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

Cordery, Rebecca; Reeves, Lucy; Zhou, Jie; Rowan, Aileen; Watber, Patricia; Rosadas, Carolina; Crone, Michael; Freemont, Paul S.; Mosscrop, Lucy; Cowley, Alice; Zelent, Gina; Bisset, Kate; LeBlond, Holly; Regmi, Sadie; Buckingham, Christian; Junaideen, Ramlah; Abdulla, Nadia; Mindlin, Miranda; Lamagni, Theresa; Barclay, Wendy S.; Taylor, Graham P.; Sriskandan, Shiranee

doi:10.1101/2021.03.08.21252839

Cited by 7 publications

(9 citation statements)

References 35 publications

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“…Reported SAR values from other school outbreak investigations from the same period that used comparable methodology ranged between 0.0 and 6.5% [9][10][11][12][13][14][15][16][17][18]. The majority of the secondary cases in these studies were asymptomatic (47.8-66.6%), in line with our observations [10,17].…”

Section: Discussionsupporting

confidence: 88%

SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

et al. 2022

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Background In fall 2020 when schools in the Netherlands operated under a limited set of COVID-19 measures, we conducted outbreaks studies in four secondary schools to gain insight in the level of school transmission and the role of SARS-CoV-2 transmission via air and surfaces. Methods Outbreak studies were performed between 11 November and 15 December 2020 when the wild-type variant of SARS-CoV-2 was dominant. Clusters of SARS-CoV-2 infections within schools were identified through a prospective school surveillance study. All school contacts of cluster cases, irrespective of symptoms, were invited for PCR testing twice within 48 h and 4–7 days later. Combined NTS and saliva samples were collected at each time point along with data on recent exposure and symptoms. Surface and active air samples were collected in the school environment. All samples were PCR-tested and sequenced when possible. Results Out of 263 sampled school contacts, 24 tested SARS-CoV-2 positive (secondary attack rate 9.1%), of which 62% remained asymptomatic and 42% had a weakly positive test result. Phylogenetic analysis on 12 subjects from 2 schools indicated a cluster of 8 and 2 secondary cases, respectively, but also other distinct strains within outbreaks. Of 51 collected air and 53 surface samples, none were SARS-CoV-2 positive. Conclusion Our study confirmed within school SARS-CoV-2 transmission and substantial silent circulation, but also multiple introductions in some cases. Absence of air or surface contamination suggests environmental contamination is not widespread during school outbreaks.

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Section: Discussionsupporting

confidence: 88%

SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

et al. 2022

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“…Reported (SAR) values from other school outbreak investigations from the same period that used comparable methodology ranged between 0.0 to 6.5% [9][10][11][12][13][14][15][16][17][18]. The majority of the secondary cases in these studies were asymptomatic (47.8%-66.6%), in line with our observations [10,17].…”

Section: Discussionsupporting

confidence: 88%

“…Only in a minority (<2-5%) of surface swab samples taken in both the classrooms of index cases and the washrooms, low amounts of viral RNA could be detected, some of which were collected before deep cleaning took place. In this study only 1/68 (1.5%) of the air samples was positive for SARS-CoV-2 [18].…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, several air samples collected in COVID-19 infected mink farms, and a high percentage of both air and surface swab samples collected in rooms in nursing homes with SARS-CoV-2 positive patients [1,22]. A previous study in London also found limited evidence of SARS-CoV-2 contamination in school environments [18]. Only in a minority (<2-5%) of surface swab samples taken in both the classrooms of index cases and the washrooms, low amounts of viral RNA could be detected, some of which were collected before deep cleaning took place.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

Jonker

Linde

Hoog

et al. 2022

Preprint

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Background: In fall 2020 when schools in the Netherlands operated under a limited set of COVID-19 measures, we conducted outbreaks studies in four secondary schools to gain insight in the level of school transmission and the role of SARS-CoV-2 transmission via air and surfaces. Methods: Outbreak studies were performed between 11 November and 15 December 2020 when the wild-type variant of SARS-CoV-2 was dominant. Clusters of SARS-CoV-2 infections within schools were identified through a prospective school surveillance study. All school contacts of cluster cases, irrespective of symptoms, were invited for PCR testing twice within 48 hrs and 4-7 days later. Combined NTS and saliva samples were collected at each time point along with data on recent exposure and symptoms. Surface and active air samples were collected in the school environment. All samples were PCR-tested and sequenced when possible. Results: Out of 263 sampled school contacts, 24 tested SARS-CoV-2 positive (secondary attack rate 9.1%), of which 62% remained asymptomatic and 42% had a weakly positive test result. Phylogenetic analysis on 12 subjects from 2 schools indicated a cluster of 8 and 2 secondary cases, respectively, but also other distinct strains within outbreaks. Of 51 collected air and 53 surface samples, none were SARS-CoV-2 positive. Conclusion: Our study confirmed within school SARS-CoV-2 transmission and substantial silent circulation, but also multiple introductions in some cases. Absence of air or surface contamination suggests environmental contamination is not widespread during school outbreaks.

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“…Our findings illustrate the wider impact of cases in children, with an increase in household clusters observed in both primary and secondary school-aged index cases. While we cannot determine definitively that subsequent cases within the household represent transmission from index cases, the risk from cohabitation makes this likely [14][15][16][17]. The rise in clusters seeded by secondary school-aged children may reflect in part the systematic asymptomatic testing of this age group at the start of the school term, leading to increased testing among household contacts.…”

Section: Discussionmentioning

confidence: 93%

Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

Chudasama¹,

Tessier²,

Flannagan³

et al. 2021

Eurosurveillance

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Easing of COVID-19 restrictions in England in the summer of 2021 was followed by a sharp rise in cases among school-aged children. Weekly rates of SARS-CoV-2 infection in primary and secondary school children reached 733.3 and 1,664.7/100,000 population, respectively, by week 39 2021. A surge in household clusters with school-aged index cases was noted at the start of the school term, with secondary cases predominantly in children aged 5–15 years and adults aged 30–49 years.

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

Cited by 7 publications

References 35 publications

SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

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