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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 . 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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