Alliance for Pandemic Preparedness

August 12, 2020

Role of Children in Household Transmission of COVID-19



  • Among 248 household contacts of 107 pediatric COVID-19 index cases, 17% of the contacts (n=41) were subsequently SARS-CoV-2 positive (average follow-up of 11 days). However, all but one contact was determined to have had the same exposure as the pediatric index case.  
  • Index cases were isolated in hospitals or community treatment centers after diagnosis. If the case needed direct care by an uninfected guardian, that guardian was provided with an N95 mask, gloves, full body suit, and goggles.  
  • In the one positive contact that didn’t share an exposure with the index case, the pediatric index case was determined to be the most likely source of exposure, constituting a secondary attack rate of 0.5% [EDITORIAL NOTE: while this secondary attack rate is low, index cases were strictly isolated after their diagnosis was confirmed. Corresponding secondary attack rates from adult index cases are not presented in this study.] 

Kim et al. (Aug 2020). Role of Children in Household Transmission of COVID-19. Archives of Disease in Childhood.