![]() ![]() Bilateral anterior nasal swab specimens were collected by either the racetrack physician or one of the racetrack veterinarians trained in collection procedures. Symptom information was elicited by asking staff if they were experiencing any COVID symptoms, such as fever, headache, or loss of taste. On the day of testing, a facility administrative employee conducted registration and collected demographic data, including self-reported race and ethnicity. Staff who tested positive by either BinaxNOW or rRT-PCR were isolated and excluded from further testing.Īll specimen collection and antigen testing occurred outdoors in the parking lot of the facility. ![]() Each round was intended to test all staff who had not yet tested positive by BinaxNOW or rRT-PCR to continue identifying potentially infectious persons. Testing frequency was determined by the LHD and changed as the outbreak progressed. The facility, in collaboration with the LHD and the California Department of Public Health (CDPH) laboratory, conducted 6 rounds of serial testing of its staff with paired BinaxNOW rapid antigen and rRT-PCR tests during November 25–December 22 (rounds 1–6). These findings could inform testing protocols used to contain future outbreaks of COVID-19 in nonhealthcare workplaces. The purpose of this analysis is to compare BinaxNOW with rRT-PCR in paired specimens from persons during a COVID-19 outbreak among horse racetrack workers. This use provided an opportunity to assess the effectiveness of the BinaxNOW rapid antigen test in detecting SARS-CoV-2 infection in a nonhealthcare workplace outbreak. The LHD decided to use BinaxNOW as a supplement to rRT-PCR to more quickly identify SARS-CoV-2–positive employees for isolation. Additional rounds of testing were needed to monitor ongoing transmission and determine when the outbreak had ended. However, some quarantined employees were permitted to return to work if they were needed to perform duties related to essential care of the horses. ![]() No staff were permitted to return to onsite residence until the outbreak had ended. Those living onsite were moved to hotel rooms to quarantine, and those living offsite quarantined in their homes. At this time, all staff were assumed to have been exposed. The initial round of rRT-PCR testing (round 0) occurred on November 14–15, 2020, and identified 169 SARS-CoV-2–positive staff who were subsequently isolated. In response, the LHD ordered that all nonessential work activities (e.g., horse racing) be stopped until mass testing of all staff demonstrated no further transmission. The outbreak was discovered by the contact tracing efforts of the local health department (LHD), the City of Berkeley Public Health Officer Unit. Performance was better among symptomatic persons, specimens with cycle threshold (C t) 1,100 horses stabled there. Previous studies of BinaxNOW compared with rRT-PCR have demonstrated a high negative percent agreement (NPA) (99.4%–100%) but variable positive percent agreement (PPA) (52.5%–89.0%). Rapid antigen tests, such as Abbott BinaxNOW ( ) test kits, offer a less expensive and faster alternative to nucleic acid amplification tests, such as real-time reverse transcription PCR (rRT-PCR), in the diagnosis of coronavirus disease (COVID-19) ( 1, 2). Our comparison supports immediate isolation for BinaxNOW-positive persons and confirmatory testing for negative persons. Of 100 specimens with cycle threshold <30, a total of 51 resulted in positive virus isolation 45 (88.2%) of those were BinaxNOW-positive. Among 127 rRT-PCR–positive specimens, the 55 with paired BinaxNOW-positive results had a lower mean cycle threshold than the 72 with paired BinaxNOW-negative results (17.8 vs. We compared BinaxNOW with rRT-PCR in 769 paired specimens from 342 persons during a coronavirus disease outbreak among horse racetrack workers in California, USA. The Abbott BinaxNOW rapid antigen test is cheaper and faster than real-time reverse transcription PCR (rRT-PCR) for detecting severe acute respiratory syndrome coronavirus 2.
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