ◽

10.1159/000514925 ◽

2021 ◽

pp. 1-8

Author(s):

Regina Sá ◽

Tiago Pinho-Bandeira ◽

Guilherme Queiroz ◽

Joana Matos ◽

João Duarte Ferreira ◽

...

Keyword(s):

Large Scale ◽

Case Control Study ◽

Statistical Significance ◽

Case Control ◽

Case Definition ◽

Suspected Case ◽

Risk Characteristics ◽

Increased Risk ◽

Wide Range ◽

Control Study

Background: Ovar was the first Portuguese municipality to declare active community transmission of SARS-CoV-2, with total lockdown decreed on March 17, 2020. This context provided conditions for a large-scale testing strategy, allowing a referral system considering other symptoms besides the ones that were part of the case definition (fever, cough, and dyspnea). This study aims to identify other symptoms associated with COVID-19 since it may clarify the pre-test probability of the occurrence of the disease. Methods: This case-control study uses primary care registers between March 29 and May 10, 2020 in Ovar municipality. Pre-test clinical and exposure-risk characteristics, reported by physicians, were collected through a form, and linked with their laboratory result. Results: The study population included a total of 919 patients, of whom 226 (24.6%) were COVID-19 cases and 693 were negative for SARS-CoV-2. Only 27.1% of the patients reporting contact with a confirmed or suspected case tested positive. In the multivariate analysis, statistical significance was obtained for headaches (OR 0.558), odynophagia (OR 0.273), anosmia (OR 2.360), and other symptoms (OR 2.157). The interaction of anosmia and odynophagia appeared as possibly relevant with a borderline statistically significant OR of 3.375. Conclusion: COVID-19 has a wide range of symptoms. Of the myriad described, the present study highlights anosmia itself and calls for additional studies on the interaction between anosmia and odynophagia. Headaches and odynophagia by themselves are not associated with an increased risk for the disease. These findings may help clinicians in deciding when to test, especially when other diseases with similar symptoms are more prevalent, namely in winter.

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Knowledge and practices regarding malaria and the National Treatment Guidelines among public health workers in Equatorial Guinea

Malaria Journal ◽

10.1186/s12936-020-03528-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Marta Blanco ◽

Pablo Suárez-Sanchez ◽

Belén García ◽

Jesús Nzang ◽

Policarpo Ncogo ◽

...

Keyword(s):

Public Health ◽

Treatment Guidelines ◽

Health Workers ◽

Health Centre ◽

Regional Hospital ◽

Malaria Treatment ◽

Diagnosis And Treatment ◽

Equatorial Guinea ◽

Public Health Facilities ◽

Health Centres

Abstract Background In 2018, an estimated 228 million cases of malaria occurred worldwide. Countries are far from having achieved reasonable levels of national protocol compliance among health workers. Lack of awareness of treatment protocols and treatment resistance by prescribers threatens to undermine progress when it comes to reducing the prevalence of this disease. This study sought to evaluate the degree of knowledge and practices regarding malaria diagnosis and treatment amongst prescribers working at the public health facilities of Bata, Equatorial Guinea. Methods A cross-sectional survey was conducted in October-December 2017 amongst all public health professionals who attended patients under the age of 15 years, with suspected malaria in the Bata District of Equatorial Guinea. Practitioners were asked about their practices and knowledge of malaria and the National Malaria Treatment Guidelines. A bivariate analysis and a logistic regression model were used to determine factors associated with their knowledge. Results Among the 44 practitioners interviewed, 59.1% worked at a Health Centre and 40.9% at the District Hospital of Bata. Important differences in knowledge and practices between hospital and health centre workers were found. Clinical diagnosis was more frequently by practitioners at the health centres (p = 0.059), while microscopy confirmation was more frequent at regional hospital (100%). Intramuscular artemether was the anti-malarial most administrated at the health centres (50.0%), while artemether-lumefantrine was the treatment most used at the regional hospital (66.7%). Most practitioners working at public health facilities (63.6%) have a low level of knowledge regarding the National Malaria Treatment Guidelines. While knowledge regarding malaria, the National Malaria Treatment Guidelines and treatment resistances is low, it was higher amongst hospital workers than amongst practitioners at health centres. Conclusions It is essential to reinforce practitioners’ knowledge, treatment and diagnosis practices and use of the National Malaria Treatment Guidelines in order to improve malaria case management and disease control in the region. A specific malaria training programme ensuring ongoing updates training is necessary in order to ensure that greater experience does not entail obsolete knowledge and, consequently, inadequate diagnosis and treatment practices.

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Clinical diagnosis in paediatric patients at urban primary health care facilities in southern Malawi: a longitudinal observational study

BMC Health Services Research ◽

10.1186/s12913-021-06151-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mtisunge Joshua Gondwe ◽

Marc Y. R. Henrion ◽

Thomasena O’Byrne ◽

Clemens Masesa ◽

Norman Lufesi ◽

...

Keyword(s):

Clinical Diagnosis ◽

Health Workers ◽

Health Centre ◽

Treatment Algorithm ◽

Secondary Level ◽

Support Staff ◽

Health Care Facilities ◽

Severe Illness ◽

Primary Health ◽

Sick Children

Abstract Background Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children. We aimed to adopt Emergency, Triage, Assessment and Treatment algorithm (ETAT) to improve ability to identify severe illness in children at primary health centre (PHC) through comparison with secondary level diagnoses. Methods We implemented ETAT mobile Health (mHealth) at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions. Results Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E, P, Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%), while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.6%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility. Conclusions Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.

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Estimating the burden of United States workers exposed to infection or disease: a key factor in containing risk of COVID-19 infection

10.1101/2020.03.02.20030288 ◽

2020 ◽

Cited By ~ 4

Author(s):

Marissa G. Baker ◽

Trevor K. Peckham ◽

Noah S. Seixas

Keyword(s):

Public Health ◽

United States ◽

Social Services ◽

Police Officers ◽

Disease Transmission ◽

Health Workers ◽

Septic Tank ◽

Risk Response ◽

Increased Risk ◽

Exposed Workers

AbstractIntroductionWith the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Understanding which occupational groups are exposed to infection and disease in the workplace can help to inform public health risk response and management for COVID-19, and subsequent infectious disease outbreaks.MethodsTo estimate the burden of United States workers exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with BLS O*NET survey data, which ranks occupations with particular physical, ergonomic, and structural exposures. For this analysis, occupations reporting exposure to infection or disease more than once a month was the focus.ResultsBased on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair).ConclusionsThe large number of persons employed in a wide variety of occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. This work also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.

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The use of dried tube specimens of Plasmodium falciparum in an external quality assessment programme to evaluate health worker performance for malaria rapid diagnostic testing in healthcare centres in Togo

10.21203/rs.3.rs-49988/v3 ◽

2021 ◽

Author(s):

Monique Ameyo DORKENOO ◽

Kafui Codjo Kouassi ◽

Adjane K. Koura ◽

Martin L Adams ◽

Komivi Gbada ◽

...

Keyword(s):

Quality Control ◽

Plasmodium Falciparum ◽

Quality Management ◽

Health Worker ◽

Health Workers ◽

Health Centre ◽

Essential Elements ◽

Ease Of Use ◽

Malaria Rdts ◽

National Quality

Abstract BackgroundThe use of rapid diagnostic tests (RDTs) to diagnose malaria is common in sub-Saharan African laboratories, remote primary health facilities and in the community. Currently, there is a lack of reliable methods to ascertain health worker competency to accurately use RDTs in the testing and diagnosis of malaria. Dried tube specimens (DTS) have been shown to be a consistent and useful method for quality control of malaria RDTs, however, its application in National Quality Management programmes has been limited.MethodsA Plasmodium falciparum strain was grown in culture and harvested to create DTS of varying parasite density (0, 100, 200, 500 and 1,000 parasites/µL). Using the dried tube specimens as quality control material, a proficiency testing (PT) programme was carried out in 80 representative health centres in Togo. Health worker competency for performing malaria RDTs was assessed using five blinded DTS samples, and the DTS were tested in the same manner as a patient sample would be tested by multiple testers per health centre. ResultsAll the DTS with 100 parasites/µl and 50% of DTS with 200 parasites/µl were classified as non-reactive during the pre-PT quality control step. Therefore, data from these parasite densities were not analysed as part of the PT dataset. PT scores across all 80 facilities and 235 testers was 100% for 0 parasites/µl, 63% for 500 parasites/µl and 93% for 1,000 parasites/µl. Overall, 59% of the 80 healthcare centres that participated in the PT programme received a score of 80% or higher on a set of 0, 500 and 1,000 parasites/ µl DTS samples. Sixty percent of health workers at these centres recorded correct test results for all three samples.ConclusionsThe use of DTS for a malaria PT programme was the first of its kind ever conducted in Togo. The ease of use and stability of the DTS illustrates that they this type of samples can be considered for the assessment of staff competency. The implementation of quality management systems, refresher training and expanded PT at remote testing facilities are essential elements to improve the quality of malaria diagnosis.

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SARS-CoV-2 screening prevalence in educational staff in Berlin, Germany, June-December 2020

10.1101/2021.05.19.21257452 ◽

2021 ◽

Author(s):

Sophia Kindzierski ◽

Welmoed van Loon ◽

Johanna Theuring ◽

Franziska Hommes ◽

Eberhard Thombansen ◽

...

Keyword(s):

Infection Prevalence ◽

Occupational Hazards ◽

Prevention Measures ◽

School Settings ◽

Occupational Risks ◽

Increased Risk ◽

Control And Prevention ◽

Educational Staff ◽

Infection Control And Prevention ◽

Pandemic Wave

SARS-CoV-2 infections in childcare and school settings potentially bear occupational risks to educational staff. We analyzed data derived from voluntary, PCR-based screening of childcare educators and teachers attending five testing sites in Berlin, Germany, between June and December 2020. Within seven months, 17,491 tests were performed (4,458 educators, 13,033 teachers). Participants were largely female (72.9%), and median age was 41 years. Overall, SARS-CoV-2 infection prevalence was 1.2% (95%CI, 1.1-1.4%). Prevalence in educational staff largely resembled community incidence until the start of the second pandemic wave in mid-September 2020, when an unsteady prevalence plateau was reached. Then, infection prevalence in teachers (1.2% [95%CI, 0.8-1.8%]) did not significantly differ from the population prevalence (0.9% [0.6-1.4%]) but it was increased in educators (2.6% [1.6-4.0%]; aOR, 1.6 [1.3-2.0]). Irrespective of occupation, those that reported contact to a confirmed SARS-CoV-2 case outside of work had increased risk of infection (aOR, 3.0 [95%CI, 1.5-5.5]). In a step-wise backwards selection, the best set of associated factors with SARS-CoV-2 infection involved age, occupation, and calendar week. These results are in line with findings that teachers do not bear an increased risk of SARS-CoV-2 infection, while childcare educators do. Infection control and prevention measures need to be strengthened in child care settings to further reduce respective occupational hazards. At the same time, the private environment appears to be the main source of SARS-CoV-2 infection for educational staff.

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