Characterising within-hospitalSARS-CoV-2 transmission events using epidemiological and viral genomic data across two pandemic waves

Hospital outbreaks of COVID19 result in considerable mortality and disruption to healthcare services and yet little is known about transmission within this setting. We characterise within hospital transmission by combining viral genomic and epidemiological data using Bayesian modelling amongst 2181 patients and healthcare workers from a large UK NHS Trust. Transmission events were compared between Wave 1 (1st March to 25th J'uly 2020) and Wave 2 (30th November 2020 to 24th January 2021). We show that staff-to-staff transmissions reduced from 31.6% to 12.9% of all infections. Patient-to-patient transmissions increased from 27.1% to 52.1%. 40%-50% of hospital-onset patient cases resulted in onward transmission compared to 4% of community-acquired cases. Control measures introduced during the pandemic likely reduced transmissions between healthcare workers but were insufficient to prevent increasing numbers of patient-to-patient transmissions. As hospital-acquired cases drive most onward transmission, earlier identification of nosocomial cases will be required to break hospital transmission chains.

Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020

Healthcare workers (HCW) are potentially at increased risk of infection with coronavirus disease (COVID-19) and may transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to vulnerable patients. We present results from staff testing at Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom. Between 16 and 29 March 2020, 1,533 symptomatic HCW were tested, of whom 282 (18%) were positive for SARS-CoV-2. Testing HCW is a crucial strategy to optimise staffing levels during this outbreak.

[Chorioretinal lesions in deaf mutes]

The paper reports a study of 216 patients of special deaf-mute schools from Craiova. The exam of them showed us the presence of retinal degenerative lesions in 17 cases (7.8%). There was not a parallelism between deafness' degree and retinal lesions expanse. In point of clinical aspect, the retinal degenerative lesions were Sjögreen retinal lesions in 6 cases, colloidal Amalric-Bessou retinal lesions in 6 cases. In 2 cases lesions had a pseudoinflammatory aspect and another 2 cases were peripheral lesions like "salt and pepper's". Only one case had pigmentary osteoblastic mobilization. Deafness was associated with oligophrenia in 15 cases, with discreet manifestations of eredoataxia Friedreich in 5 cases, with epilepsy in 2 cases and with nanism in another 2 cases. It is necessary a complex oto-neuro-ophthalmological exploration of patients with deaf-muteness.

[Parinaud's conjunctivitis]

A case of a 31-years-old young with swollen left eyelid, abundant discharge and giant conjunctival follicles of all palpebral conjunctiva. The existence of the left unilateral preauricular and submaxillary adenopathy associated with anatomo-pathological exam of the conjunctival follicles decides the diagnosis of Parinaud conjunctivitis.

[Bilateral transverse optic neuropathy]

It shows a clinical observation about optical anterior juxtabulbar bilateral neuropathy, with superacute debut, rapid and dramatic evolution in the first days, at a young woman. The disease established the marked diminuation of the visual acuity and the collapse of the visual field. The evolution was favourably under the cortisone therapy, establishing the total recovering of the visual function. Are discussed appearances about etiology and clinical specific features of optical juxtabulbar neuropathy, considering this isolated optical neuropathy like a first attack in evolution of one sclerosis in plaques.