A study indicates that younger children may be more likely to transmit Covid-19 than older children.
Early studies suggested that children do not contribute much to the spread of coronavirus. But a new study, published in JAMA Pediatrics indicates that younger children may put caregivers and older children at risk of contracting the virus.
Many children don’t have any symptoms. Those that do get sick tend to experience milder symptoms such as low-grade fever, fatigue, and cough. Some children have had severe complications, but this has been less common.
Children with underlying health conditions may be at increased risk for severe illness.
The new study examined 6 280 households between June 1 and December 31, 2020, that reported a paediatric Covid-19 case. Older children were more likely to be involved in the initial case, and 27% of the 6 280 households reported a secondary infection involving another member.
Data revealed that children ages 0 to three years old, although less likely to bring the infection into the house, were more likely to spread the virus to another member than those ages 14 to 17. Children aged four to eight also had increased odds in spreading the virus, as did those ages nine to 13, but the greatest was among the younger children.
"Differential infectivity of paediatric age groups has implications for infection prevention controls within households and schools/childcare to minimise risk of household secondary transmission," the researchers who were supported by Public Health Ontario, wrote. "Although children do not appear to transmit infection as frequently as adults, caregivers should be aware of the risk of transmission while caring for sick children in the household setting."
Researchers noted that it’s "challenging and often impossible" to isolate from sick children, and as such caregivers should implement other infection control measures like wearing masks, washing hands and keeping them separate from siblings.
While most children get mild symptoms, the Harvard Medical School notes that potentially severe and dangerous complications can occur in children. Called multisystem inflammatory syndrome in children (MIS-C), it can lead to life-threatening problems with the heart and other organs in the body. In this condition, different body parts, such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs, can become inflamed.
Symptoms of MIS-C can include:
- Fever lasting more than a couple of days
- Rash.
- "Bloodshot eyes" (redness of the white part of the eye)
- Stomach ache
- Vomiting and/or diarrhoea
- A large, swollen lymph node in the neck
- Neck pain
- Red, cracked lips
- A tongue that is redder than usual and looks like a strawberry
- Swollen hands and/or feet
- Irritability and/or unusual sleepiness or weakness
Many conditions can cause symptoms similar to those of MIS-C. Your doctor will first want to know if your child has been around someone who has tested positive for the virus and will ask about all of the above symptoms.
Results of the physical examination, a Covid-19 diagnostic or blood antibody test, and other medical tests that check for inflammation and how organs are functioning can support the diagnosis of MIS-C.
The journal Lancet Child & Adolescent Health published a study that looked at the long-term health effects of MIS-C on 46 children hospitalised with MIS-C between April and September 2020.
All of the children had systemic inflammation; most also had problems related to gastrointestinal, heart, and kidney function, and clot formation. By six months after the children were discharged from the hospital, most of these problems had resolved, without lasting organ damage in most cases. About one-third of the children continued to have muscle weakness, fatigue, and mental health difficulties. But the study could not determine whether these effects were due to MIS-C in particular, or to hospitalisation, or other factors.
Call the doctor if your child develops symptoms, particularly if their fever lasts for more than a couple of days. If the symptoms get any worse or just don't improve, call again or bring your child to an emergency room.
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