Response to COVID-19 outbreak in an inner-city food processing factory in Ghana: A case study

Introduction: On April 9, 2020, a factory worker from a food processing factory reported to the factory clinic with fever and respiratory symptoms which were later confirmed to be coronavirus disease 2019 (COVID-19). We describe the index case, its uniqueness, control and preventive measures. Methods: Using a suspected case of COVID-19 as any person in the factory with symptoms of fever or measured temperature ≥38°C and respiratory tract illness such as cough, difficulty in breathing from March 25 to April 30, 2020, we conducted active case finding. We identified and tested contacts of the index case and other cases identified. We conducted environmental assessment of the factory. Results: The index case was a 48-year-old factory worker who reported to the factory clinic on April 9, 2020 with complaints of cough for a duration of four days associated with fever, chills and body pains. Of 1,138 employees in the factory who were tested as part of contact tracing and active case search, 695 (61.1%) tested positive for COVID-19. Mean age of the case-patients was 39 (±9.8) years. There was no death. Conclusion: An outbreak of COVID-19 most likely introduced by workers from the community occurred in a food-processing factory in Ghana. The density of the workers in the factory at any given time coupled with a lack of monitoring of adherence to preventive measures probably facilitated the spread. Enforcing and monitoring the implementation of workplace safety and preventive measures for COVID-19 is necessary to prevent outbreaks at the workplace.