Outbreak of SARS-CoV2 in a tertiary institution, Ghana, March 2020: Lessons learnt through early contact tracing

Background: An outbreak of influenza COVID-19 was confirmed in March 2020 in a tertiary institution in Ghana involving 1 symptomatic case and 94 contacts. Influenza SAR-CoV-2 infection was laboratory-confirmed by PCR in the index case. With little to no knowledge of the epidemiology and transmission of the disease in the Ghanaian setting, it was important to investigate the outbreak, to determine the source and implement control measures. We document the effective response to this outbreak to guide future responses to similar outbreaks. Methods: The investigation commenced on March 18 2020, involving an initial in-depth interview with the index case and subsequently listing and identifying all possible contacts of the case. This followed two weeks daily monitoring of contacts mandatorily quarantined, testing of symptomatic contacts and treatment of the case. Results: There was one (1) confirmed case (index case), a female aged 36 years who survived after receiving treatment. Control measures were implemented as soon as a case was confirmed and included contact tracing, quarantine of all contacts, school closure, active case finding and treatment as well as post-exposure prophylaxis offered to all contacts. Conclusion: The prompt detection of the outbreak and response; contact racing, quarantine, early closure of school and prophylaxis to contacts after the initial case was detected, resulted in breaking the chain transmission of the infection.