Figure 1.

Timeline of events. Vector-borne transmission (upper part): theoretical minimum time for sporogony is 10 days under African temperature conditions. Under temperatures in Berlin during this time, at least 21 to 24 days can be expected (see text for details) – sporogony periods for both hospital and residential vector transmission are too short, arguing against this possibility of transmission. Direct/occupational exposure (lower part): only during the stay of the index patient on the obstetrics ward, there was a theoretical possibility of direct inoculation of infectious material, a short incubation time of 4 up to17 days can be expected. Occurrence of symptoms on 22 July was within the time frame to be expected for this scenario.