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Abstract

Background

SARS-CoV-2 emergence was a threat for armed forces. A COVID-19 outbreak occurred on the French aircraft carrier Charles de Gaulle from mid-March to mid-April 2020.

Aim

To understand how the virus was introduced, circulated then stopped circulation, risk factors for infection and severity, and effectiveness of preventive measures.

Methods

We considered the entire crew as a cohort and collected personal, clinical, biological, and epidemiological data. We performed viral genome sequencing and searched for SARS-CoV-2 in the environment.

Results

The attack rate was 65% (1,148/1,767); 1,568 (89%) were included. The male:female ratio was 6.9, and median age was 29 years (IQR: 24–36). We examined four clinical profiles: asymptomatic (13.0%), non-specific symptomatic (8.1%), specific symptomatic (76.3%), and severe (i.e. requiring oxygen therapy, 2.6%). Active smoking was not associated with severe COVID-19; age and obesity were risk factors. The instantaneous reproduction rate (R) and viral sequencing suggested several introductions of the virus with 4 of 5 introduced strains from within France, with an acceleration of R when lifting preventive measures. Physical distancing prevented infection (adjusted OR: 0.55; 95% CI: 0.40–0.76). Transmission may have stopped when the proportion of infected personnel was large enough to prevent circulation (65%; 95% CI: 62–68).

Conclusion

Non-specific clinical pictures of COVID-19 delayed detection of the outbreak. The lack of an isolation ward made it difficult to manage transmission; the outbreak spread until a protective threshold was reached. Physical distancing was effective when applied. Early surveillance with adapted prevention measures should prevent such an outbreak.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2022-05-26
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.21.2100612
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Investigation of a COVID-19 outbreak on the Charles de Gaulle aircraft carrier, March to April 2020: a retrospective cohort study
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Franck+de+Laval&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Laval Franck</a>, <a href="/search?value1=Herv%C3%A9+Chaudet&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chaudet Hervé</a>, <a href="/search?value1=Olivier+Gorg%C3%A9&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gorgé Olivier</a>, <a href="/search?value1=Joffrey+Marchi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marchi Joffrey</a>, <a href="/search?value1=Constance+Lacrosse&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lacrosse Constance</a>, <a href="/search?value1=Aissata+Dia&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dia Aissata</a>, <a href="/search?value1=Vanessa+Marbac&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marbac Vanessa</a>, <a href="/search?value1=Bakridine+Mmadi+Mrenda&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mmadi Mrenda Bakridine</a>, <a href="/search?value1=Ga%C3%ABtan+Texier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Texier Gaëtan</a>, <a href="/search?value1=Flavie+Letois&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Letois Flavie</a>, <a href="/search?value1=Charles+Chapus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chapus Charles</a>, <a href="/search?value1=V%C3%A9ronique+Sarilar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sarilar Véronique</a>, <a href="/search?value1=Jean-Nicolas+Tournier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tournier Jean-Nicolas</a>, <a href="/search?value1=Anthony+Levasseur&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Levasseur Anthony</a>, <a href="/search?value1=Jacques+Cobola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cobola Jacques</a>, <a href="/search?value1=Flora+Nolent&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nolent Flora</a>, <a href="/search?value1=Fabien+Dutasta&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dutasta Fabien</a>, <a href="/search?value1=Fr%C3%A9d%C3%A9ric+Janvier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Janvier Frédéric</a>, <a href="/search?value1=PA-CDG+COVID-19+investigation+group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">PA-CDG COVID-19 investigation group</a>, <a href="/search?value1=Jean-Baptiste+Meynard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Meynard Jean-Baptiste</a>, <a href="/search?value1=Vincent+Pommier+de+Santi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pommier de Santi Vincent</a></span>. Investigation of a COVID-19 outbreak on the Charles de Gaulle aircraft carrier, March to April 2020: a retrospective cohort study. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(21):pii=2100612. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.21.2100612" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.21.2100612</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 08 Jun 2021;&nbsp;&nbsp; <span class="generated">Accepted</span>: 16 Dec 2021 </span> </p>
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