You are here

Article Text

Article menu
Download PDFPDF
Global health
Nosocomial SARS-CoV-2 transmission in a neonatal unit in Botswana: chronic overcrowding meets a novel pathogen
  1. Britt Nakstad1,2,
  2. Thato Kaang1,
  3. Alemayehu Mekonnen Gezmu1 and
  4. Jonathan Strysko1,3,4
  1. 1Department of Paediatric and Adolescent Health, University of Botswana, Gaborone, Botswana
  2. 2Division of Paediatric and Adolescent Medicine, University of Oslo, Oslo, Norway
  3. 3Department of Global Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  4. 4Department of Paediatric Medicine, Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
  1. Correspondence to Dr Britt Nakstad; britt.nakstad{at}medisin.uio.no

Abstract

We describe a cluster of six SARS-CoV-2 infections occurring in a crowded neonatal unit in Botswana, including presumed transmission among mothers, postnatal mother-to-neonate transmission and three neonate-to-healthcare worker transmissions. The affected neonate, born at 25 weeks’ gestation weighing 785 g, had a positive SARS-CoV-2 test at 3 weeks of age which coincided with new onset of hypoxaemia and worsening respiratory distress. Because no isolation facility could accommodate both patient and mother, they were separated for 10 days, during which time the patient was switched from breastmilk to formula. Her subsequent clinical course was marked by several weeks of supplemental oxygen, sepsis-like presentations requiring additional antibiotics and bronchopulmonary dysplasia. Despite these complications, adequate growth was achieved likely due to early initiation of nutrition. This nosocomial cluster highlights the vulnerabilities of neonates, caregivers and healthcare workers in an overcrowded environment, and underscores the importance of uninterrupted bonding and breast feeding, even during a pandemic.

  • infectious diseases
  • neonatal intensive care
  • infection control in hospital
  • COVID-19
  • parenteral / enteral feeding

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-242421

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors BN, TK, AMG and JS contributed to the conception, acquisition and drafting of the manuscript for intellectual content, and they all approved the version submitted. BN, TK, AMG and JS gave an agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.