Abstract
Background: The epidemic dynamics of COVID-19 in the Molise region, central Italy, has dramatically changed from the beginning of May 2020, which was when infections were reported amongst Romani people. The aims of this study were to describe the characteristics of an outbreak that occurred in the Romani community and the interventions implemented for control.Methods: A retrospective analysis of outbreak data was performed to describe the SARS-CoV-2 transmission dynamics.Results: A young Romani woman was the first case reported and epidemiological investigation established a possible link with the funeral of a deceased member of this community. In total, 150 close contacts within 34 family groups in two cities were traced, and 109 (72.7%) Romani individuals were found to be infected by COVID-19. The patient's median age was 31 years, 58% were female, and the highest (20.2%) incidence occurred in the 0–9 years age group. A total of 26 (23.8%) patients developed typical SARS-CoV-2 symptoms, 15 (57.8%) were hospitalized, and 21 (22.1%) had comorbidities [most commonly hypertension (28.6%) and/or coronary heart diseases (23.8%)]. The outbreak was effectively controlled through compulsory quarantine and enhanced active surveillance.Conclusions: This is the first study providing insight into COVID-19 transmission dynamics among a Romani population living in Italy. These findings support general conclusions about the role of crowded social gatherings in SARS-CoV-2 spread, the high communicability among close contacts and household settings, and the impact of asymptomatic carriers. These features are of relevance to certain Romani customs where family gatherings are a fundamental pillar of their lives. Although difficulties emerged in interacting with Romani people related to cultural drivers, beliefs, and lifestyle, the outbreak management was effective and should be considered as a valuable model applicable to similar incidents occurring in minority populations.
Highlights
As a consequence of a rapid and sudden increase in the number of COVID-19 infections in the Lombardy region [1], the Italian health authorities implemented strict containment measures, including quarantine “red zones” in northern Italy in February 2020 [2]
This study describes the characteristics of an outbreak among the Romani community in the Molise region, the interventions implemented to interrupt the transmission, as well as public health considerations based on their socio-cultural behaviors
The COVID-19 case definition was derived from the official documents of the Italian Government (DPCM – Decree of the President of the Council of the Ministers), according to the recommendation of the Italian National Health Institute (ISS), European Centre for Disease Control (ECDC), Centers for Disease Control and Prevention (CDC), and the World Health of Organization (WHO), and comprised the detection of the SARSCoV-2 by reverse transcription (RT) PCR in a nasopharyngeal swab [7]
Summary
As a consequence of a rapid and sudden increase in the number of COVID-19 infections in the Lombardy region [1], the Italian health authorities implemented strict containment measures, including quarantine “red zones” in northern Italy in February 2020 [2]. Molise is a small Italian region of ∼300,000 inhabitants, located in central Italy. On May 7, 2020, 22 new cases were reported by the regional health authority, of which 21 belonged to a Romani community living in Campobasso, the regional capital. The epidemic dynamics of COVID-19 in the Molise region, central Italy, has dramatically changed from the beginning of May 2020, which was when infections were reported amongst Romani people. The aims of this study were to describe the characteristics of an outbreak that occurred in the Romani community and the interventions implemented for control
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