Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany - NEJM

(Letter to the editor)

Date: 05-03-2020 https://www.nejm.org/doi/full/10.1056/NEJMc2001468

Aim
Reporting a case of 2019-nCoV infection acquired outside Asia in which transmission appears to have occurred during the incubation period in the index patient.

Summary

·        Patient 1 is 33-year-old healthy German businessman

·        Meetings in Munich with business partner from Shanghai, the index patient, January 20^th 21^st

·        Index patient stayed in Germany from January 19^th to 22^nd, during her stay no signs or symptoms of infection, became ill on flight back to Shanghai and tested positive for 2019-nCov on January 26^th, on January 27^th she informed the company about her illness and contact tracing was issued.

·        Course of the disease patient 1:

• day 1 January 24^th: sore throat, chills, myalgia
• day 2: fever 39.1 and productive cough
• day 3: evening feeling better
• day 4: back to work
• PCR showed a high viral load of 2019-nCoV

·        The infection appears to have been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific. This may warrant a reassessment of transmission dynamics of the current outbreak.

·        The high amount of viral load raises concern about prolonged shedding of 2019-nCoV.