Publication:

COVID-19: timely action to prevent local transmission: a success story from Kannur District, Kerala

Background The first case of COVID-19 in Kannur district was reported in first week of March, 2020. An elderly female with multiple co-morbidities and confined to house for many years was detected to be positive for SARS-CoV-2 on third week of May, 2020. She neither had relevant travel history nor was a contact of any confirmed COVID-19 case. A special investigation team was assigned to identify the source of infection.

Methods Index case's residential premises and the concerned local Primary Health Centre (PHC) were visited to get an idea about the background details of the index case. The team members participated in focus group discussions for decision making and reviewing steps involved in the process of investigation. Data collection was done mainly through phone interviews using an open- ended questionnaire. Data collected from family members, relatives, neighbours and local leaders were compiled systematically and summarized descriptively to reach a hypothesis.

Results Rigorous contact tracing of index case and appropriate testing of the contacts were done. Interstate truck drivers bringing fish from outside Kerala, who used to deliver fish to the index case’s house were identified as the source of infection. These truck drivers used to deliver fish in the local fish market also. The district administration was immediately alerted and fish market was disinfected and closed which prevented further mushrooming of cases.

Conclusions Early epidemiological investigation for source identification and elucidation of chain of disease transmission is crucial to clamp down the outbreak efficiently.