Saturday, September 24, 2022

Study examines outbreaks of SARS-CoV-2 in children and adults after attending overnight summer camp

In a report posted recently medrxiv* Preprint Server, researchers investigate a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak among individuals attending an overnight summer camp in Texas in June 2021.

Study: Investigating an outbreak of SARS-CoV-2 at a Texas summer camp as a result of a single introduction. Image credit: Fotovica/Shutterstock


SARS-CoV-2 spread dynamics are highly variable, with most COVID-19 patients not transmitting SARS-CoV-2 and only a few coronavirus disease 2019 (COVID-19) patients secondary to SARS-CoV-2 infection are responsible. Heterogeneous SARS-CoV-2 transmission indicates that super-spreaders play an essential role in SARS-CoV-2 transmission.

Super-spreader events occur when an infected individual is responsible for an increase in secondary infections. Studies have consistently reported that educational settings do not contribute to SARS-CoV-2 community transmission. In contrast, a recent outbreak of SARS-CoV-2 in Texas occurred in 186 children and adults who attended an overnight summer camp in Texas in June 2021.

Texas outbreak

The SARS-CoV-2 outbreak occurred among overnight camp attendees at the start of the Delta variant wave in the United States (US) in June 2021, while cases in the community were still low but rising rapidly.

A total of 451 persons participated in the camp, including 364 children (under 18 years of age) and 87 adults (above 18 years of age). After the camp ended, 186 attendees developed reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection.

Among those present, 6% and 19% and 6% were partially vaccinated and fully vaccinated, respectively. Pre-arrival RT-PCR test reports were not mandatory for attending the camp, and post-arrival RT-PCR tests were not conducted. A 41% primary attack rate was observed in camp attendees, of whom 20% and 48% were vaccinated and unvaccinated, respectively.

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Ribonucleic acid (RNA) was isolated from 55 nasopharyngeal swabs obtained from SARS-CoV-2-infected camp attendees (n = 36) and community members (n = 19) and the Oxford Nanopore Genome using the ARTIC approach was subjected to sequencing. Subsequently, libraries were prepared, and bioinformatic analysis was performed. In addition, 4085 complete genomes published in the Global Initiative on Sharing All Impact Data (GISAID) database were collected from Harris County and Galveston County, Texas, and compared to genomes collected from camp attendees using the NextStrain platform. Comparisons were made phylogenetically.

SARS-CoV-2 amplicons were produced from RNA from all patients, and successfully transcribed 70% of the SARS-CoV-2 genome from 44 samples (13 Galveston County residents and 31 camp attendees) with >10X coverage was reconstructed. The results aligned with three genomes isolated from members of the Arlington family, who tested SARS-CoV-2-positive after exposure to asymptomatic campers after cAMP was terminated.

The evolution of the SARS-CoV-2 genome was determined using phylogenetic IQ-Tree analysis, which showed that all SARS-CoV-2 genomes derived from camp attendees and the Arlington family share a common ancestor. This signaled the start of a SARS-CoV-2 outbreak from a SARS-CoV-2 positive camp attendee.

In addition, the SARS-CoV-2 genome obtained from camp attendees who shared risk factors, such as common cabins or buses, did not exhibit clustering together. Similarly, SARS-CoV-2 genomes obtained from family siblings were not together, indicating that SARS-CoV-2 transmission occurred during summer camp. Interestingly, several SARS-CoV-2 genomes were obtained from individuals who did not group with camp attendees, indicating that SARS-CoV-2 was transmitted from camp attendees to the community. went.

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The phylogenetic analysis of the NextStrain platform revealed 29 genomes that exhibit clustering with the genomes of camp attendees obtained after the end of the summer camp, that is, between 28 June 2021 and 30 July 2021. This indicated that SARS-CoV-2 community transmission originated from the camp and continued till July 30, 2021.


Overall, the study findings suggested that SARS-CoV-2 super-spreading may occur during large educational gatherings. The Texas outbreak likely resulted from a single SARS-CoV-2-positive camp attendee, who transmitted SARS-CoV-2 to other campers and later community residents. This triggered a chain of SARS-CoV-2 transmission that persisted until at least the end of July 2021.

The study highlights the risks of acquiring SARS-CoV-2 infection in overnight summer camps, including COVID-19 prevention strategies such as vaccination and SARS-CoV-2 testing before and after camp attendees arrive. has not been included. In addition, the authors believe that the current work is the first of its kind to integrate epidemiological, phylogenetic and genomic approaches to investigate SARS-CoV-2 outbreaks occurring in overnight summer camps. .

*Important Information

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be considered conclusive, should guide clinical practice/health-related behavior, or be regarded as established information.

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Nation World News Desk
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