First COVID-19 Cases with High Secondary Infection among Health Workers, Sana’a Capital, April 2020: Lessons Learned and Future Opportunities

Al-Sakkaf, Ehab; Ghaleb, Yasser; Al-Dabis, Esmail; Qairan, Mohammed; Al-Amad, Mohammed; Al-Serouri, Abdulwahed; Al-Kohlani, Abdulhakim

Objectives Confirm existence of COVID-19 outbreak, conduct contact tracing, and recommend control measures. Methods Two COVID-19 cases in Sana’a Capital were met the WHO case definition. Data were collected from cases and contacts who were followed for 14 days. Nasopharyngeal swabs were taken for confirmation by Polymerase Chain Reaction (PCR). Results Two confirmed Yemeni male patients aged 20 and 40 years who had no travel history were admitted to hospital on 24 April 2020. Regarding the first patient, symptoms started on April 18th, 2020 then improved and discharged on May 5th while the second patient’s symptoms started on April 22nd but died on April 29th, 2020. Both cases had 54 contacts, 17 (32%) were health workers (HWs) that gave secondary attack rate (sAR) of 12% compared to 5% among other contacts. Four contacts (7%) were confirmed by PCR, two of them were HWs and needed admission. Conclusions First COVID-19 outbreak was confirmed among Yemeni citizens who had no travel history and with high sAR among HWs. Strict infection control among HWs should be ensured. Physical distancing, mask-wearing with appropriate disinfecting measures should be promoted especially among contacts. There is a need to strengthen national capacities to assess, detect, and respond to public health emergencies.