a b s t r a c tObjective: With the current SARS-CoV2 outbreak, countless tests need to be performed on potential symptomatic individuals, contacts and travellers. The gold standard is a quantitative polymerase chain reaction (qPCR)ebased system taking several hours to confirm positivity. For effective public health containment measures, this time span is too long. We therefore evaluated a rapid test in a highprevalence community setting. Study design: Thirty-nine randomly selected individuals at a COVID-19 screening centre were simultaneously tested via qPCR and a rapid test. Ten previously diagnosed individuals with known SARS-CoV-2 infection were also analysed. Methods: The evaluated rapid test is an IgG/IgMebased test for SARS-CoV-2 with a time to result of 20 min. Two drops of blood are needed for the test performance. Results: Of 49 individuals, 22 tested positive by repeated qPCR. In contrast, the rapid test detected only eight of those positive correctly (sensitivity: 36.4%). Of the 27 qPCR-negative individuals, 24 were detected correctly (specificity: 88.9%). Conclusion: Given the low sensitivity, we recommend not to rely on an antibody-based rapid test for public health measures such as community screenings.

The role of environmental transmission of SARS-CoV-2 remains unclear. Particularly the close contact of persons living together or cohabitating in domestic quarantine could result in high risk for exposure to the virus within the households. Therefore, the aim of this study was to investigate the whereabouts of the virus and whether useful precautions to prevent the dissemination can be given. 21 households under quarantine conditions were randomly selected for this study. All persons living in each household were recorded in terms of age, sex and time of household quarantine. Throat swabs for analysis were obtained from all adult individuals and most of the children. Air, wastewater samples and surface swabs (commodities) were obtained and analysed by RT-PCR. Positive swabs were cultivated to analyse for viral infectivity. 26 of all 43 tested adults (60.47 %) tested positive by RT-PCR. All 15 air samples were PCR-negative. 10 of 66 wastewater samples were positive for SARS-CoV-2 (15.15 %) as well as 4 of 119 object samples (3.36 %). No statistically significant correlation between PCR-positive environmental samples and the extent of infection spread inside the household could be observed. No infectious virus could be isolated under cell culture conditions. As we cannot rule out transmission through surfaces, hygienic behavioural measures are important in the households of SARS-CoV-2 infected individuals to avoid potential transmission through surfaces. The role of the domestic environment, in particular the wastewater load in washbasins and showers, in the transmission of SARS CoV-2 should be further clarified.

SARS-CoV-2 infection has been characterized as an upper and lower respiratory tract infection with symptoms ranging from sore throat, cough, headache, and fatigue to a severe respiratory syndrome that requires intensive care [1-7]. Although a lower death rate has been recorded for SARS-CoV-2 in comparison to other recent coronavirus outbreaks, such as MERS or SARS, a compromised respiratory status on admission has been associated with fatal outcomes. Among the >1200 SARS-CoV-2-infected individuals in Germany to date, many of the diagnosed persons show mild symptoms to no clinical signs of infection. Here we describe the onset and characteristics of symptoms in a cluster outbreak after a carnival celebration in a small town in the state of North Rhine-Westphalia currently contributing 43% of the total number of infected individuals in Germany to date [8]. Among the nearly 500 individuals in domestic quarantine as ordered by the Local Health Authority at that time, we interviewed 41 randomly selected individuals with qPCR confirmed SARS-CoV-2 infection. Inclusion criteria for the survey participation were: residents, positive for SARS-CoV-2 in pharyngeal swabs, ≥18 years of age, and confirmed informed consent. Median age was 40 years (IQR: 31-53, range: 18-82) and 51% were female. All persons examined had attended a carnival festivity also attended by the SARS-CoV-2positive index patient. All persons who attended this carnival festivity were tested for SARS-CoV-2 by the local health authorities 10 days later. Among survey participants, onset of symptoms began 12 days (IQR: 11-13) after probable infection and a median of 6 distinct symptoms (IQR: 4-8) were described.

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