Can my child transmit COVID-19 ?
Text updated on 2020-05-03
Yes, children can transmit the SARS-CoV-2 coronavirus. Several cases of child-to-parent transmission have been documented.
Cases of child to adult transmission have been observed. It is not yet known how common these cases are, as large-scale published studies have not yet been conducted.
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.
Several cases of transmission from a child to a parent have been published: a 3-month-old newborn in China, four children aged 12-15 years in Norway, and high school students in France. In the high school of Crépy-en-Valois (Oise, France), where 38% of the high school students tested were positive, the rate of secondary transmission (outside the place of primary infection) within the family was estimated at 11% to parents and 10% to siblings.
In Sweden, as of May 1, 2020, schools for under-16s have remained open since the beginning of the epidemic. However, schools for the over-16s closed on March 18, 2020 and the government strongly advised children to avoid contact with elderly or vulnerable people. To date, no studies have been published on school-related child-to-child and child-to-parent transmission in Sweden.
Given the current evidence, it is important that children 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.