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A large outbreak of COVID-19 in a UK prison, October 2020 to April 2021

Adamson, James P., Smith, Christopher, Pacchiarini, Nicole, Connor, Thomas Richard ORCID:, Wallsgrove, Janet, Coles, Ian, Frost, Clare, Edwards, Angharad, Sinha, Jaisi, Moore, Catherine, Perrett, Steph, Craddock, Christie, Sawyer, Clare, Waldram, Alison, Barrasa, Alicia, Thomas, Daniel Rh., Daniels, Philip and Lewis, Heather 2022. A large outbreak of COVID-19 in a UK prison, October 2020 to April 2021. Epidemiology and Infection 150 , e134. 10.1017/S0950268822000991

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Prisons are susceptible to outbreaks. Control measures focusing on isolation and cohorting negatively affect wellbeing. We present an outbreak of coronavirus disease 2019 (COVID-19) in a large male prison in Wales, UK, October 2020 to April 2021, and discuss control measures. We gathered case-information, including demographics, staff-residence postcode, resident cell number, work areas/dates, test results, staff interview dates/notes and resident prison-transfer dates. Epidemiological curves were mapped by prison location. Control measures included isolation (exclusion from work or cell-isolation), cohorting (new admissions and work-area groups), asymptomatic testing (case-finding), removal of communal dining and movement restrictions. Facemask use and enhanced hygiene were already in place. Whole-genome sequencing (WGS) and interviews determined the genetic relationship between cases plausibility of transmission. Of 453 cases, 53% (n = 242) were staff, most aged 25–34 years (11.5% females, 27.15% males) and symptomatic (64%). Crude attack-rate was higher in staff (29%, 95% CI 26–64%) than in residents (12%, 95% CI 9–15%). Whole-genome sequencing can help differentiate multiple introductions from person-to-person transmission in prisons. It should be introduced alongside asymptomatic testing as soon as possible to control prison outbreaks. Timely epidemiological investigation, including data visualisation, allowed dynamic risk assessment and proportionate control measures, minimising the reduction in resident welfare.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (
Publisher: Cambridge University Press
ISSN: 0950-2688
Date of First Compliant Deposit: 7 July 2022
Date of Acceptance: 1 May 2022
Last Modified: 04 May 2023 06:42

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