SARS-CoV-2 infections in kindergartens and associated households at the start of the second wave in Berlin, Germany—a cross-sectional study

Thielecke, Marlene; Theuring, Stefanie; Loon, Welmoed van; Hommes, Franziska; Mall, Marcus; Rosen, Alexander; Böhringer, Falko; Kalle, Christof von; Kirchberger, Valerie; Kurth, Tobias; Seybold, Joachim; Mockenhaupt, Frank P.; Chylla, Tanja; Linzbach, Elisabeth; Haar, Annkathrin von der; Körner, Jennifer; Gertler, Maximilian; Bernhard, Julian; Rössig, Heike; Kurzmann, Marco; Peters, Frederike; Wiesmann, Christoph; Horn, Johanna; Steger, Julia; Bethke, Norma; Schmidergall, Tobias; Holz, F.; Berg, Antje van den; Peña-Groth, Maria Luz

doi:10.1093/eurpub/ckab079

Cited by 13 publications

(17 citation statements)

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“…Studies of the seroprevalence of IgG against SARS-CoV-2 in school personnel and students have been published, together with information from their partners, to determine whether the prevention measures applied in the centers were effective in controlling transmission. These studies did not detect SARS-CoV-2 infections in children attending day-care during the onset of the second wave of the pandemic ( 5 ). The same conclusions were obtained in other studies carried out in Luxembourg ( 13 ) and in the United States ( 4 ), in which prevention measures were used to prevent transmission in educational centers.…”

Section: Discussionmentioning

confidence: 91%

“…Nonpharmaceutical interventions (NPIs), following the protocol launched by the Department of Education of the Catalonian Government (2), were implemented in the educational setting from the beginning of the school year: hand-washing, mandatory mask use for children older than 5, social distancing, organization of children and teachers into bubble groups whenever possible in order to maintain, as far as possible, the same groups of individuals to facilitate contact tracing, and enhanced ventilation in the classroom by keeping doors and windows open, along with other public health practices, such as screening and quarantine the whole group whenever a positive was detected. In fact, it has been demonstrated that all of these measures are essential to mitigate the transmission of SARS-CoV-2 in schools (3)(4)(5)(6)(7). However, clusters of SARS-CoV-2 infection have been detected in any number of educational centers.…”

Section: Introductionmentioning

confidence: 99%

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Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study

et al. 2021

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Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults.Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics.Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%).Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study

et al. 2021

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“…Sixteen studies were contact-tracing studies (6 school; 27 , 28 , 29 , 30 , 31 , 32 , 33 10 household [ 2 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]), 2 provided both contact-tracing and population data (both school studies [ 43 , 44 ]) and 19 were population studies (17 in educational settings; [ 9 , 10 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ] 2 were national community surveillance surveys [ 60 , 61 ]).…”

Section: Resultsmentioning

confidence: 99%

“…RT-PCR studies may under-estimate infection in children compared with serology, [36] and different seroassays may provide differing results. Many of the included studies, however, combined findings from both PCR and serology, [ 10 , 31 , 32 , 39 , 40 , 44 , 47 , 48 , 54 , 67 ] or undertook repeated PCR measures [ 40 , 44 , 45 , 49 , 50 , 51 , 53 , 60 ] Importantly, though, these issues are likely to be similar across both contact-tracing and population studies and, therefore, would not alter the notable differences we found by setting.…”

Section: Limitationsmentioning

confidence: 99%

Transmission of SARS-CoV-2 by children and young people in households and schools: A meta-analysis of population-based and contact-tracing studies

Viner

Waddington

Mytton

et al. 2022

Journal of Infection

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Background The role of children and young people (CYP) in transmission of SARS-CoV-2 in household and educational settings remains unclear. We undertook a systematic review and meta-analysis of contact-tracing and population-based studies at low risk of bias. Methods We searched 4 electronic databases on 28 July 2021 for contact-tracing studies and population-based studies informative about transmission of SARS-CoV-2 from 0-19 year olds in household or educational settings. We excluded studies at high risk of bias, including from under-ascertainment of asymptomatic infections. We undertook multilevel random effects meta-analyses of secondary attack rates (SAR: contact-tracing studies) and school infection prevalence, and used meta-regression to examine the impact of community SARS-CoV-2 incidence on school infection prevalence. Findings 4529 abstracts were reviewed, resulting in 37 included studies (16 contact-tracing; 19 population studies; 2 mixed studies). The pooled relative transmissibility of CYP compared with adults was 0.92 (0.68, 1.26) in adjusted household studies. The pooled SAR from CYP was lower (p=0.002) in school studies 0.7% (0.2, 2.7) than household studies (7.6% (3.6, 15.9) . There was no difference in SAR from CYP to child or adult contacts. School population studies showed some evidence of clustering in classes within schools. School infection prevalence was associated with contemporary community 14-day incidence (OR 1.003 (1.001, 1.004), p<0.001). Interpretation We found no difference in transmission of SARS-CoV-2 from CYP compared with adults within household settings. SAR were markedly lower in school compared with household settings, suggesting that household transmission is more important than school transmission in this pandemic. School infection prevalence was associated with community infection incidence, supporting hypotheses that school infections broadly reflect community infections. These findings are important for guiding policy decisions on shielding, vaccination school and operations during the pandemic.

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“…CoV-2 infection in the school setting or in the kindergarden 20 seems to be relatively uncommon, even though some studies did not consider asymptomatic cases. 21 A recent epidemiological investigation on the transmission of SARS-CoV-2 in 41 classes of 36 schools in northern Italy showed an overall secondary attack rate of 3.2%, that reached 6.6% in middle and high schools.…”

Section: Discussionmentioning

confidence: 99%

Reasons for SARS-CoV-2 Infection in Children and Their Role in the Transmission of Infection According to Age: a Case-control Study.

Calvani

Cantiello

Cavani

et al. 2021

Preprint

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Background. The locations where children get exposed to SARS-CoV-2 infection and their contribution in spreading the infection are still not fully understood. Aim of the article is to verify the most frequent reasons for SARS-CoV-2 infection in children and their role in the secondary transmission of the infection. Methods. A case-control study was performed in all SARS-CoV-2 positive children (n= 81) and an equal number of age- and sex- matched controls who were referred to the S. Camillo-Forlanini Pediatric Walk-in Center of Rome. The results of all SARS-CoV-2 nasopharyngeal swabs performed in children aged <18 years from October 16 to December 19, 2020 were analyzed. Results. School contacts were more frequent in controls than in cases (OR 0.49; 95% CI: 0.3-0.9), while household contacts were higher in cases (OR 5.09; 95% CI: 2.2-12.0 ). In both cases and controls, school contacts were significantly less frequent, while on the contrary household contacts seemed to be more frequent in nursery school children compared to primary school or middle/high school children. A multivariate logistic regression showed that the probability of being positive to SARS-CoV-2 was significantly lower in children who had school contacts or who had flu symptoms compared to children who had household contacts. Results showed a 30.6% secondary attack rate for household contacts. Conclusion. In our study population, the two most frequent reasons for SARS-CoV-2 infection were school and home contacts. The risk of being positive was 5 times lower in children who had school contacts than in children who had household contacts.

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SARS-CoV-2 infections in kindergartens and associated households at the start of the second wave in Berlin, Germany—a cross-sectional study

Cited by 13 publications

References 5 publications

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study

Transmission of SARS-CoV-2 by children and young people in households and schools: A meta-analysis of population-based and contact-tracing studies

Reasons for SARS-CoV-2 Infection in Children and Their Role in the Transmission of Infection According to Age: a Case-control Study.

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