Heudorf Ursel, Steul Katrin, Walczok Antoni, Gottschalk Rene
MRE-Netz Rhein-Main, Frankfurt, c/o Gesundheitsamt Frankfurt am Main, Frankfurt, Deutschland.
Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313 Frankfurt, Deutschland.
Monatsschr Kinderheilkd. 2021;169(4):322-334. doi: 10.1007/s00112-021-01134-8. Epub 2021 Mar 2.
In face of the coronavirus disease 2019 (COVID-19) pandemic, the question that children are also drivers of this pandemic and that groups, classes, or the entire facility should be closed when severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs in schools or daycare centers is always implied. These questions were investigated using the mandatory reporting data in Frankfurt am Main and the extensive testing of contact persons (CP) in schools and daycare centers after the occurrence of an index case.
The reporting data were taken from SurvStat. The index cases from daycare centers and schools were isolated and the CPs were offered PCR testing for SARS-CoV‑2 on a voluntary basis, regardless of whether symptoms suggestive of SARS-CoV‑2 had occurred or not. Deep nasal/pharyngeal swabs were collected by paramedics on behalf of the public health department of the city of Frankfurt am Main, Germany, and tested according to established standards at two accredited institutes.
From March to 31 December 2020, 22,715 COVID-19 cases were reported in Frankfurt, including 1588 (7.6%) SARS-CoV‑2 detections in children 14 years and younger. Thus, approximately half as many SARS-CoV‑2 detections were reported in children up to 14 years of age than would have corresponded to their proportion in the population. In autumn 2020, the increase in incidence in children over the weeks followed the increase in incidence in the general population, the age-related incidence of children remained below the incidence in the general population.From week 35 to week 52, index cases were reported from 143 daycare centers and 75 schools. As a result, 7915 CPs were tested. In daycare centers, SARS-CoV‑2 was detected in 4.5% of adult CPs and 2.5% of child CPs and in schools SARS-CoV‑2 was detected in 0.9% of adult CPs and 2.5% of student CPs tested. On average, less than 1 CP tested positive per index case. The rate of positive findings increased with increasing incidence in the overall population. No major outbreak occurred.
Regarding the level and timing of age-related incidences among children in Frankfurt am Main, there was no evidence that children were the drivers of the pandemic. Only a small percentage of the examined CPs in schools and daycare centers tested positive for SARS-CoV‑2. In the absence of evidence of intense transmission in the facilities, CP attendance can/should continue under hygiene conditions and there is no need to close entire groups, classes, or even facilities.
面对2019冠状病毒病（COVID-19）大流行，始终存在这样的问题，即儿童也是这一大流行的传播者，当严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在学校或日托中心出现时，是否应关闭班级、整个班级或整个机构。利用美因河畔法兰克福的强制报告数据以及在出现首例病例后对学校和日托中心接触者（CP）进行的广泛检测，对这些问题进行了调查。
报告数据取自SurvStat。日托中心和学校的首例病例被隔离，无论是否出现SARS-CoV-2相关症状，均向接触者自愿提供SARS-CoV-2的PCR检测。德国美因河畔法兰克福市公共卫生部门的护理人员采集深鼻/咽拭子，并在两个认可机构按照既定标准进行检测。
2020年3月至12月31日，法兰克福共报告22715例COVID-19病例，其中14岁及以下儿童中有1588例（7.6%）检测出SARS-CoV-2。因此，14岁及以下儿童中报告的SARS-CoV-2检测病例数约为与其在人口中所占比例相对应数量的一半。2020年秋季，儿童发病率在数周内的上升趋势与普通人群发病率的上升趋势一致，儿童的年龄相关发病率仍低于普通人群。从第35周到第52周，143所日托中心和75所学校报告了首例病例。结果，7915名接触者接受了检测。在日托中心，4.5%的成年接触者和2.5%的儿童接触者检测出SARS-CoV-2；在学校，接受检测的成年接触者中有0.9%和学生接触者中有2.5%检测出SARS-CoV-2。平均而言,每个首例病例的接触者中检测呈阳性的不到1人。阳性检出率随着总体人群发病率的增加而上升。未发生重大疫情。
关于美因河畔法兰克福儿童年龄相关发病率的水平和时间，没有证据表明儿童是大流行的传播者。学校和日托中心接受检测的接触者中只有一小部分SARS-CoV-2检测呈阳性。在没有证据表明机构内存在强烈传播的情况下，在卫生条件下接触者可以/应该继续出勤，无需关闭整个群体、班级甚至机构。
