Coronavirus (Covid-19) and children: 13-year-old with Covid-19 as source of outbreak

Filed Under: Costs, Patients

- photo by Centers for Disease Control

“There is increasing evidence that children and adolescents can efficiently transmit SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19),” Noah G. Schwartz, Anne C. Moorman, Anna Makaretz, Karen T. Chang, Victoria T. Chu, Christine M. Szablewski, Anna R. Yousaf, Marie M. Brown, Ailis Clyne, Amanda DellaGrotta, Jan Drobeniuc, Jacqueline Korpics, Adam Muir, Cherie Drenzek, Utpala Bandy, Hannah L. Kirking, Jacqueline E. Tate, ; Aron J. Hall, Tatiana M. Lanzieri and Rebekah J. Stewart write for the Centers for Disease Control Morbidity and Mortality Weekly Report. “During July–August 2020, four state health departments and CDC investigated a COVID-19 outbreak that occurred during a 3-week family gathering of five households in which an adolescent aged 13 years was the index and suspected primary patient; 11 subsequent cases occurred. Both heads of each household were interviewed to assess demographic characteristics, exposures, symptoms, close contacts, and outcomes. Parents provided data for all children, adolescents, and young adults. Thirteen of the index patient’s relatives sought viral testing; test results were reported by respondents, and all test results that were reported to be positive were verified in state reporting systems. For three children and adolescents who were not tested while symptomatic, a chemiluminescent immunoassay* detecting total antibody to SARS-CoV-2 was performed 28–46 days after symptom onset; results were positive for all three children and adolescents, including the index patient and her two brothers, indicating earlier infection. Likely exposure periods and infectious periods were estimated from symptom onset dates. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy. While away from home, the index patient was exposed during a large COVID-19 outbreak in June 2020. Because of her exposure, she sought testing for SARS-CoV-2 after returning home. A rapid antigen test performed 4 days after exposure, when she was asymptomatic, was negative. She experienced nasal congestion 2 days later, her only symptom. That same day, she, her parents, and two brothers traveled to a gathering with 15 other relatives, which began the following day. Attendees belonged to five households in four states and ranged in age from 9 to 72 years. Fourteen relatives, including the index patient, stayed in a five-bedroom, two-bathroom house for 8–25 days. These relatives did not wear face masks or practice physical distancing. An additional six relatives (an aunt, an uncle, and four cousins) visited for 10 hours on day 3 and 3 hours on day 10, when six overnight attendees were potentially infectious, but maintained physical distance and remained outdoors; none wore face masks.Among the 14 persons who stayed in the same house, 12 experienced symptoms and were subsequently found to have COVID-19 based on Council of State and Territorial Epidemiologists definitions.” “Adolescent with COVID-19 as the Source of an Outbreak at a 3-Week Family Gathering — Four States, June–July 2020,” Centers for Disease Control Morbidity and Mortality Weekly Report.