PT  - JOURNAL ARTICLE
AU  - Britt Nakstad
AU  - Thato Kaang
AU  - Alemayehu Mekonnen Gezmu
AU  - Jonathan Strysko
TI  - Nosocomial SARS-CoV-2 transmission in a neonatal unit in Botswana: chronic overcrowding meets a novel pathogen
AID  - 10.1136/bcr-2021-242421
DP  - 2021 Jun 01
TA  - BMJ Case Reports
PG  - e242421
VI  - 14
IP  - 6
4099  - http://casereports.bmj.com/content/14/6/e242421.short
4100  - http://casereports.bmj.com/content/14/6/e242421.full
SO  - BMJ Case Reports2021 Jun 01; 14
AB  - 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.