eLife (Aug 2021)
Superspreaders drive the largest outbreaks of hospital onset COVID-19 infections
- 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
Affiliations
- Christopher JR Illingworth
- ORCiD
- MRC 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 States
- William L Hamilton
- ORCiD
- University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Ben Warne
- University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Matthew Routledge
- 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 Kingdom
- Ashley Popay
- Public Health England Field Epidemiology Unit, Cambridge Institute of Public Health, Forvie Site, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Chris Jackson
- MRC Biostatistics Unit, University of Cambridge, East Forvie Building, Forvie Site, Robinson Way, Cambridge, United Kingdom
- Tom Fieldman
- University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Luke W Meredith
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Charlotte J Houldcroft
- ORCiD
- University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Myra Hosmillo
- ORCiD
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Aminu S Jahun
- ORCiD
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Laura G Caller
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Sarah L Caddy
- ORCiD
- Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom
- Anna Yakovleva
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Grant Hall
- ORCiD
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Fahad A Khokhar
- University 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
- Theresa Feltwell
- University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Malte L Pinckert
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Iliana Georgana
- ORCiD
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Yasmin Chaudhry
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Martin D Curran
- Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Surendra Parmar
- Public Health England Clinical Microbiology and Public Health Laboratory, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Dominic Sparkes
- 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 Kingdom
- Lucy Rivett
- ORCiD
- 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 Kingdom
- Nick K Jones
- ORCiD
- 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 Kingdom
- Sushmita Sridhar
- ORCiD
- University 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 Kingdom
- Sally Forrest
- Cambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, Cambridge, United Kingdom
- Tom Dymond
- Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Kayleigh Grainger
- Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Chris Workman
- Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Mark Ferris
- ORCiD
- Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Effrossyni Gkrania-Klotsas
- ORCiD
- Cambridge 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 Kingdom
- Nicholas M Brown
- ORCiD
- Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Michael P Weekes
- ORCiD
- University 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
- Stephen Baker
- ORCiD
- University 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
- Sharon J Peacock
- ORCiD
- University 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 Kingdom
- Ian G Goodfellow
- ORCiD
- University of Cambridge, Department of Pathology, Division of Virology, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Theodore Gouliouris
- University 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 Kingdom
- Daniela de Angelis
- Institut für Biologische Physik, Universität zu Köln, Köln, Germany; Public Health England, National Infection Service, London, United Kingdom
- M Estée Török
- ORCiD
- University of Cambridge, Department of Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, United Kingdom
- DOI
- https://doi.org/10.7554/eLife.67308
- Journal volume & issue
-
Vol. 10
Abstract
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.
Keywords
