Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Children in Summer Schools Applying Stringent Control Measures in Barcelona, Spain

Iolanda Jordan, Mariona Fernandez de Sevilla, Victoria Fumado, Quique Bassat, Elisenda Bonet-Carne, Claudia Fortuny, Aleix Garcia-Miquel, Cristina Jou, Cristina Adroher, María Melé Casas, Mònica Girona-Alarcon, María Hernández Garcia, Gemma Pons Tomas, Sara Ajanovic, Sara Arias, Núria Balanza, Bárbara Baro, Pere Millat-Martinez, Rosauro Varo, Sergio AlonsoEnric Álvarez-Lacalle, Daniel López, Joana Claverol, Marta Cubells, Pedro Brotons, Anna Codina, Daniel Cuadras, Patricia Bruijning-Verhagen, Saul Faust, Alasdair Munro, Carmen Muñoz-Almagro, Martí Català, Clara Prats, Juan José Garcia-Garcia, Eduard Gratacós

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Understanding the role of children in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools.

METHODS: During July 2020, we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through (1) a surveillance program in 22 summer schools of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) during 2-5 weeks; and (2) cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centers followed prevention protocols: bubble groups, handwashing, face masks, and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and the effective reproduction number in summer schools (Re*) were calculated.

RESULTS: Among the >2000 repeatedly screened participants, 30 children and 9 adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median, 9 [interquartile range, 5-10] for each primary case), among which 12 new cases (4.7%) were positive for SARS-CoV-2. The Re* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9.

CONCLUSIONS: The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission, supporting current recommendations for school opening.

Original languageEnglish
Pages (from-to)66-73
Number of pages8
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume74
Issue number1
Early online date12 Mar 2021
DOIs
Publication statusPublished - 1 Jan 2022

Keywords

  • COVID-19
  • SARS-CoV-2
  • children
  • transmission

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