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%.

State University of New York at Stony Brook

- China
- France
- Iceland
- Switzerland


Role of Children in COVID-19 Transmission by Country

Koh, G. (2020). Faculty Opinions recommendation of Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature. doi:10.3410/f.737509210.793572110

https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-CoVid-19-final-report.pdf

Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)

Walger, P., Heininger, U., Knuf, M., Exner, M., Popp, W., Fischbach, T., . . . Simon, A. (2020). Children and adolescents in the COVID-19 pandemic: Schools and daycare centers are to be opened again without restrictions. The protection of teachers, educators, carers and parents and the general hygiene rules do not conflict with this. GMS Hygiene and Infection Control. https://doi.org/10.3205/dgkh000346

Children and Adolescents in the COVID-19 Pandemic: Schools and Daycare Centers Are to Be Opened Again Without Restrictions

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. 

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