Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Households with Children, Southwest Germany, May–August 2020
Maximilian Stich, Roland Elling, Hanna Renk, Aleš Janda, Sven F. Garbade, Bárbara Müller, Hans‐Georg Kräusslich, Dorit Fabricius, Maria Zernickel, Peter Meissner, Daniela Huzly, Jürgen Grulich‐Henn, Anneke Haddad, Tessa Görne, Benedikt D. Spielberger, Linus Fritsch, Alexandra Nieters, Hartmut Hengel, Andrea Dietz, Thomas Stamminger, Tina Ganzenmueller, Natalia Ruétalo, Andreas Peter, Jonathan Remppis, Thomas Iftner, Kathrin Jeltsch, Tim Waterboer, Axel R. Franz, Georg F. Hoffmann, Corinna Engel, Klaus‐Michael Debatin, Burkhard Tönshoff, Philipp Henneke
Abstract
Resolving the role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in households with members from different generations is crucial for containing the current pandemic. We conducted a large-scale, multicenter, cross-sectional seroepidemiologic household transmission study in southwest Germany during May 11-August 1, 2020. We included 1,625 study participants from 405 households that each had ≥1 child and 1 reverse transcription PCR-confirmed SARS-CoV-2-infected index case-patient. The overall secondary attack rate was 31.6% and was significantly higher in exposed adults (37.5%) than in children (24.6%-29.2%; p = <0.015); the rate was also significantly higher when the index case-patient was >60 years of age (72.9%; p = 0.039). Other risk factors for infectiousness of the index case-patient were SARS-CoV-2-seropositivity (odds ratio [OR] 27.8, 95% CI 8.26-93.5), fever (OR 1.93, 95% CI 1.14-3.31), and cough (OR 2.07, 95% CI 1.21-3.53). Secondary infections in household contacts generate a substantial disease burden.