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BRIEF RESEARCH REPORT article

Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1378701

High SARS-CoV-2 Secondary Infection Rates in Households with Children in Georgia, USA, Fall 2020 -Winter 2021

Provisionally accepted
Kacy D. Nowak Kacy D. Nowak 1Morgan A. Lane Morgan A. Lane 2Armand M. Mbanya Armand M. Mbanya 3Jasmine R. Carter Jasmine R. Carter 4Brianna A. Binion Brianna A. Binion 3Daniel O. Espinoza Daniel O. Espinoza 2Matthew H. Collins Matthew H. Collins 2Christopher D. Heaney Christopher D. Heaney 5Nora Pisanic Nora Pisanic 6Kate Kruczynski Kate Kruczynski 6Kristoffer Spicer Kristoffer Spicer 6Gregory Rivera Gregory Rivera 6Felicia Glover Felicia Glover 7Tolulope Ojo-Akosile Tolulope Ojo-Akosile 2Robert Breiman Robert Breiman 2,4Evan J. Anderson Evan J. Anderson 7,8Felipe Lobelo Felipe Lobelo 3,4Jessica K. Fairley Jessica K. Fairley 1,2*
  • 1 Hubert Department of Public Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States
  • 2 Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia, United States
  • 3 The Southeast Permanente Medical Group, Inc., Atlanta, Georgia, United States
  • 4 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States
  • 5 Department of Environmental Health and Engineering; Department of Epidemiology; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
  • 6 Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
  • 7 Center for Childhood Infections and Vaccines, Children's Healthcare of Atlanta, Atlanta, Colorado, United States
  • 8 Department of Medicine, Division of Infectious Diseases; Department of Pediatrics, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, Georgia, United States

The final, formatted version of the article will be published soon.

    Background: A wide range of household secondary infection rates has been reported, and the role of children in population transmission dynamics for SARS-CoV-2 remains ill-defined. We sought to better understand household infection at the early in the pandemic.A cross-sectional study of 17 households in the Atlanta metropolitan area with at least one child and one case of COVID-19 in the prior 1-4 months were recruited between December 2020 to April 2021. Self-collected saliva samples were tested on a multiplexed platform to detect IgG antibodies that bind to SARS-CoV-2 antigens. Secondary infection rates (SIR) were calculated and compared.We report results on 17 families, including 66 individuals. We found an average SIR of 0.58; children and adults were similarly infected (62% children vs 75% adults (p=0.2). Two out of 17 households had a pediatric index per our definition. Number of pediatric infections (p=0.18), isolation (p= 0.34), and mask wearing (p=0.80) did not differ significantly among households with an SIR above the mean vs those with SIR below the mean. Households with higher SIR also had a higher number of symptomatic cases (p<0.001).Discussion: We demonstrated high household SIRs at the early stages of the pandemic in late 2020 to early 2021 with similar impact on children and adults. The ease of collecting saliva and the detection of asymptomatic infections highlight the advantages of this strategy and potential for scale-up.

    Keywords: Severe acute respiratory syndrome coronavirus 2, COVID-19, pediatric COVID-19, household and family, Communicable disease transmission

    Received: 30 Jan 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Nowak, Lane, Mbanya, Carter, Binion, Espinoza, Collins, Heaney, Pisanic, Kruczynski, Spicer, Rivera, Glover, Ojo-Akosile, Breiman, Anderson, Lobelo and Fairley. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jessica K. Fairley, Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, 30322, Georgia, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.