Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May-June, 2020

Abstract

To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control.

Keywords: COVID-19; Louisiana; SARS-CoV-2; United States; coronavirus disease; coronaviruses; correctional facilities; detention facilities; respiratory infections; serial testing; severe acute respiratory syndrome coronavirus 2; transmission; viruses; zoonoses.

Figure 1

Rapid transmission of SARS-CoV-2 in detention facility, Louisiana, USA, May–June 2020. Enrollment and follow-up at each timepoint for detained persons (n = 143) in dormitories A–E and F. The sequence of testing for all enrolled dormitories is shown, along with the number of persons who were positive or negative for SARS-CoV-2 by real-time reverse transcription PCR and percentage of total at each timepoint. Red boxes indicate SARS-CoV-2 positive, and blue boxes indicate SARS-CoV-2 negative. *The first positive test result for SARS-CoV-2 among persons detained occurred on the following dates in each dormitory: April 7 in A, April 9 in B and C, April 17 in D, and April 23 in E. Introduction in dormitory F likely occurred between May 11 and May 29. †One inconclusive result was considered negative; ‡One inconclusive result was considered positive. §16 persons were tested on May 26 only, 14 on May 27 only, and 2 on May 26 and June 3. ¶10 persons were tested on May 28 only, 1 on May 29 only, 1 on June 3 only, and 6 on May 28 and June 3. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Figure 2

Rapid transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in detention facility, Louisiana, USA, May–June 2020. A) C_t values and viral culture results by days from symptom onset of any symptom in SARS-CoV-2–positive detained persons. Nucleocapsid protein 1 target C_t values and viral culture results of 66 specimens from 51 persons who were positive for SARS-CoV-2 by days from reported symptom onset. C_t values and viral culture results are also shown for 14 of the 51 specimens from persons who were positive a second time, and for 1 specimen that remained positive for a third test. Vertical dashed line indicates day 14 to depict the recommended medical isolation timeframe from symptom onset for persons in congregate settings. Shapes indicate culture results, and colors indicate day of positive test result. One positive test result is not included because C_t values were not reported. B) C_t values and viral culture results for SARS-CoV-2–positive detained persons at the time of first sample collection according to dormitory residence and day of first positive result. Nucleocapsid protein 1 target C_t values and viral culture results of the first SARS-CoV-2–positive test result for 110 detained persons is shown by dormitory of residence at the time of first sample collection. Horizontal lines indicate median C_t values for first positive samples from residents in each dormitory. One positive test result from a dormitory F resident is not included because C_t value was not reported. C_t , cycle threshold.