key: cord-0922446-vce5ig78
authors: Jung, Jiwon; Hong, Min Jee; Kim, Eun Ok; Lee, Jina; Kim, Mi-Na; Kim, Sung-Han
title: Investigation of a nosocomial outbreak of COVID-19 in a pediatric ward in South Korea: Successful control by early detection and extensive contact tracing with testing
date: 2020-06-25
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2020.06.021
sha: 45cb9cb179fabe48bbaa1bf3e7ab283aae1d1332
doc_id: 922446
cord_uid: vce5ig78

We describe an outbreak investigation related to a paucisymptomatic 9-year-old girl with COVID-19 admitted at a pediatric ward in a tertiary hospital (South Korea). The pediatric wards were placed under cohort isolation and an extensive contact-tracing was carried out. Of 1,206 close and casual contacts, a female asymptomatic guardian, who was the mother (secondary case) of an infant that shared the room with the index patient, was found positive. Thirteen days after the diagnosis, her asymptomatic 2-year-old daughter (tertiary case) who contacted her at home was found positive. Early detection of an asymptomatic case based on epidemiologic link followed by extensive contact-tracing and testing for SARS-CoV-2 appears to be important in effectively containing a nosocomial outbreak of COVID-19.

To the Editor: 30 The containment of nosocomial transmission of COVID-19 poses a particularly difficult 31 challenge [1] . We recently experienced a nosocomial outbreak in a pediatric ward in a tertiary 32 care hospital in Seoul, South Korea, which was a transmission case from a child to an adult.

The index patient was a previously healthy 9-year-old girl. On March 25 th , 2020, the patient 34 presented to the emergency room of Hospital X in Gyeonggi-do, South Korea (located 30 km 35 northwest of our hospital) with a 1-day history of headache. She underwent brain computed 36 tomography, which showed intracerebral and intraventricular hemorrhage. She stayed with 37 another patient (patient A) in the same multi-patient room for one day between 25 th and 26 th

March. Patient A was diagnosed with COVID-19 later.

On March 26 th , the index patient was referred to our pediatric emergency room. She did not inital PCR result for SARS-CoV-2 from a nasopharyngeal swab specimen was negative, so 43 she was moved to a six-patient room. She did not receive any aerosol generating procedure. The index patient was promptly admitted to a negative-pressure isolation room. The 

Fast nosocomial spread of SARS-CoV2 in a French geriatric unit Lyon Study 125

Group on Covid-19 infection

Dynamics Characteristics of 406 Children with Coronavirus Disease 2019 in China: A 129 Review

An evidence summary of paediatric COVID-19 literature

A case of new coronavirus infection in three-month-old 133 infants

 101 We express our sincere condolences to the patients and their families who were affected by 102 the COVID-19 outbreak. We also greatly appreciate the healthcare workers and the staff 103 members at Asan Medical Center who helped overcome the outbreak.