Fuller, Trevon L; Bastos, Leonardo; Carvalho, Marilia Sá; Resende, Paola Cristina; Damasceno, Luana; Cruz, Oswaldo Gonçalves; Medeiros, Fernando; Calvet, Guilherme; Guaraldo, Lusiele; Nielsen-Saines, Karin; +4 more... Whitworth, James; Smith, Christopher; Siqueira, Marilda; Brasil, Patrícia; (2023) The Role of Children in Household Transmission of SARS-CoV-2 Across Four Waves of the Pandemic. Journal of the Pediatric Infectious Diseases Society, 12 (7). pp. 413-420. ISSN 2048-7193 DOI: https://doi.org/10.1093/jpids/piad044
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
BACKGROUND: It is important to understand the dynamics of SARS-CoV-2 transmission in close-contact settings such as households. We hypothesized that children would most often acquire SARS-CoV-2 from a symptomatic adult caregiver. METHODS: This prospective cohort study was conducted from April 2020 to July 2022 in a low-resource, urban settlement in Brazil. We recruited families who brought their children to a public clinic. We collected nasopharyngeal and oral swabs from household members and tracked symptoms and vaccination. RESULTS: In total, 1256 participants in 298 households were tested for SARS-CoV-2. A total of 4073 RT-PCR tests were run with 893 SARS-CoV-2 positive results (21.9%). SARS-CoV-2 cases were defined as isolated cases (N = 158) or well-defined transmission events (N = 175). The risk of household transmission was lower if the index case was a child (OR: 0.3 [95% CI: 0.16-0.55], P < .001) or was vaccinated (OR: 0.29 [95% CI: 0.1-0.85], P = .024), and higher if the index was symptomatic (OR: 2.53 [95% CI: 1.51-4.26], P < .001). The secondary attack rate for child index cases to child contacts was 0.29, whereas the secondary attack rate for adult index cases to child contacts was 0.47 (P = .08). CONCLUSIONS: In this community, children were significantly less infectious to their household contacts than adolescents or adults. Most children were infected by a symptomatic adult, usually their mother. There was a double benefit of vaccination as it protected the vaccine from severe illness and prevented onward transmission to household contacts. Our findings may also be valid for similar populations throughout Latin America.
Item Type | Article |
---|---|
Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023) Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Research Centre | Covid-19 Research |
PubMed ID | 37327193 |
Elements ID | 205144 |
Official URL | http://dx.doi.org/10.1093/jpids/piad044 |
Download
Filename: Fuller-etal-2023-The-role-of-children-in.pdf
Description: This is an author accepted manuscript version of an article accepted for publication, and following peer review. Please be aware that minor differences may exist between this version and the final version if you wish to cite from it.
Licence: Copyright the author(s)