key: cord-1027273-y9dqksa7
authors: Correa-Martínez, Carlos L.; Kampmeier, Stefanie; Kümpers, Philipp; Schwierzeck, Vera; Hennies, Marc; Hafezi, Wali; Kühn, Joachim; Pavenstädt, Hermann; Ludwig, Stephan; Mellmann, Alexander
title: A Pandemic in Times of Global Tourism: Superspreading and Exportation of COVID-19 Cases from a Ski Area in Austria
date: 2020-05-26
journal: J Clin Microbiol
DOI: 10.1128/jcm.00588-20
sha: 624bb46f6f5e740a13674a4296a601da3fcd8bcf
doc_id: 1027273
cord_uid: y9dqksa7

On January 7, 2020, the World Health Organization (WHO) announced a novel coronavirus to be the cause of unclear pneumonia cases in China.….

then initiated an investigation of allegations of unreported COVID-19 cases diagnosed in late February in Ischgl (https://www.apa.at/Site/News.de.html?idϭ6353870430).

Our findings support European data indicating the exportation of COVID-19 cases from a cluster in Ischgl. The après-ski bar where the first patient diagnosed with COVID-19 in Ischgl worked as a barkeeper was reportedly the source of many of the cases later detected in Iceland, Norway, and Denmark (https://www.spiegel.de/politik/ ausland/coronavirus-ausbruch-in-ischgl-die-brutstaette-a-8f56e5a2-635f-473a-96e9 -300b6cbf4180, https://www.bbc.com/news/world-europe-52007104). Several of our patients also reported having visited the bar. This supports the theory of a superspreading event taking place in Ischgl, a phenomenon already observed in past SARS and Middle East respiratory syndrome (MERS) outbreaks (2) (3) (4) . Considering the delayed epidemiological response, we believe that Ischgl-related cases continue to circulate undetected within and outside Europe. European travelers were banned from entering the United States on 14 March (https://www.whitehouse.gov/presidential -actions/?issue_filterϭhealthcare), 9 days after Iceland issued its epidemiological warning. An unknown number of infected travelers from Ischgl could thus have entered 

Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR

Superspreading and the effect of individual variation on disease emergence

Middle East respiratory syndrome coronavirus superspreading event involving 81 persons, Korea

Super-spreaders in infectious diseases

This study was supported by the German Research Foundation (DFG, Clinical Research Unit 342).All of us declare no conflict of interest.