Children in childcare facilities not only contracted COVID-19, but they spread the virus to other close contacts, including their parents, siblings, and potentially their teachers, CDC researchers found.
In three outbreaks in Utah, 54% of cases linked to childcare facilities occurred in children, and transmission likely occurred from children with confirmed COVID-19 to 25% of their "non-facility contacts," such as parents and siblings, with one parent hospitalized, reported Cuc Tran, PhD, of the CDC, and colleagues.
Moreover, transmission to adults was confirmed in two of three children with asymptomatic infection, the authors wrote in an early edition of the
Ten adults who worked at the childcare facility also contracted the infection, with contact tracing showing they were facility-associated cases, Tran and colleagues noted.
Of the 12 children who acquired the virus in childcare facilities, transmission was documented to at least 12 of 46 non-facility contacts, according to this report.
The role of children in spreading COVID-19 continues to be a hot-button topic as schools reopen around the country, though the authors noted the data about transmission from young children are "limited."
Earlier studies, notably one on a Georgia summer camp in which the , have not dissuaded some federal officials from insisting it doesn't occur. that Paul Alexander, MSc, MHSc, PhD, in the Department of Health and Human Services' communications office, wrote in a recent email, "There is no data, none, zero, across the entire world, that shows children especially young children, spread this virus to other children, or to adults or to their teachers. None."
In the current study, Tran and colleagues investigated three COVID-19 outbreaks in Utah childcare facilities from April 1 to July 10. Overall, 184 individuals had an epidemiologic link to one of the three facilities, and 54% of these individuals were female. These included 110 children (median age 7, range <1 year to 16). The 74 adults had a median age of 30 (range 19-78).
There were 31 confirmed cases among facility staff members and attendees, of which 22 were facility-associated cases (10 adults and 12 children), with the remainder among contacts of staff members or attendees. The 12 children had 83 contacts, 55% of whom were not facility-associated. Among those contacts, seven confirmed and five probable infections developed. Mothers accounted for six of these cases and siblings for three.
Among 162 contacts of facility-associated cases, 94 had no symptoms and were not tested. Nine contacts developed confirmed infections and seven were probable cases.
While the authors noted COVID-19 is less severe in children, "children can still play a role in transmission" and highlighted the finding of virus spread from asymptomatic children to adult contacts.
Tran and colleagues recommended that childcare facilities should not be exempt from now-familiar infection control measures -- especially masking by staff, as some children are too young to wear masks, along with hand hygiene and frequent cleaning and disinfecting of high-touch surfaces.
Disclosures
Lopez disclosed no conflicts of interest.
Tran disclosed no conflicts of interest.
One co-author disclosed support from the Council of State and Territorial Epidemiologists.
Primary Source
Morbidity and Mortality Weekly Report
Lopez AS, et al "Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities -- Salt Lake City, Utah, April-July 2020" MMWR 2020; DOI: 10.15585/mmwr.mm6937e3.