What role do children play in the spread of the coronavirus? That is one of the key questions in the considerations about the possible relaxation of measures to curb the corona outbreak as well as possible. Until now, we know that a covid infection in children is usually mild and sometimes without symptoms.
That does not mean that children can never get a very serious covid infection. For example, a 12-year-old girl died in Belgium and a 16-year-old boy fought in intensive care for his life in Breda.
The Outbreak Management Team, which advises the cabinet on the measures, today met to discuss the role of children in the corona epidemic, among other things. In their advice of April 14, the experts stated that reopening primary schools and nurseries is likely to have little effect on the number of IC beds needed, as infections in children are almost always mild.
But it will inevitably lead to more infections of schoolchildren and their parents and possibly also more infections because it gets busier on the street.
How contagious are children?
It is not disputed that the infections in children in most cases do not lead to serious complaints. But there is a lot of uncertainty about the degree of contagion of children with a mild infection or an infection without symptoms.
Since March 24, RIVM has been investigating the spread of the coronavirus within a hundred families. The results should provide more information about the role of children, but are not expected before 1 June.
Virologists and epidemiologists are also unanimous that people with a severe infection are much more contagious than people with a mild infection. But it is not yet clear how contagious children with a mild infection are; the same goes for children who have an infection without symptoms.
Great research
Researchers from the University of Campinas in the Brazilian state of São Paulo conducted a meta-analysis of 34 studies involving over 1100 participants under the age of 18 who had a Covid-19 infection. More than 1 percent of them became seriously ill and just over 2 percent became seriously ill. More than half of the children in the study had no symptoms, or very mild ones.
However, a small minority of 16 percent of the children had a fever, and even fewer had symptoms of a respiratory infection. These symptoms occur in roughly four out of five patients in adults.
“Fever and symptoms of respiratory infections should not be considered characteristic of covid-19 in children,” the researchers conclude. That makes it difficult to make diagnoses, so it is not always known whether children are a potential source of infection. Moreover, under the Dutch test policy they are therefore not eligible for a corona test.
Virus in stool
The Brazilian scientists also report that, according to various studies, the coronavirus remains present in the feces and nasal fluid of children with mild or no symptoms for a longer period of time.
One of those studies was published in Nature Medicine last month. The Chinese researchers had tested more than 700 children on covid-19 after contact with proven patients. Ten tested positive for the virus. After treatment, the virus remained detectable in rectal samples much longer than in samples taken from the nose, even after the children had shown negative results in a corona test.
A month earlier, other Chinese researchers in an equally small study in Clinical Infectious Diseases also concluded that children who recover from a covid infection have the virus in their airways and feces for a longer period of time. In the faeces of mild patients, the virus was diagnosed for at least two weeks and in some cases for a month.
Contamination route
Both research groups underline that their results represent “a challenge to contain the corona epidemic” because “the oral-faecal pathway” may play a role in the spread of the coronavirus.
Italian virologist Massimo Gatti, head of infectious diseases at the Sacco Hospital in Milan, recommends flushing the toilet with the lid closed. That is desirable, he said in the Italian newspaper Corriere della Sera, because “every time the toilet is flushed, fine moisture droplets are created with virus particles that can be contagious.” However, such hygiene measures seem difficult to implement at primary schools and nurseries.
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