Improving baseline serological investigations for dental workers at specialized dental center

Objective: Serological tests for dental workers have been suggested by different international agencies to ensure the safety of dental practitioners and, subsequently, their patients. In our organization, the percentage of dental workers who underwent serological tests was low (26%). Material and Methods: An intervention was designed using three sequential PDSA cycles to test changes proposed by team members. The percentage of dental workers who underwent these tests was used as the measure. Results: During the project period, the percentage of dental workers who underwent serological tests within nine months increased from 24% to 87%. Amongst the three interventions, the final one exhibited the most prominent change leading to major improvement. Conclusion: Serological tests are essential investigational data used to ensure the safety of dental workers, which subsequently also enhances patient safety. Further interventions are highly recommended to maximize the number of dental workers who undergo serological investigation.

Epidemiological, virological and serological investigation into a SARS-CoV-2 outbreak (Alpha variant) in a primary school in Geneva, Switzerland: a prospective longitudinal study

Background Twenty-one months into the pandemic, the extent to which young children get infected and transmit SARS-CoV-2 in school settings remains controversial, in particular with variants of concern. We report a prospective epidemiological, virological and serological investigation of a SARS-CoV-2 outbreak in a primary school in Geneva, Switzerland, in April-May 2021. Methods This outbreak investigation is part of a longitudinal, prospective, primary school-based surveillance study (SEROCoV-Schools). It involved repeated testing of pupils and teachers and household members of participants who tested positive. Rapid antigen tests and/or real-time reverse transcription polymerase chain reaction were performed at Day 0-2 and Day 5-7; serologies on dried capillary blood samples were performed at Day 0-2 and Day 30. Contact tracing interviews and SARS-CoV-2 whole genome sequencing were carried out for positive cases. Results This SARS-CoV-2 outbreak caused by the Alpha variant involved 20 children aged 4 to 6 years from 4 classes, 2 teachers and 3 household members. Infection attack rates were between 11.8 and 62.0% among pupils from the 4 classes, 22.2% among teachers and 0% among non-teaching staff. Secondary attack rate among household members was 10.7%. Symptoms were reported by 63% of infected children, 100% of teachers and 66.7% of household members. All analysed sequences but one showed 100% identity. Serological tests detected 8 seroconversions unidentified by SARS-CoV-2 virological tests. Conclusions This study confirmed child-to-child and child-to-adult transmission of the infection. SARS-CoV-2 can spread rapidly between children and adults in school settings, and is thereby introduced into households. Effective measures to limit transmission in schools have the potential to reduce the overall community circulation.

Molecular and serological investigation of the 2021 COVID-19 case surge in Mongolian vaccinees

A surge in Covid-19 cases in Mongolia in March 2021 resulted in a government-mandated shutdown. This shutdown was relaxed in May 2021 as case numbers decreased and nationwide vaccination rates using Sinopharm, Covishield/AstraZeneca, Sputnik V, and Pfizer/BioNTech vaccines exceeded 50% of the population. Case rates increased again in early June 2021 in both vaccinated and non-vaccinated individuals. To determine whether the surge was due to the emergence of Delta or another variant, or vaccine failure, a rapid, opportunistic investigation was conducted that comprised virus sequence analysis of nasal swab samples from breakthrough cases and antibody assays of plasma from healthy vaccinees. More than 90% of breakthrough infections during the second case surge were due to the Alpha variant. Spike protein ELISA and SARS-CoV-2 neutralization assays data revealed large differences in plasma titers of antibodies to SARS-CoV-2, with mRNA vaccines eliciting higher titers than adenovirus-vectored or killed virus vaccines.

Outbreak of SARS-CoV-2 Lineage 20I/501Y.V1 in a Nursing Home Underlines the Crucial Role of Vaccination in Both Residents and Staff

Elderly residents in nursing homes are at very high risk of life-threatening COVID-19-related outcomes. In this report, an epidemiological and serological investigation of a SARS-CoV-2 outbreak in an Italian nursing home is described. Among the residents, all but one (19/20) were regularly vaccinated against SARS-CoV-2. In mid-February 2021, a non-vaccinated staff member of the nursing home was diagnosed with the SARS-CoV-2 infection. Following the outbreak investigation, a total of 70% (14/20) of residents aged 77–100 years were found positive. The phylogenetic analysis showed that the outbreak was caused by the SARS-CoV-2 variant of concern 202012/01 (the so-called “UK variant”). However, all but one positive subjects (13/14) were fully asymptomatic. The only symptomatic patient was a vaccinated 86-year-old female with a highly compromised health background and deceased approximately two weeks later. The subsequent serological investigation showed that the deceased patient was the only vaccinated subject that did not develop the anti-spike protein antibody response, therefore being likely a vaccine non-responder. Although the available mRNA SARS-CoV-2 vaccine was not able to prevent several asymptomatic infections, it was able to avert most symptomatic disease cases caused by the SARS-CoV-2 variant of concern 202012/01 in nursing home residents.