Investigation of Four Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Rwanda, 2020

• Published in: International journal of environmental research and public health 2021-06, Vol.18 (13), p.7018
• Main Authors: Nsekuye, Olivier, Rwagasore, Edson, Muhimpundu, Marie Aime, El-Khatib, Ziad, Ntabanganyimana, Daniel, Kamayirese, Eric Noël, Ruyange, Laurent, Umutoni, Angela, Adeline, Adeline Kabeja, Ntaganira, Joseph, Nsazimana, Sabin, Omolo, Jared
• Format: Article
• Language: English
• Subjects: Contact; Contact tracing; Containment; Coronaviruses; Cough; COVID-19; Epidemiology; Fever; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Households; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Hälsovetenskap; Infektionsmedicin; Klinisk medicin; Medicin och hälsovetenskap; Nightclubs; Respiratory diseases; Risk; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18137018

We reported the findings of the first Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) four clusters identified in Rwanda. Case-investigations included contact elicitation, testing, and isolation/quarantine of confirmed cases. Socio-demographic and clinical data on cases and contacts were collected. A confirmed case was a person with laboratory confirmation of SARS-CoV-2 infection (PCR) while a contact was any person who had contact with a SARS-CoV-2 confirmed case within 72 h prior, to 14 days after symptom onset; or 14 days before collection of the laboratory-positive sample for asymptomatic cases. High risk contacts were those who had come into unprotected face-to-face contact or had been in a closed environment with a SARS-CoV-2 case for >15 min. Forty cases were reported from four clusters by 22 April 2020, accounting for 61% of locally transmitted cases within six weeks. Clusters A, B, C and D were associated with two nightclubs, one house party, and different families or households living in the same compound (multi-family dwelling). Thirty-six of the 1035 contacts tested were positive (secondary attack rate: 3.5%). Positivity rates were highest among the high-risk contacts compared to low-risk contacts (10% vs. 2.2%). Index cases in three of the clusters were imported through international travelling. Fifteen of the 40 cases (38%) were asymptomatic while 13/25 (52%) and 8/25 (32%) of symptomatic cases had a cough and fever respectively. Gatherings in closed spaces were the main early drivers of transmission. Systematic case-investigations contact tracing and testing likely contributed to the early containment of SARS-CoV-2 in Rwanda.