Genomic Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Among University Students in Western Pennsylvania

• Published in: The Journal of infectious diseases 2023-06, Vol.228 (1), p.37-45
• Main Authors: Srinivasa, Vatsala Rangachar, Griffith, Marissa P, Waggle, Kady D, Johnson, Monika, Zhu, Lei, Williams, John V, Marsh, Jane W, Van Tyne, Daria, Harrison, Lee H, Martin, Elise M
• Format: Article
• Language: English
• Subjects: College campuses; Contact tracing; Coronaviruses; Disease transmission; Epidemiology; Severe acute respiratory syndrome coronavirus 2; Students; Whole genome sequencing
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiad041

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) control on college campuses is challenging given communal living and student social dynamics. Understanding SARS-CoV-2 transmission among college students is important for the development of optimal control strategies. Methods SARS-CoV-2 nasal swab samples were collected from University of Pittsburgh students for symptomatic testing and asymptomatic surveillance from August 2020 through April 2021 from 3 campuses. Whole-genome sequencing (WGS) was performed on 308 samples, and contact tracing information collected from students was used to identify transmission clusters. Results We identified 31 Pangolin lineages of SARS-CoV-2, the majority belonging to B.1.1.7 (Alpha) and B.1.2 lineages. Contact tracing identified 142 students (46%) clustering with each other; WGS identified 53 putative transmission clusters involving 216 students (70%). WGS identified transmissions that were missed by contact tracing. However, 84 cases (27%) could not be linked by either WGS or contact tracing. Clusters were most frequently linked to students residing in the same dormitory, off-campus roommates, friends, or athletic activities. Conclusions The majority of SARS-CoV-2–positive samples clustered by WGS, indicating significant transmission across campuses. The combination of WGS and contact tracing maximized the identification of SARS-CoV-2 transmission on campus. WGS can be used as a strategy to mitigate, and further prevent transmission among students. Whole-genome sequencing and contact tracing maximized identification of severe acute respiratory syndrome coronavirus 2 transmission among university students. This combined approach is an optimal strategy to inform infection prevention and control practices on campus and mitigate viral transmission among students.