D uring the ongoing coronavirus disease (COV-ID-19) pandemic, worldwide, >85 million severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections had been reported as of January 7, 2021 (https://covid19.who.int). Although it was clear from the beginning of the pandemic that symptomatic transmission of SARS-CoV-2 occurs, presymptomatic transmission has also been described (1-6). Furthermore, transmission from asymptomatic cases was deemed possible on the basis of fi ndings that viral load of asymptomatic cases was similar to that of symptomatic cases (7). Understanding how transmission occurs from asymptomatic cases and from symptomatic cases in their presymptomatic and symptomatic phase, as well as the frequency of transmission, is essential for public health management. We assessed asymptomatic, presymptomatic, and symptomatic transmission during an outbreak investigation of 59 COVID-19 cases by determining secondary attack rates (SAR) according to the respective exposure periods. In addition, we estimated key parameters such as serial interval and incubation period.

S (2020). Mass gathering events and undetected transmission of SARS-CoV-2 in vulnerable populations leading to an outbreak with high case fatality ratio in the district of Tirschenreuth, Germany. Epidemiology and Infection 148, e252, 1-6.

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