Comparing susceptibility and contagiousness in concurrent outbreaks with a non-VOC and the VOC SARS-CoV-2 variant B.1.1.7 in daycare centers in Hamburg, Germany

Int J Hyg Environ Health. 2022 Mar:240:113928. doi: 10.1016/j.ijheh.2022.113928. Epub 2022 Jan 24.


We describe two outbreaks of SARS-CoV-2 in daycare centers in the metropolitan area of Hamburg, Germany. The outbreaks occurred in rapid chronological succession, in neighborhoods with a very similar sociodemographic structure, thus allowing for cross-comparison of these events. We combined classical and molecular epidemiologic investigation methods to study infection entry, spread within the facilities, and subsequent transmission of infections to households. Epidemiologic and molecular evidence suggests a superspreading event with a non-variant of concern (non-VOC) SARS CoV-2 strain at the root of the first outbreak. The second outbreak involved two childcare facilities experiencing infection activity with the variant of concern (VOC) B.1.1.7 (Alpha). We show that the index cases in all outbreaks had been childcare workers, and that children contributed substantially to secondary transmission of SARS-CoV-2 infection from childcare facilities to households. The frequency of secondary transmissions in households originating from B.1.1.7-infected children was increased compared to children with non-VOC infections. Self-reported symptoms, particularly cough and rhinitis, occurred more frequently in B.1.1.7-infected children. Especially in light of the rapidly spreading VOC B.1.617.2 (Delta), our data underline the notion that rigorous SARS-CoV-2 testing in combination with screening of contacts regardless of symptoms is an important measure to prevent SARS-CoV-2 infection of unvaccinated individuals in daycare centers and associated households.

Keywords: Hygiene measures in daycare centers; Infection in daycare centers; Non-variant of concern; SARS-CoV-2; Transmissions in daycare centers; Variant of concern.

Publication types

  • Comparative Study

MeSH terms

  • COVID-19 Testing
  • COVID-19* / diagnosis
  • COVID-19* / virology
  • Child
  • Child Day Care Centers*
  • Disease Outbreaks
  • Germany / epidemiology
  • Humans
  • SARS-CoV-2*

Supplementary concepts

  • SARS-CoV-2 variants