SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Transmission of SARS-CoV-2 by children to contacts in schools and households: a prospective cohort and environmental sampling study in London.

Cordery, R; Reeves, L; Zhou, J; Rowan, A; Watber, P; Rosadas, C; Crone, M; Storch, M; Freemont, P; Mosscrop, L; et al. Cordery, R; Reeves, L; Zhou, J; Rowan, A; Watber, P; Rosadas, C; Crone, M; Storch, M; Freemont, P; Mosscrop, L; Cowley, A; Zelent, G; Bisset, K; Le Blond, H; Regmi, S; Buckingham, C; Junaideen, R; Abdulla, N; Eliahoo, J; Mindlin, M; Lamagni, T; Barclay, W; Taylor, GP; Sriskandan, S (2022) Transmission of SARS-CoV-2 by children to contacts in schools and households: a prospective cohort and environmental sampling study in London. Lancet Microbe, 3 (11). e814-e823. ISSN 2666-5247 https://doi.org/10.1016/S2666-5247(22)00124-0
SGUL Authors: Mindlin, Miranda Juliet

[img]
Preview
PDF Published Version
Available under License Creative Commons Attribution.

Download (740kB) | Preview
[img]
Preview
PDF (Supplementary appendix) Published Version
Available under License Creative Commons Attribution.

Download (941kB) | Preview

Abstract

BACKGROUND: Assessing transmission of SARS-CoV-2 by children in schools is of crucial importance to inform public health action. We assessed frequency of acquisition of SARS-CoV-2 by contacts of pupils with COVID-19 in schools and households, and quantified SARS-CoV-2 shedding into air and onto fomites in both settings. METHODS: We did a prospective cohort and environmental sampling study in London, UK in eight schools. Schools reporting new cases of SARS-CoV-2 infection to local health protection teams were invited to take part if a child index case had been attending school in the 48 h before a positive SARS-CoV-2 PCR test. At the time of the study, PCR testing was available to symptomatic individuals only. Children aged 2-14 years (extended to <18 years in November, 2020) with a new nose or throat swab SARS-CoV-2 positive PCR from an accredited laboratory were included. Incidents involving exposure to at least one index pupil with COVID-19 were identified (the prevailing variants were original, α, and δ). Weekly PCR testing for SARS-CoV-2 was done on immediate classroom contacts (the so-called bubble), non-bubble school contacts, and household contacts of index pupils. Testing was supported by genome sequencing and on-surface and air samples from school and home environments. FINDINGS: Between October, 2020, and July, 2021 from the eight schools included, secondary transmission of SARS-CoV-2 was not detected in 28 bubble contacts, representing ten bubble classes (participation rate 8·8% [IQR 4·6-15·3]). Across eight non-bubble classes, 3 (2%) of 62 pupils tested positive, but these were unrelated to the original index case (participation rate 22·5% [9·7-32·3]). All three were asymptomatic and tested positive in one setting on the same day. In contrast, secondary transmission to previously negative household contacts from infected index pupils was found in six (17%) of 35 household contacts rising to 13 (28%) of 47 household contacts when considering all potential infections in household contacts. Environmental contamination with SARS-CoV-2 was rare in schools: fomite SARS-CoV-2 was identified in four (2%) of 189 samples in bubble classrooms, two (2%) of 127 samples in non-bubble classrooms, and five (4%) of 130 samples in washrooms. This contrasted with fomites in households, where SARS-CoV-2 was identified in 60 (24%) of 248 bedroom samples, 66 (27%) of 241 communal room samples, and 21 (11%) 188 bathroom samples. Air sampling identified SARS-CoV-2 RNA in just one (2%) of 68 of school air samples, compared with 21 (25%) of 85 air samples taken in homes. INTERPRETATION: There was no evidence of large-scale SARS-CoV-2 transmission in schools with precautions in place. Low levels of environmental contamination in schools are consistent with low transmission frequency and suggest adequate cleaning and ventilation in schools during the period of study. The high frequency of secondary transmission in households associated with evident viral shedding throughout the home suggests a need to improve advice to households with infection in children to prevent onward community spread. The data suggest that SARS-CoV-2 transmission from children in any setting is very likely to occur when precautions are reduced. FUNDING: UK Research and Innovation and UK Department of Health and Social Care, National Institute for Health and Care Research.

Item Type: Article
Additional Information: Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Lancet Microbe
ISSN: 2666-5247
Language: eng
Dates:
DateEvent
2 November 2022Published
24 August 2022Published Online
29 April 2022Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
COV0322UK Research and Innovationhttp://dx.doi.org/10.13039/100014013
COV0322Department of Health and Social Carehttp://dx.doi.org/10.13039/501100000276
PubMed ID: 36029775
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/114744
Publisher's version: https://doi.org/10.1016/S2666-5247(22)00124-0

Actions (login required)

Edit Item Edit Item