Children under the age of 18 have a low infection rate in China. Infected Children only accounted for 2.4% of all confirmed/reported cases. Through contact tracing, it has been largely identified that infected children were found in households with infected adults. In the Guangdong province, the estimate for the secondary attack rate was 3-10%.

Role of Children in COVID-19 Transmission in China

An analysis of a hyper-spreader event in the french alps speaks against the increased risk of infection from children. 11 out of 16 hotel guests in the French Alps were infected with SARS-CoV-2 and among the infected guests was a 9-year old child with mild symptoms of respiratory infection and a co-infection with influenza and picornaviruses. Despite attending three different schools and skiing school, upon extensive contact tracing and testing, 70 contacts had respiratory symptoms and 46 had other respiratory viruses but, not a single SARS-CoV-2 infection was found. In another major outbreak at a secondary school in France, only 2.7% of children under 15 years were tested positive for SARS-CoV-2. 

Role of Children in COVID-19 Transmission in France

As of April 4, 2020, in a study targeting people at high risk for infection including people who were symptomatic, traveled to high-risk countries or were in contact with infected people, 1221 of 9199 (13.3%) people recruited for targeted testing were tested positive for SARS-CoV-2. 87 of 10,797 (0.8%) recruited through open invitation were tested positive as well as 13 of 2283 (0.6%) people from the random-population screening. A total of 6% of Iceland's population was screened. In the population screening, no child received a positive test result compared to 0.8%  (children over the age of 10) from the open invitation testing. In the targeted testing, it was also found that only 6.7% of children under 10 years of age were tested positive. 

Role of Children in COVID-19 Transmission in Iceland

A study on COVID-19 transmission dynamics within families of children with RT-PCR confirmed infections in Geneva, Switzerland showed that only a minute percentage of children were suspected to be the index cases (patient zero/first documented case) within families. From March 10 to April 10, 2020, 40 children under 16 years of age that were diagnosed at the Geneva University Hospital underwent extensive contact tracing and of the 39 evaluable households, only 3 households had a child/children suspected to be the index case, having symptoms preceding the adults. Children in the remaining households developed symptoms after or concurrent with adult household contacts. This suggests that children are more likely to acquire COVID-19 from adults, rather than transmitting it to adults. 

Role of Children in COVID-19 Transmission in Switzerland

- China
- France
- Iceland
- Switzerland


State University of New York at Stony Brook

Current data shows that infection rates of SARS-CoV-2 are low among children. It then can be said that they do not play a prominent role in the disease transmission of COVID-19 during the pandemic. Although the actual infection rate cannot be known due to under-reporting and a lack of available results from seroepidemiological studies, there are numerous findings against an increased risk of infection from children and findings that show a lower rate of infection and of contagion especially in children under the age of 10. It was also found that the transmission of SARS-CoV-2 is typically from an infected adult to a child and that a lack of evidence remains for the transmission of infection from an infected child to an adult. The cause of this lower virus transmission rate is still unknown, which calls for further investigations. 

Learn Before

Related

Learn After