Transmission Dynamics of SARS-CoV-2 during an Outbreak in a Roma Community in Thessaly, Greece—Control Measures and Lessons Learned

Michalis Koureas, Matthaios Speletas, Zacharoula Bogogiannidou, Dimitris Babalis, Vassilios Pinakas, Ourania Pinaka, Apostolos Komnos, Stella Tsoutsa, Georgia Papadamou, Maria A. Kyritsi, Alexandros Vontas, Vasileios Nakoulas, Spyros Sapounas, Nikolaos Kanellopoulos, Dimitrios Kalompatsios, Vassiliki Papadouli, Katerina Dadouli, Soteris Soteriades, Paraskevi Mina, Varvara A. Mouchtouri, Lemonia Anagnostopoulos, Kostantinos E. Stamoulis, Kostantinos Agorastos, Efthimia A. Petinaki, Panagiotis Prezerakos, Sotirios Tsiodras and Christos Hadjichristodoulou
Additional contact information
Michalis Koureas: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Matthaios Speletas: Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
Zacharoula Bogogiannidou: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Dimitris Babalis: General Hospital of Larissa, 41221 Larissa, Greece
Vassilios Pinakas: Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece
Ourania Pinaka: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Apostolos Komnos: General Hospital of Larissa, 41221 Larissa, Greece
Stella Tsoutsa: General Hospital of Larissa, 41221 Larissa, Greece
Georgia Papadamou: Emergency Department, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece
Maria A. Kyritsi: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Alexandros Vontas: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Vasileios Nakoulas: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Spyros Sapounas: Hellenic National Public Health Organization, 15123 Athens, Greece
Nikolaos Kanellopoulos: Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece
Dimitrios Kalompatsios: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Vassiliki Papadouli: Local Health Unit of Ampelokipi, 5th Regional Health Authority of Thessaly & Sterea, Ministry of Health, 41447 Larissa, Greece
Katerina Dadouli: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Soteris Soteriades: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Paraskevi Mina: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Varvara A. Mouchtouri: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Lemonia Anagnostopoulos: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
Kostantinos E. Stamoulis: Hellenic National Blood Transfusion Center, 13677 Athens, Greece
Kostantinos Agorastos: Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece
Efthimia A. Petinaki: Department of Microbiology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
Panagiotis Prezerakos: Department of Nursing, University of the Peloponnese, 22100 Tripoli, Greece
Sotirios Tsiodras: Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
Christos Hadjichristodoulou: Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece

IJERPH, 2021, vol. 18, issue 6, 1-13

Abstract: A COVID-19 outbreak occurred among residents of a Roma settlement in Greece (8 April–4 June 2020). The aim of this study was to identify factors associated with an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to evaluate the effectiveness of control measures implemented. Data were analyzed from individuals that were tested for SARS-CoV-2 during contact tracing, population screening or hospital visits. RT-PCR was used for the detection of SARS-CoV-2 in oropharyngeal samples. Risk factors for household secondary attack rates (SAR) and hospitalization with COVID-19 were examined using chi-square tests, Fisher’s exact tests and logistic regression analyses. During the outbreak, 142 cases, 20 hospitalizations and 1 death were recorded, with a total of 2273 individuals tested. The risk of hospitalization was associated with age (OR: 1.04, 95% CI: 1.02–1.07) and Cycle threshold (Ct) values (OR for a decrease in Ct values by 1: 1.18, 95% CI: 1.07–1.31). Household SAR was estimated at 38.62% (95% CI: 32.50–45.01%). After the designation of an isolation facility for cases, household SAR declined from 74.42% to 31.03%. Household size was associated with the risk of infection (OR: 2.65, 95% CI: 1.00–7.07). The presence of COVID-19 symptoms among index cases was correlated with higher transmission (OR: 23.68, 95% CI 2.21–253.74) in multivariate analysis, while age was found to be associated with SAR only in univariate analysis. Roma communities can be particularly vulnerable to the spread of SARS-CoV-2. In similar settings, symptomatic cases are more important transmitters of SARS-CoV-2. Within these communities, immediate measures should be implemented to mitigate disease spread.

Keywords: SARS-CoV-2; COVID-19; control measures; household transmission; vulnerable populations; asymptomatic transmission (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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