TY - JOUR
T1 - SARS-CoV-2 Outbreak Dynamics in an Isolated US Military Recruit Training Center with Rigorous Prevention Measures
AU - Lizewski, Rhonda A.
AU - Sealfon, Rachel S.G.
AU - Park, Sang Woo
AU - Smith, Gregory R.
AU - Porter, Chad K.
AU - Gonzalez-Reiche, Ana S.
AU - Ge, Yongchao
AU - Miller, Clare M.
AU - Goforth, Carl W.
AU - Pincas, Hanna
AU - Termini, Michael S.
AU - Ramos, Irene
AU - Nair, Venugopalan D.
AU - Lizewski, Stephen E.
AU - Alshammary, Hala
AU - Cer, Regina Z.
AU - Chen, Hua Wei
AU - George, Mary Catherine
AU - Arnold, Catherine E.
AU - Glang, Lindsay A.
AU - Long, Kyle A.
AU - Malagon, Francisco
AU - Marayag, Jan J.
AU - Nunez, Edgar
AU - Rice, Gregory K.
AU - Santa Ana, Ernesto
AU - Schilling, Megan A.
AU - Smith, Darci R.
AU - Sugiharto, Victor A.
AU - Sun, Peifang
AU - Van De Guchte, Adriana
AU - Khan, Zenab
AU - Dutta, Jayeeta
AU - Vangeti, Sindhu
AU - Voegtly, Logan J.
AU - Weir, Dawn L.
AU - Metcalf, C. Jessica E.
AU - Troyanskaya, Olga G.
AU - Bishop-Lilly, Kimberly A.
AU - Grenfell, Bryan T.
AU - Van Bakel, Harm
AU - Letizia, Andrew G.
AU - Sealfon, Stuart C.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background: Marine recruits training at Parris Island experienced an unexpectedly high rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, despite preventive measures including a supervised, 2-week, pre-entry quarantine. We characterize SARS-CoV-2 transmission in this cohort. Methods: Between May and November 2020, we monitored 2,469 unvaccinated, mostly male, Marine recruits prospectively during basic training. If participants tested negative for SARS-CoV-2 by quantitative polymerase chain reaction (qPCR) at the end of quarantine, they were transferred to the training site in segregated companies and underwent biweekly testing for 6 weeks. We assessed the effects of coronavirus disease 2019 (COVID-19) prevention measures on other respiratory infections with passive surveillance data, performed phylogenetic analysis, and modeled transmission dynamics and testing regimens. Results: Preventive measures were associated with drastically lower rates of other respiratory illnesses. However, among the trainees, 1,107 (44.8%) tested SARS-CoV-2-positive, with either mild or no symptoms. Phylogenetic analysis of viral genomes from 580 participants revealed that all cases but one were linked to five independent introductions, each characterized by accumulation of mutations across and within companies, and similar viral isolates in individuals from the same company. Variation in company transmission rates (mean reproduction number R0; 5.5 [95% confidence interval [CI], 5.0, 6.1]) could be accounted for by multiple initial cases within a company and superspreader events. Simulations indicate that frequent rapid-report testing with case isolation may minimize outbreaks. Conclusions: Transmission of wild-type SARS-CoV-2 among Marine recruits was approximately twice that seen in the community. Insights from SARS-CoV-2 outbreak dynamics and mutations spread in a remote, congregate setting may inform effective mitigation strategies.
AB - Background: Marine recruits training at Parris Island experienced an unexpectedly high rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, despite preventive measures including a supervised, 2-week, pre-entry quarantine. We characterize SARS-CoV-2 transmission in this cohort. Methods: Between May and November 2020, we monitored 2,469 unvaccinated, mostly male, Marine recruits prospectively during basic training. If participants tested negative for SARS-CoV-2 by quantitative polymerase chain reaction (qPCR) at the end of quarantine, they were transferred to the training site in segregated companies and underwent biweekly testing for 6 weeks. We assessed the effects of coronavirus disease 2019 (COVID-19) prevention measures on other respiratory infections with passive surveillance data, performed phylogenetic analysis, and modeled transmission dynamics and testing regimens. Results: Preventive measures were associated with drastically lower rates of other respiratory illnesses. However, among the trainees, 1,107 (44.8%) tested SARS-CoV-2-positive, with either mild or no symptoms. Phylogenetic analysis of viral genomes from 580 participants revealed that all cases but one were linked to five independent introductions, each characterized by accumulation of mutations across and within companies, and similar viral isolates in individuals from the same company. Variation in company transmission rates (mean reproduction number R0; 5.5 [95% confidence interval [CI], 5.0, 6.1]) could be accounted for by multiple initial cases within a company and superspreader events. Simulations indicate that frequent rapid-report testing with case isolation may minimize outbreaks. Conclusions: Transmission of wild-type SARS-CoV-2 among Marine recruits was approximately twice that seen in the community. Insights from SARS-CoV-2 outbreak dynamics and mutations spread in a remote, congregate setting may inform effective mitigation strategies.
KW - Congregate setting
KW - Mathematical modeling
KW - Phylogenetic analysis
KW - Severe acute respiratory syndrome coronavirus 2
KW - Superspreader events
KW - Transmission dynamics
KW - U.S. Military
UR - http://www.scopus.com/inward/record.url?scp=85139406811&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85139406811&partnerID=8YFLogxK
U2 - 10.1097/EDE.0000000000001523
DO - 10.1097/EDE.0000000000001523
M3 - Article
C2 - 35944149
AN - SCOPUS:85139406811
SN - 1044-3983
VL - 33
SP - 797
EP - 807
JO - Epidemiology
JF - Epidemiology
IS - 6
ER -