Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Short Communication
Year : 2022 | Month : August | Volume : 16 | Issue : 8 | Page : LM01 - LM04 Full Version

Response to an Outbreak of COVID-19 Infection Among Undergraduate Medical Students in Mumbai, Maharashtra


Published: August 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/56016.16714
Anuradha Kunal Shah, Kosturi Dakshit, Gajanan Dattatray Velhal

1. Assistant Professor, Department of Community Medicine, Seth GSMC & KEMH, Mumbai, Maharashtra, India. 2. Junior Resident, Department of Community Medicine, Seth GSMC & KEMH, Mumbai, Maharashtra, India. 3. Professor and Head, Department of Community Medicine, Seth GSMC & KEMH, Mumbai, Maharashtra, India.

Correspondence Address :
Kosturi Dakshit,
Department of Community Medicine, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.
E-mail: kosturi.18@gmail.com

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) is an infectious disease. The most effective way to slow down the transmission is by social distancing and following all the preventive protocols.

Aim: To describe the outbreak of COVID-19 in forty Undergraduate (UG) medical students of a medical college in Mumbai during September 2021 steps taken to control the spread as well as to break the chain of transmission of COVID-19 infection.

Materials and Methods: The institutional contact tracing team contacted the positive case and identified contacts as soon as they were notified during September 2021 at Seth GSMC & KEMH, Mumbai, Maharashtra, India. A total of 40 students were isolated due to the contraction of COVID infection. History was taken by telephonic calls. Meetings were held among the institute and hostel authorities to prevent the spread. All the contacts of positive cases were separated in a quarantine facility. COVID appropriate behaviour (CAB) was implemented strictly and swab of symptomatic students was taken for Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). Non-academic leisure activities were suspended temporarily. Academic lectures were shifted to an online platform.

Results: This outbreak lasted over a period of 10 days, a total of 40 students were isolated and 89 students were quarantined. Most of the students who were infected were residing in the hostels, 27 (67.5%) and had come in contact with other positive students during the college’s cultural fest. Majority of positive cases had received both doses of COVID vaccination. Mild symptoms were present in 87.5% students and rest were asymptomatic. Cases were detected from the same cluster of students and follow-up was done for the next two weeks.

Conclusion: Strategies like scheduled testing for in-campus students, strict implementation of CAB and temporary withdrawal of activities which causes gathering helped effectively to control the spread.

Keywords

Contact-tracing, Isolation, Coronavirus Disease-2019, Quarantine

On 11th march 2020 COVID-19 infection was notified as pandemic in India by World Health Organization (WHO) (1). It is an infectious disease which is caused by Severe Acute Respiratory Syndrome- Coronavirus-2 (SARS-CoV-2) virus. Virus spreads from infected person via droplets. Till 29th September 2021, India has faced two COVID-19 waves with continuous high testing for COVID-19 (1),(2). After the introduction of vaccination drive in India on January 2021 for COVID-19, widespread vaccination is being done throughout the country (2).

During the second wave, the average number of daily cases in the city was 1713 to 2654 and in state the numbers were 14900 to 18300 (3),(4). Delta variant of COVID-19, was predominantly in circulation at that time (5). As the COVID-19 pandemic is on a downward curve similar outbreaks are expected in a closed institution setting. This report describes the outbreak and intervention done to prevent further spread. The strategies as described further may be useful for other institutes in responding to similar events.

Material and Methods

This study describes the COVID-19 outbreak at Seth GSMC and KEMH, Mumbai, Maharashtra, India, from 28th September, 2021 to 7th October, 2021. Ethical clearance was taken from institutional ethics committee (EC/OA-144). Written informed consent was obtained from all cases

A total of 40 UG medical students of a medical college in Mumbai contracted COVID-19 infection within a span of 10 days. (Table/Fig 1) (6). An institutional contact tracing team was set up in the study area at the beginning of the pandemic. Whenever a positive case was detected, it was immediately notified to the team. Details of the positive case and history regarding contacts with other people were asked via telephone and assessed. This was followed by calls to the contacts of the cases to cross verify the history of contacts. All contacts were quarantined in a separate facility provided by the institute.

Description of the outbreak: A total of 40 cases were detected in this outbreak and total of 87 contacts were quarantined against the contacts while the peak of cases was on day 2 followed by day 3. The details are described below (Table/Fig 1).

Day 1: four students from MBBS second year were detected COVID-19 positive by the Reverse Transcription-Polymerase Chain Reaction test (RT-PCR). Contact tracing was initiated immediately and a total of 19 students who were significant contacts (exposed to a laboratory confirmed COVID-19 case, was sharing same room or same working environment, was in close proximity within 6 feet and exposed >15 minutes duration without any Personal Protective Equipment (PPE) (7) were quarantined against them for 14 days in a facility provided by the institute. The four positive cases were also in contact with each other. History revealed that the index case i.e., (IC) first case which comes to the notice of the health facility (8) was a common contact of many students as he attended several meetings as a class representative and participated in a few cultural and literary activities. Symptomatic contacts were asked to test immediately and seven other students having significant contact with IC were quarantined. The COVID-19 infected students were sent to the hospital for isolation to prevent further spread in hostels that have shared lavatories and dining areas. All students were asked to avoid gathering for food, academic or leisure activities. Other students who were part of the cultural and literary fests were also asked to get tested immediately if they were symptomatic.

Day 2: Another seven students from MBBS second year and five students from MBBS first year were detected COVID-19 positive. Of the seven MBBS second year students, three were in quarantine already and the rest had significant contact with the students placed in quarantine on the previous day. Cases had overlapping contacts. Another 10 students of MBBS second year who were identified as contacts were quarantined. Eleven students of MBBS first year were also quarantined. Though the MBBS first year and MBBS second year positive students didn’t report any direct contact with each other, they were part of cultural and literary activities and visited the same canteen premises often. All the cultural and literary fest activities were withheld with immediate effect and all the students involved were asked to test for COVID-19 immediately irrespective of symptoms. On-campus canteen used by UG students was found as a common source of infection. Higher authorities were informed about the situation.

Day 3: In the morning, a meeting was conducted with the head of the institution and other stakeholders. Based on the urgency of the situation, prompt measures were taken to end the chain of transmission- all on-campus leisure cultural and literary fest activities and meeting points including eateries were strictly closed for UG students. Use of masks and social distancing norms were reinforced in public places including hostel corridors. Surprise visits in the hostel were taken by the wardens to ensure adherence to CAB. Academic activities were continued via online mode and off-campus students were asked not to come unless they wanted to use hospital facilities. Scheduled screening by RT-PCR test was started for all the on-campus UG students. Active surveillance (door to door) was done in the hostels by hostel in-charges for symptomatic students which was followed by Rapid antigen test (RAT) and RT-PCR testing.

Hostel buildings (rooms, corridors, lavatories and other common places) were disinfected frequently with 5% hypochlorite solution under supervision (9). All support staff working in the hostels were also asked to undergo testing. E-commerce delivery agents were restricted to the common entrance only and students were asked to use contactless delivery. Nine new cases from MBBS second year were also detected positive, out of which two were already quarantined and developed symptoms during their quarantine period and were tested immediately. The other seven were also symptomatic and gave a history of contact with cases from Day 1 which was previously denied. Ten fresh students were quarantined against these cases, and seven were already in quarantine due to contact with positive cases. Apart from this, two MBBS first year students also tested positive. One of the positive MBBS students had a total of 19 contacts and all were quarantined. As hostels were not suited for isolation, COVID positive students residing in hostels were isolated in hospital and COVID positive day scholars opted for home isolation.

Day 4: Four new cases from MBBS second year and one new case from MBBS first year were detected positive. This positive MBBS first year student had developed symptoms during quarantine period, hence got tested. Eight new contacts from MBBS second year and one from MBBS first year were quarantined against them immediately. Scheduled testing for detecting the cases was continued.

Day 5: One MBBS third year student was tested positive and one student from the same batch was quarantined for being his contact. There was no history of contact with any of the previously isolated or quarantined students. However, the hostel premises were the same.

Day 6: Another student from MBBS third year and one student from final year MBBS turned positive with five contacts who were quarantined. Cases were part of cultural activities described previously.

Day 7: Two MBBS second year students and one final MBBS student were detected positive. One among these two MBBS second year students, was already quarantined and tested positive on the fourth day of quarantine. There was no new significant contact for this case. The other positive MBBS second year student had no contact with any of the previous cases. His roommate was his only contact and was quarantined. The final MBBS student reported being in contact with a positive case. This case had one significant contact who was quarantined promptly.

Day 8: One MBBS second year student was positive who gave no history of contact with any of the previously positive cases but participated in some cultural activities. Four new students were quarantined.

Day 9: No case was detected.

Day 10: A MBBS second year student was detected positive. He didn’t have any history of contact with any of the previous cases but lived in the room adjacent to the COVID-19 positive students.

No case was detected thereafter from this cluster for upto two weeks. All students were re-tested at the end of quarantine. All students were discharged following the isolation period (at least 7 days have passed from the day of testing positive and no fever for 3 successive days) (10). Full recovery was seen among all students.

Results

Total of 40 students were tested positive for COVID-19 infection and were isolated within span of 10 days. Mean age of the cases was 19.98 ±1.07 years (Range: 18-22). Among these students, 25 (62.5%) were male and 15 (37.5%) were female. Majority of cases were detected from MBBS second year (70%).

The probable source of infection in 26 (65%) cases was contact with positive case. Majority of the cases, 67.5%, were residing in hostels only.

55% of positive cases opted for hospital isolation and 67.5% of contacts opted for institutional quarantine. 11 students (27.5%) tested positive from their quarantine.

Majority of the cases were symptomatic (87.5%) and mostly tested positive via RT-PCR test (92.5%). Cough (45.71%) was the most common symptom observed. All symptoms were mild in nature; despite of this due to non-availability of adequate isolation facility in hostels, some students were admitted in hospital. All of them were fully vaccinated with covisheild except only one (not vaccinated). The clinico-epidemiological details of forty students who tested positive are given in (Table/Fig 2).

Discussion

An outbreak in the institution campus is always a challenge for the administration. With the decreasing trend of COVID-19 cases elsewhere, such outbreaks can create panic too. Vaccines play a crucial role in limiting the spread of virus and severity of the disease. This may also create a false belief among people leading to relaxation of the norms of CAB. Breakthrough infections (≥14 days after second dose) have been reported after COVID-19 vaccination (11).This was witnessed among the UG students of our institute where forty students were tested positive within a span of 10 days, 39 of which were breakthrough infections. The cultural and literary fest activities, common eateries, group studies, group sports became a potential source of infection spread and hostels became the hotspots.

The contact tracing team, under the aegis of the Department of Community Medicine, acted promptly to prevent the spread of this outbreak. Since most (67.5%) of the students were staying in the hostel, they were each other’s contact. About 65% cases were exposed due to contact with positive cases, and another 20% reported the exposure during group outings, group studies, canteen, cultural activities and sports. In 15%, the source was unknown. This necessitates isolation of positive students (asymptomatic also) in an isolation facility to prevent further spread in the hostel. Separation of exposed students and mandatory quarantine for 14 days further helped in breaking the chain of transmission.

Many students (87.5%) reported mild symptoms lasting for an average of two-three days. Symptoms in few students had resolved even before they were tested. Among the positives, 27.5% developed symptoms during their quarantine period and turned out positive.

A study by Fox MD et al, describes an outbreak of COVID-19 in the university campus of Indiana which was prevented by aggressive testing, withdraw of in person classes for some days, tracing of contacts and isolation of cases (12). Walke HT et al, also reported strategies followed in the university of Georgia during arrival of students in campus where they have mentioned that two phased testing- pre arrival testing and follow up testing after one week, scheduled weekly screening, testing on demand and random testing of students were helpful to detect cases and prevent an outbreak (13). In our institute contact tracing, testing of symptomatic students and contacts of cases, isolation of cases, quarantine of contacts, active case finding in hostel, testing at the end of the quarantine period, temporary closure of cultural and sports events, temporary use of virtual mode of classes and strict implementation of CAB helped to prevent the spread of COVID-19.

Limitation(s)

There is no provision for going to the site and investigate the outbreak. Entire procedure is telephonic call based. Since contact tracing relies mostly on history given by the case and probable contacts, it is not always possible to identify all contacts. Students may hide history of contact delaying the process.

Conclusion

Decreasing trends of cases may lead to relaxation of restrictions which may cause some clusters of positive cases. Aggressive testing, timed contact tracing, reinforcement of CAB, availability of isolation and quarantine facilities were helpful in successful hotspot containment. This model of control of outbreak can be followed if there are any cases of further similar episodes anywhere.

References

1.
WHO. Situation in numbers. Nov Coronavirus Dis Situat Updat Report-11 2020;11:12-5. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200411-sitrep-82-covid-19.pdf.
2.
East S, Region A. Covid-19?: Status Across States 2021:9-11.
3.
COVID-19 September 29 Highlights: Mumbai now has 26,001 active cases; Maharashtra sees 430 deaths in 24 hours n.d. https://mumbaimirror.indiatimes.com/coronavirus/news/covid-19-september-29-highlights-mumbai-now-has-26001-active-cases-maharashtra-sees-430-deaths-in-24-hours/articleshow/78389550.cms (accessed 13 December 2021).
4.
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DOI and Others

DOI: 10.7860/JCDR/2022/56016.16714

Date of Submission: Mar 01, 2022
Date of Peer Review: Apr 13, 2022
Date of Acceptance: Jun 07, 2022
Date of Publishing: Aug 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 10, 2022
• Manual Googling: Apr 11, 2022
• iThenticate Software: Jul 29, 2022 (5%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
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  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
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