Global Biosecurity (Aug 2021)

COVID-19 outbreak in Islamabad resulting from a travel-associated primary case: A case series

  • Shafiq ur Rehman,
  • Moin Iqbal Qaisrani,
  • Sana Habib Abbasi,
  • Aliya Jabeen,
  • Mumtaz Ali Khan,
  • Jamil A Ansari,
  • Aamer Ikram

Journal volume & issue
Vol. 3, no. 1


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'Background:' On 18 March 2020, the second case of COVID-19 in the capital territory was reported by the local health department of Islamabad who presented with typical COVID-19 symptoms and had travel history. As per directions of Chief FEDSD, a team of field epidemiologists conducted outbreak investigations. The main objectives of this study were to investigate the clinical and epidemiological patterns of disease transmission and implementation of recommended SOPs. 'Methods:' Descriptive outbreak investigation followed by contact tracing was done in Kot Hathyal, Islamabad, from 21March to 4 April 2020. Each case was enrolled as per the WHO predefined case definition and questionnaire, and data was maintained in line list. The daily health status of affected individuals was monitored physically as well as through phone calls. Data was maintained in Microsoft Excel. Secondary attack rate, median age, male to female ratio and 95% confidence interval was calculated in OpenEpi (version 3.01) for low and high risk contact groups. 'Results:' During investigation, 17 confirmed COVID-19 cases were enrolled as a result of contact with index case, male to female ratio was 5:1, and median age was 41 years (34 to 56 years). All cases exhibited symptoms compatible with COVID-19 except two. The median incubation period was 4 days. The secondary attack rate was 81.80%. No transmission from asymptomatic cases were noted. 'Conclusion:' The index case was a foreign national who had arrived in Pakistan mid-November 2019 to attend a religious gathering at Lahore from 12 to 15 March 2020. The intra and inter city travel caused the introduction of 17 new cases in Islamabad. Due to the lack of fully-fledged isolation centers in Islamabad, a home-based isolation strategy was introduced for the first time in the country. As the affected area was densely populated, the whole area was cordoned off for two weeks. This was also the country’s first lockdown.