Resolving the role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in households with members from different generations is crucial for containing the current pandemic. We conducted a large-scale, multicenter, cross-sectional seroepidemiologic household transmission study in southwest Germany during May 11–August 1, 2020. We included 1,625 study participants from 405 households that each had ≥1 child and 1 reverse transcription PCR–confirmed SARS-CoV-2–infected index case-patient. The overall secondary attack rate was 31.6% and was significantly higher in exposed adults (37.5%) than in children (24.6%–29.2%; p = <0.015); the rate was also significantly higher when the index case-patient was >60 years of age (72.9%; p = 0.039). Other risk factors for infectiousness of the index case-patient were SARS-CoV-2–seropositivity (odds ratio [OR] 27.8, 95% CI 8.26–93.5), fever (OR 1.93, 95% CI 1.14–3.31), and cough (OR 2.07, 95% CI 1.21–3.53). Secondary infections in household contacts generate a substantial disease burden.

解决严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 在具有不同世代成员的家庭中传播的作用对于遏制当前的大流行至关重要。我们于 2020 年 5 月 11 日至 8 月 1 日在德国西南部进行了一项大规模、多中心、横断面血清流行病学家庭传播研究。我们包括来自 405 个家庭的 1,625 名研究参与者，每个家庭都有 1 个孩子和 1 个逆转录 PCR 证实的 SARS -CoV-2 感染的指示病例。总体继发率为 31.6%，暴露的成人 (37.5%) 显着高于儿童 (24.6%–29.2%；p = < 0.015)；当指示病例患者>60 岁（72.9%；p = 0.039）。指示病例患者传染性的其他风险因素是 SARS-CoV-2 血清阳性（比值比 [OR] 27.8，95% CI 8.26-93.5）、发烧（OR 1.93，95% CI 1.14-3.31）和咳嗽（OR 2.07，95% CI 1.21–3.53）。家庭接触者的继发感染会产生巨大的疾病负担。