Role of children in household transmission of COVID-19

Abstract

ObjectiveTransmissibility of COVID-19 by children in the household is not clear. Herein, we describe children’s role in household transmission of COVID-19.Design and settingAll paediatric COVID-19 index cases and their household members reported from 20 January to 6 April 2020 in South Korea were reviewed. The secondary attack rate (SAR) from child index case to household secondary case was calculated. Epidemiological and clinical findings of child index case-household secondary case pair was assessed.ResultsA total of 107 paediatric COVID-19 index cases and 248 of their household members were identified. One pair of paediatric index-secondary household case was identified, giving a household SAR of 0.5% (95% CI 0.0% to 2.6%). The index case was self-quarantined at home after international travel, stayed in her room, but shared a meal table with the secondary case.ConclusionThe SAR from children to household members was low in the setting of social distancing, underscoring the importance of rigorous contact tracing and early isolation in limiting transmission within households.

Household Transmission of SARS-CoV-2

“…26,31,37,45,58,60,65,68,71,72 Estimated mean secondary attack rate for household contacts was 16.4% (95% CI, 13.4%-19.6%) and family contacts was 17.4% (95% CI, 12.7%-22.5%). One study 40 ). Secondary attack rates for household and family contacts were more than 3 times higher than for close contacts (4.8%; 95% CI, 3.4%-6.5%; P < .001) (eFigure 2 in the Supplement).…”

“…Limited data suggest children have not played a substantive role in household transmission of SARS-CoV-2. 40,[103][104][105] However, a study in South Korea of 10 592 household contacts noted relatively high transmission from index cases who were aged 10 to 19 years. 51 Although children seem to be at reduced risk for symptomatic disease, it is still unclear whether they shed virus similarly to adults.…”

COVID ‐19, children and schools: overlooked and at risk

“…21 In a subsequent study, the authors noted that almost all of the child index cases shared the same exposure as their adult contacts. 22 Thus, while the children developed symptoms first, it is possible that some may not have been true index cases. However, preliminary data from Italy are also concerning.…”

Potential Role of Children in the Household Transmission of SARS-CoV-2 Infection in Catalonia (Spain)

“…Therefore, household contact tracing studies can be highly effective for COVID-19 prevention [2]. In South Korea, two similar studies demonstrated dissenting transmission rates within households from SARS-CoV-2 infected children [1,3]. In Europe (French Alps), a study of a cluster with twelve secondary cases included a symptomatic child who attended three schools without transmitting the virus to any of his contacts [4].…”