Arnaud Fontanet, Rebecca Grant, Laura Tondeur, Yoann Madec, Ludivine Grzelak, Isabelle Cailleau, Marie-Noelle Ungeheuer, Charlotte Renaudat, Sandrine Fernandes Pellerin, Lucie Kuhmel, Isabelle Staropoli, Francois Anna, Pierre Charneau, Caroline Demeret, Timothee Bruel, Olivier Schwartz, Bruno Hoen
The extent of SARS-CoV-2 transmission among pupils in primary schools and their families is unknown.
Between 28-30 April 2020, a retrospective cohort study was conducted among pupils, their parents and relatives, and staff of primary schools exposed to SARS-CoV-2 in February and March 2020 in a city north of Paris, France. Participants completed a questionnaire that covered sociodemographic information and history of recent symptoms. A blood sample was tested for the presence of anti-SARS-CoV-2 antibodies using a flow-cytometry-based assay.
The infection attack rate (IAR) was 45/510 (8.8%), 3/42 (7.1%), 1/28 (3.6%), 76/641 (11.9%) and 14/119 (11.8%) among primary school pupils, teachers, non-teaching staff, parents, and relatives, respectively (P = 0.29). Prior to school closure on February 14, three SARS-CoV-2 infected pupils attended three separate schools with no secondary cases in the following 14 days among pupils, teachers and non-teaching staff of the same schools. Familial clustering of cases was documented by the high proportion of antibodies among parents and relatives of infected pupils (36/59 = 61.0% and 4/9 = 44.4%, respectively). In children, disease manifestations were mild, and 24/58 (41.4%) of infected children were asymptomatic.
In young children, SARS-CoV-2 infection was largely mild or asymptomatic and there was no evidence of onwards transmission from children in the school setting.