Children under the age of 5 have 10 to 100 times more genetic material of the new coronavirus in their nose compared to older children and adults, according to a small study published Thursday in the journal JAMA Pediatrics.
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GLASGOW, SCOTLAND – JANUARY 28: Children wave their hands at a private nursery school on January 28, 2005 in Glasgow, Scotland. The average price of preschool care increased in the past year, bringing child care prices to an average of £ 200 in parts of the southeast. Many parents working in the UK have applied for subsidies for the care of preschool-age children, such as those in France, where almost 100% of three-year-olds are in preschool, despite the fact that school attendance it is not compulsory until they are five years old. (Photo by Christopher Furlong / Getty Images)
While the study did not measure transmissibility, it raises questions, just as schools begin to reopen, about the ease with which the new coronavirus can spread through the under-5 ensemble.
“We had just realized that some of the children we were testing for SARS CoV-2 were positive, the younger children seemed to have a high amount of viral nucleic acid, a high viral load in the nose, compared to some of our older children and adults, “lead author Dr. Taylor Heald-Sargent, a pediatric infectious disease specialist at Lurie Children’s Hospital in Chicago, told CNN. “And so, when … we actually ran the numbers, controlled by a few things, we discovered that there was actually a statistically significant greater amount of genes encoded by SARS, which generally correlates with more viruses, in the nose of younger children five years, compared to older children and adults. “
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Heald-Sargent and his team analyzed 145 swab samples collected from patients with mild to moderate Covid-19 within one week of symptom onset; 46 of them were from children under 5 years old, 51 were from 5 to 17 years old, and 48 were from adults between 18 and 65 years old. The samples were collected between the end of March and the end of April from various hospitalized and outpatients. , the emergency department and test drive sites at a pediatric tertiary medical center in Chicago.
They found that those under the age of 5 had a statistically significant higher amount of virus particles in the nose that correlated with “10 to 100 times more coronavirus in the upper respiratory tract …” the researchers wrote in their Article.
Heald-Sargent says more studies are needed to analyze the transmissibility of SARS-CoV-2 in children. “So far, this transmission does not appear to come primarily from children,” said Heald-Sargent.
But his team noted in the document that, due to the stay-at-home measures implemented in mid-March, many young children had fewer opportunities to broadcast.
“The question was still out there: could it possibly be passed on from children?” she said, noting that the absence of evidence is not evidence of absence.
If other respiratory viruses are an indication, he said, the answer may be yes.
“Any elementary school teacher or pediatrician will tell you, [young children] They are fairly effective small vectors of virus transmission, because we get very sick in the winter from these children, “he said.” I think looking at other viruses that are similar … it seems more likely that children are transmitted. “
Other experts say that while they are not surprised by the findings, it is good to have the study.
“The data in pediatrics has not been as robust as that of adults with Covid-19, so it is really good to have additional virological data in pediatric patients,” said Dr. Alpana Waghmare of Seattle Children’s.
“The authors did a good job comparing a fairly robust sample size of subjects in different age ranges and using a fairly straightforward research design to look at differences in viral load in these age groups,” said Waghmare, an assistant professor at pediatrics. in the pediatric infectious disease division at the University of Washington.
Waghmare said the findings are consistent with other published studies looking at viral loads in a spectrum of respiratory viruses in pediatric populations. “It is not surprising to find higher viral loads in children. I think the question of what exactly that means for transmission is still unclear,” she said.
Dr. Michael Smit, a pediatric infectious disease doctor at Children’s Hospital Los Angeles, agrees, and more.
“We have known for quite some time that for certain respiratory viruses, the youngest children are the breeding ground and are the part of the population that spreads it to the rest of the community,” said Smit, who is also an epidemiologist at the hospital. and the medical director of infection prevention and control.
Smit said it has been shown before with respiratory syncytial virus (RSV), and his own group’s research, published as a research letter in the JAMA Network Open in mid-May, showed the same thing with seasonal coronaviruses. “Therefore, it is a known phenomenon in pediatrics that younger children may be the main drivers of the spread of disease and communities.”
However, there are still questions about the new coronavirus. A recent study in South Korea found that youth ages 10 to 19 transmitted Covid-19 within households as much as adults, but children ages 9 and younger transmitted the virus at much lower rates.
The problem remains, what can you do about it?
“Once you discover the dynamics of how much virus there is and in what age groups it tends to be older and younger, that can help us form strategies for surveillance, testing and isolation,” he said.
Heald-Sargent said that very young children’s “behavioral habits,” for example, a lack of awareness about personal space and personal hygiene, all restless play, practical play, and cleaning of eyes and noses make It is difficult to control any possible spread, but it is important to try.
“It is difficult to get them to wear their masks and wash their hands and not put everything in their mouth and nose,” he said.
“Getting adults to model good behavior, having them encourage their children to wash their hands and wear their mask as much as possible, clean high-contact areas, be careful with diapers” are good practices, he said, adding than young children generally to please their parents.
On a societal level, he said it will also be important to implement infection control practices such as contact tracking and taking steps at school, such as keeping children in the same small groups, to limit the spread.
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