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2022-11-17Zeitschriftenartikel
Analysis of two choir outbreaks acting in concert to characterize long- range transmission risks through SARS-CoV-2, Berlin, Germany, 2020
dc.contributor.authorReichert, Felix
dc.contributor.authorStier, Oliver
dc.contributor.authorHartmann, Anne
dc.contributor.authorRuscher, Claudia
dc.contributor.authorBrinkmann, Annika
dc.contributor.authorGrossegesse, Marica
dc.contributor.authorNeumann, Markus
dc.contributor.authorWerber, Dirk
dc.contributor.authorHausner, Marius
dc.contributor.authorKunze, Mareike
dc.contributor.authorWeiß, Bettina
dc.contributor.authorMichel, Janine
dc.contributor.authorNitsche, Andreas
dc.contributor.authoran der Heiden, Matthias
dc.contributor.authorKriegel, Martin
dc.contributor.authorCorman, Victor Max
dc.contributor.authorJones, Terry Carleton
dc.contributor.authorDrosten, Christian
dc.contributor.authorBrommann, Tobias
dc.contributor.authorBuchholz, Udo
dc.date.accessioned2024-09-04T10:41:56Z
dc.date.available2024-09-04T10:41:56Z
dc.date.issued2022-11-17none
dc.identifier.other10.1371/journal.pone.0277699
dc.identifier.urihttp://edoc.rki.de/176904/12086
dc.description.abstractBackground Superspreading events are important drivers of the SARS-CoV-2 pandemic and long-range (LR) transmission is believed to play a major role. We investigated two choir outbreaks with different attack rates (AR) to analyze the contribution of LR transmission and highlight important measures for prevention. Methods We conducted two retrospective cohort studies and obtained demographic, clinical, laboratory and contact data, performed SARS-CoV-2 serology, whole genome sequencing (WGS), calculated LR transmission probabilities, measured particle emissions of selected choir members, and calculated particle air concentrations and inhalation doses. Results We included 65 (84%) and 42 (100%) members of choirs 1 and 2, respectively, of whom 58 (89%) and 10 (24%) became cases. WGS confirmed strain identity in both choirs. Both primary cases transmitted presymptomatically. Particle emission rate when singing was 7 times higher compared to talking. In choir 1, the median concentration of primary cases’ emitted particles in the room was estimated to be 8 times higher, exposure at least 30 minutes longer and room volume smaller than in choir 2, resulting in markedly different estimated probabilities for LR transmission (mode: 90% vs. 16%, 95% CI: 80–95% vs. 6–36%). According to a risk model, the first transmission in choir 1 occurred likely after 8 minutes of singing. Conclusions The attack rate of the two choirs differed significantly reflecting the differences in LR transmission risks. The pooled proportion of cases due to LR transmission was substantial (81%; 55/68 cases) and was facilitated by likely highly infectious primary cases, high particle emission rates, and indoor rehearsing for an extended time. Even in large rooms, singing of an infectious person may lead to secondary infections through LR exposure within minutes. In the context of indoor gatherings without mask-wearing and waning or insufficient immunity, these results highlight the ongoing importance of non-pharmaceutical interventions wherever aerosols can accumulate.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleAnalysis of two choir outbreaks acting in concert to characterize long- range transmission risks through SARS-CoV-2, Berlin, Germany, 2020none
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/12086-9
dc.type.versionpublishedVersionnone
local.edoc.container-titlePLOS ONEnone
local.edoc.container-issn1932-6203none
local.edoc.pages23none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://journals.plos.org/plosone/none
local.edoc.container-publisher-namePLOSnone
local.edoc.container-volume17none
local.edoc.container-issue11none
local.edoc.container-reportyear2022none
dc.description.versionPeer Reviewednone

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