scholarly journals Role of children in household transmission of COVID-19

2020 ◽  
pp. archdischild-2020-319910 ◽  
Author(s):  
Jieun Kim ◽  
Young June Choe ◽  
Jin Lee ◽  
Young Joon Park ◽  
Ok Park ◽  
...  
Keyword(s):  
Attack Rate ◽  
Index Case ◽  
Clinical Findings ◽  
International Travel ◽  
Contact Tracing ◽  
Secondary Case ◽  
Household Transmission ◽  
Household Members ◽  
Index Cases

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.

scholarly journals Household SARS-CoV-2 transmission and children: a network prospective study

2021 ◽  
Author(s):  
Antoni Soriano-Arandes ◽  
Anna Gatell ◽  
Pepe Serrano ◽  
Mireia Biosca ◽  
Ferran Campillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Index Case ◽  
Viral Transmission ◽  
Transmission Risk ◽  
School Interventions ◽  
Household Transmission ◽  
Household Members ◽  
School Period ◽  
Index Cases

Abstract Background The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. Here, we describe the epidemiological and clinical characteristics of children with COVID-19 in Catalonia (Spain) and investigate the dynamics of household transmission. Methods Prospective, observational, multicenter study performed during summer and school periods (1 July-31 October, 2020), in which epidemiological and clinical features, and viral transmission dynamics were analyzed in COVID-19 patients <16 years. A pediatric index case was established when a child was the first individual infected within a household. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infections. Results The study included 1040 COVID-19 patients <16 years. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (p=0.02), and when compared to adults (p=0.006). No individual or environmental risk factors associated with the SAR were identified. Conclusions Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.

scholarly journals A meta-analysis on the role of children in SARS-CoV-2 in household transmission clusters

2020 ◽  
Author(s):  
Yanshan Zhu ◽  
Conor J Bloxham ◽  
Katina D Hulme ◽  
Jane E Sinclair ◽  
Zhen Wei Marcus Tong ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Risk Ratio ◽  
Attack Rate ◽  
Index Case ◽  
Meta Analysis ◽  
Household Contacts ◽  
Household Transmission ◽  
Potential Vaccine ◽  
Index Cases

Abstract The role of children in the spread of SARS-CoV-2 remains highly controversial. To address this issue, we performed a meta-analysis of the published literature on household SARS-CoV-2 transmission clusters (n=213 from 12 countries). Only 8 (3.8%) transmission clusters were identified as having a paediatric index case. Asymptomatic index cases were associated with a lower secondary attack in contacts than symptomatic index cases (estimate risk ratio [RR], 0.17; 95% confidence interval [CI], 0.09-0.29). To determine the susceptibility of children to household infections the secondary attack rate (SAR) in paediatric household contacts was assessed. The secondary attack rate in paediatric household contacts was lower than in adult household contacts (RR, 0.62; 95% CI, 0.42-0.91). These data have important implications for the ongoing management of the COVID-19 pandemic, including potential vaccine prioritization strategies.

scholarly journals A meta-analysis on the role of children in SARS-CoV-2 in household transmission clusters

2020 ◽  
Author(s):  
Yanshan Zhu ◽  
Conor J. Bloxham ◽  
Katina D. Hulme ◽  
Jane E. Sinclair ◽  
Zhen Wei Marcus Tong ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Family Member ◽  
Attack Rate ◽  
Index Case ◽  
Meta Analysis ◽  
Household Contacts ◽  
Household Transmission ◽  
Potential Vaccine ◽  
Index Cases

ABSTRACTThe role of children in the spread of SARS-CoV-2 remains highly controversial. To address this issue, we performed a meta-analysis of the published literature on household SARS-CoV-2 transmission clusters (n=213 from 12 countries). Only 8 (3.8%) transmission clusters were identified as having a paediatric index case. Asymptomatic index cases were associated with a lower secondary attack in contacts than symptomatic index cases (estimate risk ratio [RR], 0.17; 95% confidence interval [CI], 0.09-0.29). To determine the susceptibility of children to household infections the secondary attack rate (SAR) in paediatric household contacts was assessed. The secondary attack rate in paediatric household contacts was lower than in adult household contacts (RR, 0.62; 95% CI, 0.42-0.91). These data have important implications for the ongoing management of the COVID-19 pandemic, including potential vaccine prioritization strategies.40-word summaryIn household transmission clusters of SARS-CoV-2 children are unlikely to be the index case. Children are also less likely than adults to be infected with SARS-CoV-2 from a family member.

scholarly journals Role of ACE2 And TMPRSS2 Protease In SARS-CoV-2 Dynamics Among Household Contacts of PCR-Confirmed Cases: Impact of A Combined Serological Signature Analysis On Diagnosis

2021 ◽  
Author(s):  
Jesús Poch-Páez ◽  
yeray nóvoa-medina ◽  
Abián Montesdeoca-Melián ◽  
Araceli Hernández-Betancor ◽  
Francisco J. Rodríguez-Esparragón ◽  
...  
Keyword(s):  
Disease Susceptibility ◽  
Index Case ◽  
Age Groups ◽  
Testing Strategy ◽  
Past Infection ◽  
Household Contacts ◽  
Household Transmission ◽  
Household Members ◽  
Benign Course

Abstract Background: To examine the hypothesis that ACE2 and TMPRSS2 expression are related to disease susceptibility and severity across age groups and to evaluate the role children play in the household transmission of SARS-CoV-2.Methods: We used a combined serological strategy to confirm past infection in subjects diagnosed with COVID-19 between march 10th and June 2nd 2020 and to evaluate their household members. We also quantified ACE2 and TPMRSS2 expression from saliva. A total of 258 households were included in the study, for a total of 650 volunteers (including 89 children aged under 18 years of age).Results: Our combined testing strategy increased our sensibility by 10%. Antibody indexes decreased with age in children and increased with age in adults. They also increased with disease severity. ACE2 expression was slightly increased in younger children. ACE2 was not related to any other factors. We did not find any relationship between TMPRSS2 expression and any of the studied factors. Children are less frequently infected by SARS-CoV-2 (OR=0,56), they present fewer symptoms and decreased severity. Age and sharing the bedroom with an index case increases the risk of acquiring the infection. The risk in adults increases with age, whereas in children, it increases in younger children. Conclusions: Our results do not support that the level of expression of ACE2 and TMPRSS2 might be related to susceptibility or severity of COVID19 disease. Children have a decreased susceptibility to SARS-CoV-2 infection compared to adults and, when infected, they present less symptoms and a more benign course.

scholarly journals High attack rates of SARS-CoV-2 infection through household-transmission: a prospective study

2020 ◽  
Author(s):  
Kanika Kuwelker ◽  
Fan Zhou ◽  
Bjørn Blomberg ◽  
Sarah Lartey ◽  
Karl Albert Brokstad ◽  
...  
Keyword(s):  
Attack Rate ◽  
Index Case ◽  
Rt Pcr ◽  
Younger Adults ◽  
Household Transmission ◽  
Antibody Titres ◽  
Household Members ◽  
Polymerase Chain ◽  
A Prospective Study ◽  
Rule Out

AbstractBackgroundHousehold attack rates of SARS-CoV-2 ranging from 7% to 38% have been reported, using reverse transcription polymerase chain reaction (RT-PCR) of respiratory samples. Lower attack rates were described in children, but the importance of age in household transmission dynamics remains to be clarified.MethodsDuring the first month of the outbreak, we enrolled 112 households (291 participants) in a prospective case-ascertained study, collecting demographic and clinical data from index cases and household members. Sera were collected 6-8 weeks after index case symptom onset, to measure SARS-CoV-2-specific antibodies.FindingsT Local Ethics Committee (#118664). he overall household attack rate was 45% assessed by seroconversion, and 47% when also including RT-PCR positives. Serology identified a significantly higher number of infected household members than RT-PCR. Attack rates were equally high in children (43%) and young adults (46%), but highest among household members aged ≥60 years (72%). The attack rate was 16% in asymptomatic household members, and 42% in RT-PCR negative household members. Older adults generally had higher antibody titres than younger adults. The risk of household transmission was higher when the index case had fever or dyspnoea during acute illness but not associated with cough.InterpretationSerological assays provide more accurate estimates of household secondary attack rate than RT-PCR, especially among children who have a lower RT-PCR positivity rate. Children are equally susceptible to infection as adults, but elderly show higher attack rates. Negative RT-PCR or lack of symptoms are not sufficient to rule out infection in household members.FundingHelse Vest (F-11628), Trond Mohn Foundation (TMS2020TMT05).

scholarly journals Secondary transmission of SARS-CoV-2 in educational settings in Northern Italy from September 2020 to April 2021: a population-based study

2021 ◽  
Author(s):  
Olivera Djuric ◽  
Elisabetta Larosa ◽  
Mariateresa Cassinadri ◽  
Silvia Cilloni ◽  
Eufemia Bisaccia ◽  
...  
Keyword(s):  
Attack Rate ◽  
Index Case ◽  
School Setting ◽  
Population Based ◽  
Contact Tracing ◽  
Secondary Case ◽  
Secondary Transmission ◽  
Source Of Infection ◽  
Alpha Variant ◽  
Type Of School

Background: We aimed to quantify the risk of transmission of SARS-CoV-2 in the school setting by type of school, characteristics of the index case and calendar period in the Reggio Emilia province (RE), Italy, from school reopening in September 2020 until the beginning of April 2021. The secondary aim was to estimate the promptness of contact tracing. Methods: A population-based analysis of surveillance data of all COVID-19 cases occurring in RE, Italy, from September 1, 2020, to April 4th, 2021, for which a school contact and/or exposure was suspected. Indicator of the delay in contact tracing was computed as the time elapsed since positivity of the index case and the date on which the swab for classmates was scheduled (or most were scheduled). Results: Overall, 30,426 and 13,571 contacts among classmates and teachers/staff, respectively, were identified and received recommendation for testing; 43,414 (98.7%) performed the test. Secondary transmission occurred in about 40% of the investigated classes, and the overall secondary case attack rate was 4%, slightly higher when the index case was a teacher, but with almost no differences by type of school and stable during the study period. Promptness of contact tracing increased during the study period, reducing the time from index case identification and testing of contacts from 7 to 3 days, as well the ability to identify possible source of infection in the index case (from 42% in September/October, to 22% in November, to 50% in December-April). Conclusions: Despite the spread of the Alpha variant during the study period in RE, the secondary case attack rate remained stable from school reopening in September 2020 until the beginning of April 2021.

scholarly journals Transmission and serotype features of hand foot mouth disease in household contacts in Dong Thap, Vietnam

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuong Quoc Hoang ◽  
Thao Thanh Thi Nguyen ◽  
Nguyen Xuan Ho ◽  
Hai Duc Nguyen ◽  
An Binh Nguyen ◽  
...  
Keyword(s):  
Attack Rate ◽  
Neutralizing Antibodies ◽  
Index Case ◽  
Fold Increase ◽  
Mouth Disease ◽  
Rt Pcr ◽  
Household Contacts ◽  
Two Samples ◽  
Household Members ◽  
Index Cases

Abstract Background Hand, foot and mouth disease (HFMD) has emerged as a major public health issue in Vietnam since 2003. We aimed to investigate the household transmission of HFMD and its causative viruses from 150 households in a high incidence province in Vietnam. Methods A longitudinal study was conducted in patients presenting to the provincial hospital with a HFMD-like syndrome, along with their household members between April and August 2014 in Dong Thap Province. Each participant was followed up for 2 weeks. We enrolled 150 patients aged under 15 who were clinically diagnosed with HFMD in Dong Thap Hospital, 600 household members, and 581/600 household members completed the study. All participants were interviewed using a standard questionnaire. Throat swabs and blood samples were taken for molecular detection of viruses and assessment of neutralizing antibodies, respectively. Index cases were defined using a clinical case definition, household contact cases were defined using a similar definition applied to the 2 weeks before admission and 2 weeks after discharge of the index case. Characteristics of index cases, household contacts, the attack rate, serotype features and related factors of HFMD were reported. Result Among 150 index cases, 113 were laboratory confirmed: 90/150 were RT-PCR-positive, 101/142 had a ≥ 4-fold increase of neutralizing antibody against Enterovirus A71 (EV-A71), Coxsackievirus (CV) A6 or CV-A16 across the two samples collected. 80/150 (53%) were males, and 45/150 (30%) were under the age of 1. The predominant serotype was CV-A6, identified in 57/87 (65.5%) of the specimens. No deaths were reported. Among 581 household contacts, 148 were laboratory confirmed: 12/581 were RT-PCR-positive, 142/545 had a ≥ 4-fold increase of neutralizing antibodies against EV-A71, CV-A6 or CV-A16; 4 cases experienced HFMD in the past 4 weeks. Attack rate among household contacts was 148/581 (25.5%). In 7/12 (58%) instances, the index and secondary cases were infected with the same serotype. Having a relationship to index case was significantly associated with EV infection. Conclusion The attack rate among household contacts was relatively high (25.5%) in this study and it seems justified to also consider the household setting as an additional target for intervention programs.

scholarly journals Characteristics of Household Transmission of COVID-19

2020 ◽  
Vol 71 (8) ◽  
pp. 1943-1946 ◽  
Author(s):  
Wei Li ◽  
Bo Zhang ◽  
Jianhua Lu ◽  
Shihua Liu ◽  
Zhiqiang Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Attack Rate ◽  
Rt Pcr ◽  
Spousal Relationship ◽  
Telephone Interviews ◽  
Household Contacts ◽  
Household Transmission ◽  
Household Members ◽  
Baseline Characteristics ◽  
Index Cases

Abstract Background Since December 2019, SARS-CoV-2 has extended to most parts of China with >80 000 cases and to at least 100 countries with >60 000 international cases as of 15 March 2020. Here we used a household cohort study to determine the features of household transmission of COVID-19. Methods A total of 105 index patients and 392 household contacts were enrolled. Both index patients and household members were tested by SARS-CoV-2 RT-PCR. Information on all recruited individuals was extracted from medical records and confirmed or supplemented by telephone interviews. The baseline characteristics of index cases and contact patients were described. Secondary attack rates of SARS-CoV-2 to contact members were computed and the risk factors for transmission within the household were estimated. Results Secondary transmission of SARS-CoV-2 developed in 64 of 392 household contacts (16.3%). The secondary attack rate to children was 4% compared with 17.1% for adults. The secondary attack rate to the contacts within the households with index patients quarantined by themselves since onset of symptoms was 0% compared with 16.9% for contacts without quarantined index patients. The secondary attack rate to contacts who were spouses of index cases was 27.8% compared with 17.3% for other adult members in the households. Conclusions The secondary attack rate of SARS-CoV-2 in household is 16.3%. Age of household contacts and spousal relationship to the index case are risk factors for transmission of SARS-CoV-2 within a household. Quarantine of index patients at home since onset of symptoms is useful to prevent the transmission of SARS-Co-2 within a household.

Evaluation of Family Clusters of Children with SARS-CoV-2: Children Do Not Play the Leading Role

2021 ◽  
Author(s):  
Zeynep Ergenc ◽  
Eda Kepenekli ◽  
Betül Şenyürek ◽  
Nurhayat Yakut ◽  
Perran Boran
Keyword(s):  
Index Case ◽  
Index Patient ◽  
Contact Tracing ◽  
Age Group ◽  
Pediatric Age ◽  
Rt Pcr ◽  
Adult Individual ◽  
Household Transmission ◽  
Pediatric Age Group

Abstract Objective The exact role of children in the household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not clear. In this study, we investigated the role of children with coronavirus disease 2019 (COVID-19) in household transmission by identifying the index patient and contact tracing the household members. Methods A total of 103 children with COVID-19 who attended Marmara University Pendik Training and Research Hospital, Istanbul, between 25th March and 27th May 2020 were included in the study. A family cluster was defined as a group of ≥two confirmed cases of SARS-CoV-2 in the same family, and a household contact (HHC) was defined as any person who had stayed in the same residence. Results In total, 78 family clusters and 307 HHCs belonging to these clusters were screened. In only four clusters was the index case determined to be in the pediatric age group (5.1%). Fathers, mothers, grandparents, and adult siblings were identified as the index cases in 37 (47.4%), 18 (23.0%), 8 (10.2%), and 6 (7.7%) clusters, respectively. Of the 307 HHCs, 88 were in the pediatric age group, and 39 were SARS-CoV-2 RT-PCR positive. Conclusion Our data showed that SARS-CoV-2 is uncommon in children without any history of contact to a RT-PCR test positive patient. The role of children as the index patient in family clusters is 5.1%, and the actual index case is usually an adult individual who has had an outside contact.

scholarly journals High secondary attack rate and persistence of SARS-CoV-2 antibodies in household transmission study participants, Finland 2020

2021 ◽  
Author(s):  
Timothee Dub ◽  
Hanna Nohynek ◽  
Lotta Hagberg ◽  
Oona Liedes ◽  
Anu Haveri ◽  
...  
Keyword(s):  
Attack Rate ◽  
Neutralizing Antibodies ◽  
Serum Samples ◽  
Household Transmission ◽  
Transmission Study ◽  
Household Members ◽  
Transmission Studies ◽  
Study Participants ◽  
Index Cases

Background Household transmission studies offer the opportunity to assess both secondary attack rate and persistence of SARS-CoV-2 antibodies over time. Methods We invited confirmed COVID-19 cases and their household members to attend up to four household visits with collection of nasopharyngeal and serum samples over 28 days after index case onset. We calculated secondary attack rates (SAR) based on the presence of SARS-CoV-2 nucleoprotein IgG antibodies (IgG Ab) and/or neutralizing antibodies (NAb) overall and per households. Three and six months later, we assessed the persistence of SARS-CoV-2 antibodies. Findings We recruited 39 index cases and 90 household members. Among 87 household members evaluated, SAR was 48% (n=42), including 37 symptomatic secondary cases. In total, 80/129 (62%) participants developed both IgG Ab and NAb, while three participants only developed IgG Ab. Among participants who had both IgG Ab and NAb during the initial follow-up, 68/69 (99%) and 63/70 (90%) had IgG Ab and NAb at 3 months, while at 6 months, 59/75 (79%) and 63/75 (84%) had IgG Ab and NAb, respectively. Participants who required hospital care had initially 5-fold IgG Ab concentrations compared to cases with mild symptoms and 8-fold compared to asymptomatic cases. Interpretation Following detection of a COVID-19 case in a household, other members had a high risk of becoming infected. Follow-up of participants showed strong persistence of antibodies in most cases. Funding This study was supported by THL coordinated funding for COVID-19 research (Finnish Government's supplementary budget) and by the Academy of Finland (Decision number 336431).

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