Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Clin Infect Dis. 2022 Jan 7;74(1):66-73. doi: 10.1093/cid/ciab227.
Understanding the role of children in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools.
During July 2020, we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through (1) a surveillance program in 22 summer schools of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) during 2-5 weeks; and (2) cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centers followed prevention protocols: bubble groups, handwashing, face masks, and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and the effective reproduction number in summer schools (Re*) were calculated.
Among the >2000 repeatedly screened participants, 30 children and 9 adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median, 9 [interquartile range, 5-10] for each primary case), among which 12 new cases (4.7%) were positive for SARS-CoV-2. The Re* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9.
The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission, supporting current recommendations for school opening.
了解儿童在严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）传播中的作用对于指导大流行期间学校的决策至关重要。我们旨在描述夏季学校中儿童和成人工作人员之间 SARS-CoV-2 的传播。
在 2020 年 7 月期间，我们前瞻性地招募了巴塞罗那夏季学校中患有 SARS-CoV-2 感染的儿童和成人工作人员。通过（1）在 22 所夏季学校中进行的一项 1905 名参与者的监测计划，该计划包括在 2-5 周内每周对 SARS-CoV-2 逆转录聚合酶链反应（RT-PCR）进行唾液采样；以及（2）通过加泰罗尼亚儿童卫生监测系统识别的病例，该系统通过鼻咽 RT-PCR 诊断 SARS-CoV-2 感染。所有中心均遵循预防协议：泡沫组，洗手，戴口罩，并主要在户外进行活动。通过鼻咽 RT-PCR 评估同一泡沫内原发性病例的接触者。计算夏季学校中的继发攻击率和有效繁殖数（Re*）。
在反复筛查的 2000 多名参与者中，发现 30 名儿童和 9 名成年人是原发性病例。总共研究了这些原发性病例的 253 名密切接触者（中位数为每个原发性病例 9 [四分位距，5-10]），其中 12 例新病例（4.7％）对 SARS-CoV-2 呈阳性。Re*为 0.3，而巴塞罗那同一地区同期普通人群的比率为 1.9。
在严格的预防措施下，在类似学校设施中上学的儿童感染 SARS-CoV-2 的传播率低于普通人群中的报告率。这表明，在预防措施下，学校不太可能成为 SARS-CoV-2 传播的放大器，支持当前有关学校开放的建议。
