Children can have many particles of the coronavirus in their noses even if they have no symptoms or are only slightly ill. That makes them a potential source for further spread of the virus. Because the lack of disease symptoms is not a reliable indication of whether children have and can spread the virus, infection prevention measures are needed when schools reopen.
That is what scientists affiliated with a number of hospitals and scientific institutions in Boston, including the Harvard Medical School. They recently released their findings published in The Journal of Pediatrics.
The Dutch pediatrician and epidemiologist Patricia Bruijning from UMC Utrecht is not very impressed. “I know the study, but I find it of little relevance to the reopening of schools.” Bruijning finds the research group – children who come to the hospital with a suspicion of covid-19 – “a very selected group and probably not very representative of the average teenager”. After all, “the sicker you are, the greater the amount of virus particles you have”. According to Bruijning, “the study adds very little to what we already knew”.
‘What You Would Expect’
The US researchers enrolled 192 children in their study, 49 of whom had a confirmed SARS-CoV-2 infection. Eighteen had the serious condition MIS (Multisystem Inflammatory Syndrome), which is associated with covid-19 in some children and not in others. The remaining 125 children had tested negative for SARS-CoV-2.
Three young children who had no complaints but were tested because they had come into contact with an infected person, were found to have many virus particles in their noses. In fact, according to the researchers, “significantly more than hospitalized seriously ill adults with symptoms of more than seven days”.
“That is exactly what you would expect,” says Bruijning. “Because in people who have complaints for more than seven days, the amount of virus particles is usually a lot lower than at the start of the infection. In my opinion, it is a nonsensical comparison.”
Infectiousness
It is generally believed that the more virus particles a covid-19 patient carries, the more contagious he or she is. But it is not certain whether this also applies to young children with many virus particles in their noses. “To do this, the virus must also be spread in the air in large quantities by those children,” says Bruijning.
“We don’t know exactly what that relationship is like for young children. But it is possible that because of a lower tidal volume and lower exhalation rates, they bring less virus into their environment than an adult with the same amount of virus. That is still an open question. which needs further investigation. “
The American study is not about the contagiousness of children, the scientists write. But “children with many virus particles and nonspecific symptoms such as colds and coughs are likely to transmit SARS-CoV-2 as easily as other viral infections that are spread via droplets. If schools reopen completely without the necessary precautions, children are likely to have a play a greater role in this pandemic. “
Infectiepreventie
Of all the children in the study who were infected, only half had a fever. The remainder showed no symptoms or only nonspecific signs of disease. At the same time, a third of all sick schoolchildren who reported to hospitals at the height of the Boston epidemic had a SARS-CoV-2 infection.
“For infection control, it is essential to identify infected children as early as possible for quarantine,” write the researchers. But according to the American scientists that is difficult because about half of the children have no symptoms or are very mild. Especially now that the schools are reopening, this is a cause for concern in their eyes.
“Infection prevention measures should minimize the risk of the virus spreading, with a focus on strategies with social distancing-precautions, the use of face masks and / or distance education. ”Furthermore, according to the authors, schools could routinely test their students for SARS-CoV-2.
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