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01 april 2020

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

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.


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

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

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

·        Course of the disease patient 1:

  • day 1 January 24th: 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.