Symptoms and Transmission of SARS-CoV-2 Among Children — Utah and Wisconsin, March–May 2020
Author:
Laws Rebecca L.12, Chancey Rebecca J.12, Rabold Elizabeth M.13, Chu Victoria T.13, Lewis Nathaniel M.134, Fajans Mark1, Reses Hannah E.1, Duca Lindsey M.13, Dawson Patrick13, Conners Erin E.1, Gharpure Radhika13, Yin Sherry1, Buono Sean15, Pomeroy Mary13, Yousaf Anna R.13, Owusu Daniel13, Wadhwa Ashutosh15, Pevzner Eric1, Battey Katherine A.1, Njuguna Henry1, Fields Victoria L.13, Salvatore Phillip13, O’Hegarty Michelle1, Vuong Jeni1, Gregory Christopher J.1, Banks Michelle1, Rispens Jared13, Dietrich Elizabeth1, Marcenac Perrine13, Matanock Almea1, Pray Ian136, Westergaard Ryan6, Dasu Trivikram7, Bhattacharyya Sanjib7, Christiansen Ann8, Page Lindsey7, Dunn Angela4, Atkinson-Dunn Robyn4, Christensen Kim4, Kiphibane Tair9, Willardson Sarah10, Fox Garrett1, Ye Dongni1, Nabity Scott A.1, Binder Alison1, Freeman Brandi D.15, Lester Sandra1, Mills Lisa1, Thornburg Natalie1, Hall Aron J.1, Fry Alicia M.1, Tate Jacqueline E.1, Tran Cuc H.1, Kirking Hannah L.1
Affiliation:
1. COVID-19 Response Team, 2. Contributed equally as co-first authors 3. Epidemic Intelligence Service, and 4. Utah Department of Health, Salt Lake City, Utah; 5. Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, Georgia; 6. Wisconsin Department of Health Services, Madison, Wisconsin; 7. City of Milwaukee Health Department, Milwaukee, Wisconsin; 8. North Shore Health Department, Milwaukee, Wisconsin; 9. Salt Lake County Health Department, Salt Lake City, Utah; and 10. Davis County Health Department, Clearfield, Utah
Abstract
BACKGROUND AND OBJECTIVES:
Limited data exist on severe acute respiratory syndrome coronavirus 2 in children. We described infection rates and symptom profiles among pediatric household contacts of individuals with coronavirus disease 2019.
METHODS:
We enrolled individuals with coronavirus disease 2019 and their household contacts, assessed daily symptoms prospectively for 14 days, and obtained specimens for severe acute respiratory syndrome coronavirus 2 real-time reverse transcription polymerase chain reaction and serology testing. Among pediatric contacts (<18 years), we described transmission, assessed the risk factors for infection, and calculated symptom positive and negative predictive values. We compared secondary infection rates and symptoms between pediatric and adult contacts using generalized estimating equations.
RESULTS:
Among 58 households, 188 contacts were enrolled (120 adults; 68 children). Secondary infection rates for adults (30%) and children (28%) were similar. Among households with potential for transmission from children, child-to-adult transmission may have occurred in 2 of 10 (20%), and child-to-child transmission may have occurred in 1 of 6 (17%). Pediatric case patients most commonly reported headache (79%), sore throat (68%), and rhinorrhea (68%); symptoms had low positive predictive values, except measured fever (100%; 95% confidence interval [CI]: 44% to 100%). Compared with symptomatic adults, children were less likely to report cough (odds ratio [OR]: 0.15; 95% CI: 0.04 to 0.57), loss of taste (OR: 0.21; 95% CI: 0.06 to 0.74), and loss of smell (OR: 0.29; 95% CI: 0.09 to 0.96) and more likely to report sore throat (OR: 3.4; 95% CI: 1.04 to 11.18).
CONCLUSIONS:
Children and adults had similar secondary infection rates, but children generally had less frequent and severe symptoms. In two states early in the pandemic, we observed possible transmission from children in approximately one-fifth of households with potential to observe such transmission patterns.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology, and Child Health
Cited by
85 articles.
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