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On June 29, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by asymptomatic and presymptomatic persons poses important challenges to controlling spread of the disease, particularly in congregate settings such as correctional and detention facilities (1). On March 29, 2020, a staff member in a correctional and detention facility in Louisiana developed symptoms † and later had a positive test result for SARS-CoV-2. During April 2-May 7, two additional cases were detected among staff members, and 36 cases were detected among incarcerated and detained persons at the facility; these persons were removed from dormitories and isolated, and the five dormitories that they had resided in before diagnosis were quarantined. On May 7, CDC and the Louisiana Department of Health initiated an investigation to assess the prevalence of SARS-CoV-2 infection among incarcerated and detained persons residing in quarantined dormitories. Goals of this investigation included evaluating COVID-19 symptoms in this setting and assessing the effectiveness of serial testing to identify additional persons with SARS-CoV-2 infection as part of efforts to mitigate transmission. During May 7-21, testing of 98 incarcerated and detained persons residing in the five quarantined dormitories (A-E) identified an additional 71 cases of SARS-CoV-2 infection; 32 (45%) were among persons who reported no symptoms at the time of testing, including three who were presymptomatic. Eighteen cases (25%) were identified in persons who had received negative test results during previous testing rounds. Serial testing of contacts from shared living quarters identified persons with SARS-CoV-2 infection who would not have been detected by symptom screening alone or by testing at a single time point. Prompt identification and isolation of infected persons is important to reduce further transmission in congregate settings such as correctional and detention facilities and the communities to which persons return when released. * These two authors contributed equally. † COVID-19-related signs and symptoms include subjective fever, cough, shortness of breath, chills, muscle aches, headache, sore throat, loss of taste, or loss of smell. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/ symptoms.html. * During the 2 months preceding the date of data collection. † During the 2 months preceding testing and during the 14-day testing period. The person who was asymptomatic and had a positive test result on day 14 had not developed symptoms at follow-up 1 week later. § Persons who reported onset of symptoms after the date of specimen collection, which resulted in a positive test.

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C orrectional and detention facilities face unique challenges for controlling severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease (COVID-19). These challenges include an inability for incarcerated or detained persons to socially distance and an ongoing risk for virus introduction caused by staff movement outside and within the facilities (1,2). These inherent difficulties underpin increased rates of SARS-CoV-2 infections and deaths among incarcerated and detained persons compared with the general population; 146,472 cases and 1,122 deaths in this population were reported in the United States as of October 20, 2020 (3,4). The Centers for Disease Control and Prevention (CDC) released interim guidance for management of COVID-19 in correctional and detention facilities; however, some facilities reported limitations to fully implementing the guidance (5-7). In addition, the potential for asymptomatic and presymptomatic transmission limits the effectiveness of symptom screening to identify cases and halt transmission (8-10). In other congregate settings, serial testing and physically separating persons based on their SARS-CoV-2 test results have been used to interrupt transmission (11,12). We investigated a COVID-19 outbreak in a detention center in Louisiana, USA (facility X) and used a serial testing strategy to identify infections and interrupt transmission in affected dormitories. All residents of affected dormitories underwent SARS-CoV-2 testing to assess the extent of transmission within the dormitory, to cohort detained persons based on their test result to prevent transmission, and to evaluate the utility of serial testing in this setting. We report the findings of this investigation; initial results were previously reported (13).