Can my child transmit COVID-19 ?
Text updated on 2020-10-30
Yes, children can transmit the SARS-CoV-2 coronavirus. Numerous cases of both adult-to-adult and child-to-child transmission have been documented.
Numerous cases of both child-to-adult and child-to-child transmission have been observed.
The amount of SARS-CoV-2 coronavirus detected in feces and nasopharyngeal secretions of children with SARS COVID-19 is comparable to that measured in adults.
Numerous cases of transmission from a child to a parent have been published: a 3-month-old newborn in China, an 8-month-old child in the United States, four 12-15 year-old children in Norway, high school students in France, etc. Numerous cases of transmission from child to child, of all ages, have also been reported.
Children can sometimes act as 'super-propagators': 17 children monitored by the Israeli Ministry of Health infected more than 10 people each.
Some studies suggest that under normal conditions, when schools are open, children tend to infect more children their own age. It is not yet known whether children are as or less contaminating as adults. See the question Children's role in the COVID-19 epidemic: what do we know?
Because children can transmit coronavirus, it is important that they avoid contact with elderly and vulnerable people.
Viral particles were found by RT-qPCR in the feces of 8 persons (including 6 children) among 27 infected persons tested. Four weeks after the onset of infection, one adult and two children (2 and 3 years old) still had viral particles in their stools, but no longer had any in their nose and throat swabs. However, it is not known whether the virus in the stool retained its infectivity.Ma, X., Su, L., Zhang, Y., Zhang, X., Gai, Z., & Zhang, Z. (2020). Do children need a longer time to shed SARS-CoV-2 in stool than adults?. Journal of Microbiology, Immunology and Infection.
The amount of SARS-CoV-2 virus detected in feces and nasopharyngeal secretions in three children with COVID-19 is comparable to that measured in adults.Xing, Y. H., Ni, W., Wu, Q., Li, W. J., Li, G. J., Wang, W. D., ... & Xing, Q. S. (2020). Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019. Journal of Microbiology, Immunology and Infection.
The viral loads measured in children are as high as in adults (>3000 measured cases and 49 children).Jones, T.C., Mühlemann, B., Veith, T., Zuchowski, M., Hofmann, J., Stein, A., Edelmann, A., Max Corman, V., Drosten, C. (2020) An analysis of SARS-CoV-2 viral load by patient age.
Study of 10 children who caught COVID-19 in January-February 2020. A 3-month-old newborn baby, who was being cared for by others, infected both parents, who developed symptoms 7 days after caring for the baby without protection.Cai, J., Xu, J., Lin, D., Xu, L., Qu, Z., Zhang, Y., ... & Xia, A. (2020). A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clinical Infectious Diseases.
In the Crépy-en-Valois high school (Oise, France), 38% of the students, 43% of the teachers, and 59% of the staff working in the school who were given a serological test were positive, confirming SARS-CoV-2 infections. The rate of secondary intra-familial transmission was estimated at 11% to parents and 10% to siblings.Fontanet, A., Shearer, L., Madec, Y., Grant, R., Besombes, C., Jolly, N., ... & Temmam, S. (2020). Cluster of COVID-19 in northern France: A retrospective closed cohort study. medRxiv.
The monitoring of infections in Norway has identified four probable cases of transmission of the virus by children. All four were between 12 and 15 years of age.Fretheim, A. (2020). The role of children in the transmission of SARS-CoV-2 (COVID-19)-. Norwegian Institute of Public Health. Rapid review.
The epidemiological study of 391 Shenzhen COVID-19 patients and their contacts indicates that children have a similar risk of infection to the general population. Note: Other studies show that the risk is lower for children.Bi, Q., Wu, Y., Mei, S., Ye, C., Zou, X., Zhang, Z., ... & Gao, W. (2020). Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of their close contacts. MedRxiv.
Mathematical models indicate that proactive school closures alone cannot stop the spread of SARS-Cov-2, but can reduce peak incidence by 40-60% and, thus, delay the epidemic.Zhang J., Litvinova M., Liang Y., et al (2020) Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China. Science, Apr 29;eabb8001.
Closure of schools for children over 16 only in Sweden.Decision of the Swedish Public Health Authority of March 17, 2020.
Study in New South Wales, Australia. In 10 high schools, 8 students and 4 staff members were tested COVID-positive; of their 695 close contacts within the high school, 235 had a nasopharyngeal swab (all negative) and 75 had a serological test (only 1 positive case, high school-to-high school transmission). In 5 primary schools, 1 student and 5 staff members tested COVID-positive; of their 168 close contacts within the school, 68 had a nasopharyngeal swab (only 1 positive, personnel-to-student transmission). This study therefore reveals a low rate of transmission within schools, when they close as soon as the first COVID case is detected.COVID-19 in schools. The experience in New South Wales. National Centre for Immunisation Research and Surveillance (NCIRS). 26 April 2020.
An 8-month-old and an 8-year-old child were infected by an adult at a daycare centre in Salt Lake City. They both transmitted COVID-19 to their parents. In another school, several 6-10 year old children were infected by an adult and then transmitted the disease to their parents, some of these children being asymptomatic. One of the infected parents was hospitalized.Lopez, A. S., Hill, M., Antezano, J., Vilven, D., Rutner, T., Bogdanow, L., ... & Tate, J. E. (2020). Transmission dynamics of COVID-19 outbreaks associated with child care facilities-Salt Lake City, Utah, April-July 2020. Morbidity and Mortality Weekly Report, 69(37), 1319.
COVID-19 epidemic at a youth camp in Georgia, U.S.A. in June 2020. A teenager began to have symptoms of COVID-19 on the sixth day of camp and tested positive the next day. Of the 344 camp participants tested, 76% (260) tested positive. The overall attack rate was 51% in 6-10 year olds, 44% in 11-17 year olds and 33% in 18-21 year olds. The longer the length of stay in the camp, the higher the attack rates. Wearing a mask was not required for camp participants.Szablewski, C. M., Chang, K. T., Brown, M. M., Chu, V. T., Yousaf, A. R., Anyalechi, N., ... & McDaniel, C. J. (2020). SARS-CoV-2 transmission and infection among attendees of an overnight camp-Georgia, June 2020. Morbidity and Mortality Weekly Report, 69(31), 1023.
Extremely detailed Israeli study of children between January and September 2020, before and after the reopening of schools. 677,982 RT-qPCR tests were conducted on children in Israel between January 27 and September 24, 2020. Of these, 8% (55,288) were positive. In comparison, 157,229 out of 2,548,273 (6%) were positive in adults. The opening of schools is associated with an increase in the rate of COVID-positive children and their closure with a decrease. Excluding transmissions caused by adults, children tend to be infected by other children in their own age group. Seven children each infected 10 people, three each infected 12 people, and one child infected 24 people.Israel, Ministry of Health, COVID-19 Report, 18 October 2020.