Transmission from children to family members in US childcare setting

Simon Collins, HIV i-Base

A report in the 11 September edition of the US CDC MMWR included cases of onward transmission from 13 children under 10 years old attending three childcare facilities in Salt Lake City.

These reports were from retrospective reviews of transmission patterns from three outbreaks from 1 April to 10 July 2020. Of the 12 children who acquired COVID-19 in a facility, transfer was documented to at least 12 (26%) of 46 nonfacility contacts.

Overall, 184 people, including 110 (60%) children had a link to one of the three facilities. Among these, 31/184 confirmed COVID-19 cases occurred; 13 (42%) in children (all mild and without symptoms) and 18 in adults. 

Median age of the adults and children was 30 years (range: 19 to 78 years) and 7 (range: 0.2–16 years), respectively.

Of the 46 non-facility contacts for the 12 children, 12 developed COVID-19 (seven confirmed and five probable). These included six mothers and three siblings.

The study notes that testing criteria for adults included having symptoms that could have underestimated transmission cases and that criteria for testing also changed during the study period, but also that uncertainty about the source case in one of the facilities, that some of those associated cases might have come from outside.

The study noted that although COVID-19 symptoms were mild in the children, this still led to likely transmission to adults, including to parents and possibly to teachers..

Reference

Lopez AS et al. Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020. US CDC MMWR, ePub. DOI:10.15585/mmwr.mm6937e3. (11 September 2020).
https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e3.htm