High-risk populations amid the coronavirus disease (COVID-19) pandemic are urged to stay at home and isolate themselves since they are more likely to experience severe illness or even death. These include the elderly, those who have weakened immune systems, and those with underlying medical conditions.
Children and adolescents are deemed at low risk of COVID-19 infection. Still, new research provides an insight into the role of younger people in the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19.
A team of researchers from the Georgia Department of Public Health and the U.S Centers for Disease Control and Prevention (CDC) aimed to determine the secondary attack rates (SAR) among household contacts of children and adolescents who contracted SARS-CoV-2 during an outbreak at an overnight camp in June.
Colorized scanning electron micrograph of an apoptotic cell (green) heavily infected with SARS-CoV-2 virus particles (purple), isolated from a patient sample. Image at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: NIAID
To arrive at the study findings, the CDC worked alongside local and state health departments to contact all camp attendees and their parents or guardians for a phone interview. The researchers utilized a structured questionnaire and collected vital data of the camp attendees, including their testing history and a list of household contacts.
The camp attendees were between 7 and 19 years old. The team wanted to identify the household contacts of those who attended the camp and provided self-reported evidence of SARS-CoV-2 infection by molecular or antigen testing.
Further, the researchers interviewed each household contact to get the dates of exposure to the camp attendee during the period when they were infectious. Apart from these, the team also obtained SARS-CoV-2 testing history, clinical manifestations of COVID-19, and potential community exposures.
What the study found
The study, which was published but has not been peer-reviewed in the open-source medRxiv* server, has found 224 primary cases in 194 households with 526 household contacts. Overall, there were 163 households with one primary case and 456 household contacts, 30 households with two primary cases and 68 household contacts, and one household with three coprimary cases and two household contacts.
The average age of the 224 primary cases was 14 years old, wherein 51 percent were females, and 88 percent were nonHispanic White. Further, of the COVID-19 cases, 82 percent presented with symptoms, such as upper respiratory symptoms, loss of smell and taste, gastrointestinal symptoms, and lower respiratory symptoms. Also, none of the primary cases were hospitalized.
Meanwhile, of the 526 household contacts, the average age was 46 years old. Of these, 67 percent were parents of the cases, 31 percent were siblings, 2 percent were extended family members, and 1 percent were not family members.
Among the 434 interviewed household contacts, 90 percent were non-Hispanic white, and 14 percent had at least one underlying health condition. The researchers also identified 48 household contacts as secondary cases, wherein 92 percent had symptoms.
Based on the study findings, the researchers found that children and adolescents transmitted SARS-CoV-2 to both young and adult household contacts, consistent with the transmission dynamics of other viral respiratory diseases.
The researchers also noted that the COVID-19 cases in children have led to 10 percent of the adult secondary cases that needed hospitalization. Children and teens may not be as heavily impacted as adults amid the coronavirus pandemic, but they play a role in its transmission.
“Our findings show that children and adolescents can transmit SARS-CoV-2 to adult contacts and other children in a household setting,” the researchers wrote in the paper.
Opening of classes
During the study period, between July and August, classes have already reopened in many parts of the world despite being plagued with the coronavirus pandemic. Children and adolescents, who make up most of the students in schools, are potential superspreaders who can bring the virus to their homes.
Still, despite the reopening of classes, health experts reiterate the importance of personal hygiene, proper handwashing, social distancing, and universal masking in the battle against the coronavirus.
So far, the United States has the most significant number of COVID-19 cases, topping more than 7.85 million, followed by 7.17 million cases in India. More than 215,000 have already died in the United States and an estimated 3.12 million recoveries.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.