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SARS-CoV-2 Outbreak Dynamics in an Isolated US Military Recruit Training Center With Rigorous Prevention Measures.


ABSTRACT:

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 R 0 ; 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.

SUBMITTER: Lizewski RA 

PROVIDER: S-EPMC9531985 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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SARS-CoV-2 Outbreak Dynamics in an Isolated US Military Recruit Training Center With Rigorous Prevention Measures.

Lizewski Rhonda A RA   Sealfon Rachel S G RSG   Park Sang Woo SW   Smith Gregory R GR   Porter Chad K CK   Gonzalez-Reiche Ana S AS   Ge Yongchao Y   Miller Clare M CM   Goforth Carl W CW   Pincas Hanna H   Termini Michael S MS   Ramos Irene I   Nair Venugopalan D VD   Lizewski Stephen E SE   Alshammary Hala H   Cer Regina Z RZ   Chen Hua Wei HW   George Mary-Catherine MC   Arnold Catherine E CE   Glang Lindsay A LA   Long Kyle A KA   Malagon Francisco F   Marayag Jan J JJ   Nunez Edgar E   Rice Gregory K GK   Santa Ana Ernesto E   Schilling Megan A MA   Smith Darci R DR   Sugiharto Victor A VA   Sun Peifang P   van de Guchte Adriana A   Khan Zenab Z   Dutta Jayeeta J   Vangeti Sindhu S   Voegtly Logan J LJ   Weir Dawn L DL   Metcalf C Jessica E CJE   Troyanskaya Olga G OG   Bishop-Lilly Kimberly A KA   Grenfell Bryan T BT   van Bakel Harm H   Letizia Andrew G AG   Sealfon Stuart C SC  

Epidemiology (Cambridge, Mass.) 20220805 6


<h4>Background</h4>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.<h4>Methods</h4>Between May and November 2020, we monitored 2,469 unvaccinated, mostly male, Marine recruits prospectively during basic training. If participants tested negative for SARS-Co  ...[more]

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