To the Editor
In a scenario just like that described by Kasper et al. (Dec. 17 situation)1 on the usS. Theodore Roosevelt, an outbreak of coronavirus illness 2019 (Covid-19) occurred on the French plane service Charles de Gaulle in April 2020. Medical and biologic knowledge for all 1739 crew members have been collected on arrival on the Toulon harbor and through quarantine. We used the identical definitions as Kasper et al. to categorise circumstances as confirmed or suspected. We discovered that 1121 crew members (64%) examined optimistic for extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse-transcriptase–polymerase chain response (RT-PCR). Amongst these, 24% have been asymptomatic (Fig. S1 within the Supplementary Appendix, obtainable with the total textual content of this letter at NEJM.org).
SARS-CoV-2 serologic testing carried out in 1706 crew members confirmed that 60% have been antibody-positive on the finish of quarantine. Percentages of crew members who have been antibody-positive differed amongst symptomatic (64%), asymptomatic (84%), and hospitalized (91%) RT-PCR–optimistic crew members.2 These variations could have been associated to residual optimistic RT-PCR outcomes from an older an infection in crew members who have been asymptomatic and to an absence of seroconversion in those that have been mildly symptomatic.3-5 Among the many crew members with suspected Covid-19, 30% had optimistic serologic check outcomes, which means that they could have had SARS-CoV-2 an infection. Our serologic knowledge present variety with respect to seroconversion throughout a Covid-19 outbreak in a younger, wholesome inhabitants and illustrate the complexities of viral circulation and of conducting an outbreak investigation.
Olivier Bylicki, M.D.
Nicolas Paleiron, M.D.
Frédéric Janvier, M.D.
Navy Instruction Hospital Sainte Anne, Toulon, France
[email protected]
No potential battle of curiosity related to this letter was reported.
This letter was revealed on February 10, 2021, at NEJM.org.
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1. Kasper MR, Geibe JR, Sears CL, et al. An outbreak of Covid-19 on an plane service. N Engl J Med 2020;383:2417–2426.
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2. Muench P, Jochum S, Wenderoth V, et al. Growth and validation of the Elecsys Anti-SARS-CoV-2 immunoassay as a extremely particular device for figuring out previous publicity to SARS-CoV-2. J Clin Microbiol 2020;58(10):e01694-20–e01694-20.
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3. Solar J, Xiao J, Solar R, et al. Extended persistence of SARS-CoV-2 RNA in physique fluids. Emerg Infect Dis 2020;26:1834–1838.
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4. Wang X, Guo X, Xin Q, et al. Neutralizing antibody responses to SARS-CoV-2 in COVID-19 inpatients and convalescent sufferers. Clin Infect Dis 2020 June 4 (Epub forward of print).
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5. Xiang F, Wang X, He X, et al. Antibody detection and dynamic traits in sufferers with coronavirus illness 2019. Clin Infect Dis 2020;71:1930–1934.
Response
Matthew R. Kasper, Ph.D.
U.S. Navy Bureau of Drugs and Surgical procedure, Falls Church, VA
[email protected]
Jesse R. Geibe, M.D.
Navy and Marine Corps Public Well being Middle, Portsmouth, VA
Since publication of their article, the authors report no additional potential battle of curiosity.
This letter was revealed on February 10, 2021, at NEJM.org.
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1. Payne DC, Smith-Jeffcoat SE, Nowak G, et al. SARS-CoV-2 infections and serologic responses from a pattern of U.S. Navy service members — USS Theodore Roosevelt, April 2020. MMWR Morb Mortal Wkly Rep 2020;69:714–721.
