Objective: To characterize SARS-CoV-2 transmission following a COVID-19 outbreak in an emergency childcare centre (ECCC) in April 2020 in Quebec, Canada. Methods: The study population consisted of all the children and employees who attended the ECCC as well as household contacts of the confirmed COVID-19 cases. Of the 120 individuals in the study, five cases were confirmed by epidemiological link and 25 were identified as COVID-19 by RT-PCR among which 19 were analyzed by viral whole genome sequencing. Descriptive epidemiology, social network visualization, and phylogenetic analysis were used to characterize viral transmission. Results: Phylogenetic analysis identified two separate introductions of distinct lineages of SARS-CoV-2 and estimated an average effective reproductive number of Re = 1.9 (range 0.9–4.9) with a mean doubling time of 3.2 days (range 2.1–5.2). The first and most prevalent lineage was introduced by two asymptomatic children who were likely infected by their parent, a confirmed COVID-19 case working in a long-term care centre. Among infected household adults, attack rates were significantly higher in mothers than in fathers (risk ratio = 4.5; 95% CI 1.1–18.7). The extent of transmission makes it one of the largest documented outbreaks in a daycare in Canada. Conclusion: The analyses carried out showed the probable origin and direction of the transmission of the infection (adult-child, child-adult, and child-child), thus highlighting how asymptomatic children can efficiently transmit SARS-CoV-2.
CITATION STYLE
Soto, J. C., Barakat, M., Hutter, J. A., Kiely, M., Moreira, S., Shapiro, B. J., … Lessard, R. (2021). Outbreak investigation of SARS-CoV-2 transmission in an emergency childcare centre. Canadian Journal of Public Health, 112(4), 566–575. https://doi.org/10.17269/s41997-021-00544-1
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