Pediatric cases of COVID-19 constitute between 1% to 10% of all confirmed cases of COVID-19; variation exists by jurisdiction.
Few case reports exist of confirmed child-to-other transmission. Contact tracing studies suggest that children are unlikely to be transmitters of the disease. Households are the most likely environments for transmission.
A recent large South Korean contact tracing study however (in pre-print) found that household COVID-19 transmission rates for children age 10-19 were significantly higher than in adults; transmission rates for children age 0-9 were relatively low.
AUGUST 7th, 2020 UPDATE: No new studies examining secondary attack rates of pediatric index cases were found. Studies continue to suggest low transmission from pediatric cases, and high proportion of pediatric cases being asymptomatic to mildly symptomatic.
MARCH 9th, 2021 UPDATE: Variants of Concerns are an emerging threat, but literature on pediatric prevalence and transmissibility is sparse. The British variant seems more transmissible (secondary attack rate higher) but follows the same age-related distribution of cases seen earlier in the pandemic.
Sulaiman, F; Coomaran, V; Muhajarine, N; Dalidowicz, M; Miller, L. What are the effects of the new COVID variants on transmission and school reopenings in pediatric populations? 2021 Mar 30; Document no.: PH030801 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 14p. (CEST rapid review report)
Howell-Spooner, B., Mueller, M. What are the effects of the new COVID variants on transmission and school reopenings in pediatric populations? 2021 Aug 18, Document no.: PH030801v2 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 49 p. (CEST evidence search report).
· The CDC does not recommend universal symptom screening (all students in K-12 grades) to be done by schools prior to entry
· Schools/districts should individually work with public health officials to determine the necessity and details of implementing any testing strategies
· European CDC recommends that all symptomatic individuals and asymptomatic high-risk close contacts should be referred for testing – fast and effective contact tracing following testing is key
· Large scale universal testing in school settings has not been studied and it’s efficacy compared to implementation of other infection prevention control measures is unknown
· Large scale testing in school settings to date has largely been done in response to an outbreak, not as routine surveillance
Badea, A; Muhajarine, N; Howell-Spooner, B; Mueller, M. What laboratory surveillance testing strategies are effective for COVID-19 in school settings? 2020 Aug 27; Document no.: PH082501 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST rapid review report)
Howell-Spooner, B; Mueller, M. What laboratory surveillance testing strategies are effective for COVID-19 in school settings? 2020 Aug 25; Document no.: PH082501-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 15 p. (CEST evidence search report)