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Children Are Unlikely to Have Been the Primary Source of Household SARS-CoV-2 Infections

32 Pages Posted: 9 Apr 2020

See all articles by Yanshan Zhu

Yanshan Zhu

University of Queensland, School of Chemistry & Molecular Biosciences

Conor J. Bloxham

University of Queensland - School Biomedical Science

Katina D. Hulme

University of Queensland, School of Chemistry & Molecular Biosciences

Jane E. Sinclair

University of Queensland, School of Chemistry & Molecular Biosciences

Zhen Wei Marcus Tong

University of Queensland, School of Chemistry & Molecular Biosciences

Lauren E. Steele

University of Queensland, School of Chemistry & Molecular Biosciences

Ellesandra C. Noye

University of Queensland, School of Chemistry & Molecular Biosciences

Jiahai Lu

Sun Yat-Sen University (SYSU) - School of Public Health

Keng Yih Chew

University of Queensland, School of Chemistry & Molecular Biosciences

Janessa Pickering

Perth Children’s Hospital - Wesfarmer's Centre for Vaccines and Infectious Diseases

Charles Gilks

University of Queensland - School of Public Health

Asha C. Bowen

Perth Children’s Hospital - Wesfarmer's Centre for Vaccines and Infectious Diseases

Kirsty R. Short

University of Queensland, School of Chemistry & Molecular Biosciences; University of Queensland - School of Public Health

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Abstract

Background: Since its identification on the 7th of January 2020, SARS-CoV-2 has spread to more than 180 countries worldwide, causing >11,000 deaths. At present, viral disease and transmission amongst children is incompletely understood. Specifically, there is concern that children could be an important source of SARS-CoV-2 in household transmission clusters.

Methods: We performed an observational study analysing literature published between December 2019 and March 2020 of the clinical features of SARS-CoV-2 in children and descriptions of household transmission clusters of SARS-CoV-2. In these studies the index case of each cluster defined as the individual in the household cluster who first developed symptoms.

Findings: Drawing on studies from China, Singapore, South Korea, Japan, and Iran a broad range of clinical symptoms were observed in children. These ranged from asymptomatic to severe disease. Of the 31 household transmission clusters that were identified, 9.7% (3/31) were identified as having a paediatric index case. This is in contrast other zoonotic infections (namely H5N1 influenza virus) where 54% (30/56) of transmission clusters identified children as the index case.

Interpretation: Whilst SARS-CoV-2 can cause mild disease in children, the data available to date suggests that children have not played a substantive role in the intra-household transmission of SARS-CoV-2.

Funding Statement: KRS was supported by the Australian Research Council [DE180100512]. ACB receives funding from the National Health and Medical Research Council with an Investigator Award (1175509). The sponsors of this study had no role in the study design, collection, analysis, and interpretation of data, report writing, or the decision to submit for publication.

Declaration of Interests: No conflict of interests to declare.

Keywords: SARS-CoV-2; Children; Clinical features; Household transmission; Paediatric index case

Suggested Citation

Zhu, Yanshan and Bloxham, Conor J. and Hulme, Katina D. and Sinclair, Jane E. and Tong, Zhen Wei Marcus and Steele, Lauren E. and Noye, Ellesandra C. and Lu, Jiahai and Chew, Keng Yih and Pickering, Janessa and Gilks, Charles and Bowen, Asha C. and Short, Kirsty R., Children Are Unlikely to Have Been the Primary Source of Household SARS-CoV-2 Infections (3/27/2020). Available at SSRN: https://ssrn.com/abstract=3564428 or http://dx.doi.org/10.2139/ssrn.3564428

Yanshan Zhu

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Conor J. Bloxham

University of Queensland - School Biomedical Science

Brisbane
Australia

Katina D. Hulme

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Jane E. Sinclair

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Zhen Wei Marcus Tong

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Lauren E. Steele

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Ellesandra C. Noye

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Jiahai Lu

Sun Yat-Sen University (SYSU) - School of Public Health ( email )

China

Keng Yih Chew

University of Queensland, School of Chemistry & Molecular Biosciences

St. Lucia
Brisbane
Australia

Janessa Pickering

Perth Children’s Hospital - Wesfarmer's Centre for Vaccines and Infectious Diseases

Nedlands
Perth, Western Australia
Australia

Charles Gilks

University of Queensland - School of Public Health

St Lucia
Brisbane
Australia

Asha C. Bowen

Perth Children’s Hospital - Wesfarmer's Centre for Vaccines and Infectious Diseases

Nedlands
Perth, Western Australia
Australia

Kirsty R. Short (Contact Author)

University of Queensland, School of Chemistry & Molecular Biosciences ( email )

St. Lucia
Brisbane
Australia

University of Queensland - School of Public Health ( email )

St Lucia
Brisbane
Australia

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