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.

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.

[Successful reduction of the SCORAD score by a short-time teaching method using a simplified skin model in children with atopic eczema in a 6-week comparison]. / Erfolgreiche Reduktion des SCORAD-scores bei Kindern mit atopischem Ekzem im 6-Wochen-Vergleich durch Kurzschulung mit einem vereinfachten Hautmodell.

BACKGROUND: In order to achieve a long-term stabilizing effect on the clinical condition of the skin of patients with atopic eczema, it is imperative to perform consistent topical skincare. Because of time pressures during normal office visits, it is impossible to thoroughly counsel patients who suffer from atopic eczema. We performed a randomized and prospective comparative study to evaluate the outpatient effectiveness of a short-time but impressive teaching and counselling method using the skin model developed by Kardorff and Schnelle-Parker. PATIENTS AND METHODS: Thirty outpatients between 3 and 6 years old with moderate or severe atopic eczema were evaluated. Half of the patients were trained by an active, 10-min demonstration with the skin model on day 0 and day 14. Patients in the control group received verbal instructions of the same duration, as in routine dermatological practice. The SCORAD score was measured blindly on days 0, 14 and 42. RESULTS: After 42 days, the SCORAD score of the patients taught by the use of the Kardorff-Schnelle-Parker skin model was significantly reduced compared to the control group (P < 0.006). CONCLUSIONS: By counselling atopic children, even of preschool age, with the easily understandable skin model incorporating the sense of touch, better compliance concerning regular skincare can be achieved. We expect positive effects in the long-term management of atopic eczema.