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1.
Clin Infect Dis ; 75(Supplement_1): S110-S120, 2022 Aug 15.
Article in English | MEDLINE | ID: covidwho-1908772

ABSTRACT

BACKGROUND: Comprehensive pathogen genomic surveillance represents a powerful tool to complement and advance precision vaccinology. The emergence of the Alpha variant in December 2020 and the resulting efforts to track the spread of this and other severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern led to an expansion of genomic sequencing activities in Germany. METHODS: At Robert Koch Institute (RKI), the German National Institute of Public Health, we established the Integrated Molecular Surveillance for SARS-CoV-2 (IMS-SC2) network to perform SARS-CoV-2 genomic surveillance at the national scale, SARS-CoV-2-positive samples from laboratories distributed across Germany regularly undergo whole-genome sequencing at RKI. RESULTS: We report analyses of 3623 SARS-CoV-2 genomes collected between December 2020 and December 2021, of which 3282 were randomly sampled. All variants of concern were identified in the sequenced sample set, at ratios equivalent to those in the 100-fold larger German GISAID sequence dataset from the same time period. Phylogenetic analysis confirmed variant assignments. Multiple mutations of concern emerged during the observation period. To model vaccine effectiveness in vitro, we employed authentic-virus neutralization assays, confirming that both the Beta and Zeta variants are capable of immune evasion. The IMS-SC2 sequence dataset facilitated an estimate of the SARS-CoV-2 incidence based on genetic evolution rates. Together with modeled vaccine efficacies, Delta-specific incidence estimation indicated that the German vaccination campaign contributed substantially to a deceleration of the nascent German Delta wave. CONCLUSIONS: SARS-CoV-2 molecular and genomic surveillance may inform public health policies including vaccination strategies and enable a proactive approach to controlling coronavirus disease 2019 spread as the virus evolves.

3.
Lancet Reg Health Eur ; 11: 100262, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1499011
4.
Patterns (N Y) ; 2(6): 100264, 2021 Jun 11.
Article in English | MEDLINE | ID: covidwho-1386425

ABSTRACT

While large-scale vaccination campaigns against SARS-CoV-2 are rolled out at the time of writing, non-pharmaceutical interventions (NPIs), including the isolation of infected individuals and quarantine of exposed individuals, remain central measures to contain the spread of SARS-CoV-2. Strategies that combine NPIs with innovative SARS-CoV-2 testing strategies may increase containment efficacy and help to shorten quarantine durations. We developed a user-friendly software tool that implements a recently published stochastic within-host viral dynamics model that captures temporal attributes of the viral infection, such as test sensitivity, infectiousness, and the occurrence of symptoms. Based on this model, the software allows to evaluate the efficacy of user-defined, arbitrary NPI and testing strategies in reducing the transmission potential in different contexts. The software thus enables decision makers to explore NPI strategies and perform hypothesis testing, e.g., with regard to the utilization of novel diagnostics or with regard to containing novel virus variants.

6.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(9): 1050-1057, 2021 Sep.
Article in German | MEDLINE | ID: covidwho-1330362

ABSTRACT

The global spread of the coronavirus SARS-CoV­2 has massively impacted health, economic, and social systems. Although effective vaccines are now available, it is likely that this pathogen will become endemic and stay with us for years. In order to most effectively protect others and oneself from SARS-CoV­2 infection, an understanding of how SARS-CoV­2 is transmitted is of utmost importance.In this review paper, we explain transmission routes with an eye towards protecting others and oneself. We also address characteristics of SARS-CoV­2 transmission in the community. This work will help to clarify the following questions based on the available literature: When and for how long is an infected person contagious? How is the virus excreted? How is the virus taken up? How does the virus spread in society?Human-to-human transmission of SARS-CoV­2 is strongly determined by pathogen molecular characteristics as well as the kinetics of replication, shedding, and infection. SARS-CoV­2 is transmitted primarily via human aerosols, which infected persons can excrete even if symptoms of the disease are not (yet) present. Most infected people cause only a few secondary cases, whereas a few cases (so-called super-spreaders) cause a high number of secondary infections - at the population level one speaks of a so-called "overdispersion." These special characteristics of SARS-CoV­2 (asymptomatic aerosol transmission and overdispersion) make the pandemic difficult to control.


Subject(s)
COVID-19 , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control , Germany , Humans , Pandemics , SARS-CoV-2
7.
Microorganisms ; 9(7)2021 Jul 14.
Article in English | MEDLINE | ID: covidwho-1323308

ABSTRACT

Human parainfluenza viruses (HPIVs) are important causes of respiratory illness, especially in young children. However, surveillance for HPIV is rarely performed continuously, and national-level epidemiologic and genetic data are scarce. Within the German sentinel system, to monitor acute respiratory infections (ARI), 4463 respiratory specimens collected from outpatients < 5 years of age between October 2015 and September 2019 were retrospectively screened for HPIV 1-4 using real-time PCR. HPIV was identified in 459 (10%) samples. HPIV-3 was the most common HPIV-type, with 234 detections, followed by HPIV-1 (113), HPIV-4 (61), and HPIV-2 (49). HPIV-3 was more frequently associated with age < 2 years, and HPIV-4 was more frequently associated with pneumonia compared to other HPIV types. HPIV circulation displayed distinct seasonal patterns, which appeared to vary by type. Phylogenetic characterization clustered HPIV-1 in Clades 2 and 3. Reclassification was performed for HPIV-2, provisionally assigning two distinct HPIV-2 groups and six clades, with German HPIV-2s clustering in Clade 2.4. HPIV-3 clustered in C1, C3, C5, and, interestingly, in A. HPIV-4 clustered in Clades 2.1 and 2.2. The results of this study may serve to inform future approaches to diagnose and prevent HPIV infections, which contribute substantially to ARI in young children in Germany.

8.
Lancet Reg Health Eur ; 6: 100112, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1260816

ABSTRACT

BACKGROUND: During the initial COVID-19 response, Germany's Federal Government implemented several nonpharmaceutical interventions (NPIs) that were instrumental in suppressing early exponential spread of SARS-CoV-2. NPI effect on the transmission of other respiratory viruses has not been examined at the national level thus far. METHODS: Upper respiratory tract specimens from 3580 patients with acute respiratory infection (ARI), collected within the nationwide German ARI Sentinel, underwent RT-PCR diagnostics for multiple respiratory viruses. The observation period (weeks 1-38 of 2020) included the time before, during and after a far-reaching contact ban. Detection rates for different viruses were compared to 2017-2019 sentinel data (15350 samples; week 1-38, 11823 samples). FINDINGS: The March 2020 contact ban, which was followed by a mask mandate, was associated with an unprecedented and sustained decline of multiple respiratory viruses. Among these, rhinovirus was the single agent that resurged to levels equalling those of previous years. Rhinovirus rebound was first observed in children, after schools and daycares had reopened. By contrast, other nonenveloped viruses (i.e. gastroenteritis viruses reported at the national level) suppressed after the shutdown did not rebound. INTERPRETATION: Contact restrictions with a subsequent mask mandate in spring may substantially reduce respiratory virus circulation. This reduction appears sustained for most viruses, indicating that the activity of influenza and other respiratory viruses during the subsequent winter season might be low,whereas rhinovirus resurgence, potentially driven by transmission in educational institutions in a setting of waning population immunity, might signal predominance of rhinovirus-related ARIs. FUNDING: Robert Koch-Institute and German Ministry of Health.

9.
Patterns (N Y) ; 2(6): 100262, 2021 Jun 11.
Article in English | MEDLINE | ID: covidwho-1237843

ABSTRACT

Non-pharmaceutical interventions (NPIs) remain decisive tools to contain SARS-CoV-2. Strategies that combine NPIs with testing may improve efficacy and shorten quarantine durations. We developed a stochastic within-host model of SARS-CoV-2 that captures temporal changes in test sensitivities, incubation periods, and infectious periods. We used the model to simulate relative transmission risk for (1) isolation of symptomatic individuals, (2) contact person management, and (3) quarantine of incoming travelers. We estimated that testing travelers at entry reduces transmission risks to 21.3% ([20.7, 23.9], by PCR) and 27.9% ([27.1, 31.1], by rapid diagnostic test [RDT]), compared with unrestricted entry. We calculated that 4 (PCR) or 5 (RDT) days of pre-test quarantine are non-inferior to 10 days of quarantine for incoming travelers and that 8 (PCR) or 10 (RDT) days of pre-test quarantine are non-inferior to 14 days of post-exposure quarantine. De-isolation of infected individuals 13 days after symptom onset may reduce the transmission risk to <0.2% (<0.01, 6.0).

10.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 403-411, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1196567

ABSTRACT

The collection of data on SARS-CoV­2 tests is central to the assessment of the infection rate in the context of the COVID-19 pandemic. At the Robert Koch Institute (RKI), data collected from various laboratory data recording systems are consolidated. First, this article aims to exemplify significant aspects regarding test procedures. Subsequently the different systems for recording laboratory tests are described and test numbers from the RKI test laboratory query and the laboratory-based SARS-CoV­2 surveillance as well as accounting data from the Association of Statutory Health Insurance Physicians for SARS-CoV­2 laboratory tests are shown.Early in the pandemic, the RKI test laboratory query and the laboratory-based SARS-CoV­2 surveillance became available and able to evaluate data on performed tests and test capacities. By recording the positive and negative test results, statements about the total number of tests and the proportion of positive test rates can be made. While the aggregate test numbers are largely representative nationwide, they are not always representative at the state and district level. The billing data of the Association of Statutory Health Insurance Physicians can complement the laboratory data afterwards. In addition, it can provide a retrospective assessment of the total number of SARS-CoV­2 numbers in Germany, because the services provided by statutory health insurers (around 85% of the population in Germany) are included. The various laboratory data recording systems complement one another and the evaluations flow into the recommended measures for the pandemic response.


Subject(s)
COVID-19 , Pandemics , COVID-19 Testing , Germany/epidemiology , Humans , Retrospective Studies , SARS-CoV-2
11.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 403-411, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1184643

ABSTRACT

The collection of data on SARS-CoV­2 tests is central to the assessment of the infection rate in the context of the COVID-19 pandemic. At the Robert Koch Institute (RKI), data collected from various laboratory data recording systems are consolidated. First, this article aims to exemplify significant aspects regarding test procedures. Subsequently the different systems for recording laboratory tests are described and test numbers from the RKI test laboratory query and the laboratory-based SARS-CoV­2 surveillance as well as accounting data from the Association of Statutory Health Insurance Physicians for SARS-CoV­2 laboratory tests are shown.Early in the pandemic, the RKI test laboratory query and the laboratory-based SARS-CoV­2 surveillance became available and able to evaluate data on performed tests and test capacities. By recording the positive and negative test results, statements about the total number of tests and the proportion of positive test rates can be made. While the aggregate test numbers are largely representative nationwide, they are not always representative at the state and district level. The billing data of the Association of Statutory Health Insurance Physicians can complement the laboratory data afterwards. In addition, it can provide a retrospective assessment of the total number of SARS-CoV­2 numbers in Germany, because the services provided by statutory health insurers (around 85% of the population in Germany) are included. The various laboratory data recording systems complement one another and the evaluations flow into the recommended measures for the pandemic response.


Subject(s)
COVID-19 , Pandemics , COVID-19 Testing , Germany/epidemiology , Humans , Retrospective Studies , SARS-CoV-2
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