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. 2021 Apr;27(4):1159-1163.
doi: 10.3201/eid2704.204576. Epub 2021 Feb 18.

Analysis of Asymptomatic and Presymptomatic Transmission in SARS-CoV-2 Outbreak, Germany, 2020

Jennifer K Bender, Michael Brandl, Michael Höhle, Udo Buchholz, Nadine Zeitlmann

Analysis of Asymptomatic and Presymptomatic Transmission in SARS-CoV-2 Outbreak, Germany, 2020

Jennifer K Bender et al. Emerg Infect Dis. 2021 Apr.

Abstract

We determined secondary attack rates (SAR) among close contacts of 59 asymptomatic and symptomatic coronavirus disease case-patients by presymptomatic and symptomatic exposure. We observed no transmission from asymptomatic case-patients and highest SAR through presymptomatic exposure. Rapid quarantine of close contacts with or without symptoms is needed to prevent presymptomatic transmission.

Keywords: COVID-19; Germany; SARS-CoV-2; asymptomatic diseases; contact; coronavirus disease; disease transmission; epidemiology; infectious; respiratory infections; risk; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

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Figures

Figure
Figure
Transmission tree of the investigated cluster of coronavirus disease that evolved in a district in southern Germany. Cases 39, 40, and 60 participated in the survey but were not included in the analysis because we had no information on source case. Cases 7 and 27 did not participate in the survey and thus, no information on source case was available. Dashed lines represent source case–infectee pairs in which the infectee reported >1 possible source case; solid lines represent source case–infectee pairs in which only 1 source case was mapped to the infectee. Asterisks (*) indicate asymptomatic cases. Implausible transmissions (e.g., ID 6) were omitted.
See this image and copyright information in PMC

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