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Educational Setting and SARS-CoV-2 Transmission Among Children With Multisystem Inflammatory Syndrome: A French
Celia Guenver1,2, Mehdi Oualha3, Corinne Levy4,5
1Assistance Publique-Hôpitaux de Paris, Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France.
Insights
Multisystem inflammatory syndrome in children (MIS-C) cases are primarily linked to household SARS-CoV-2 transmission, not schools. School closures may not significantly impact the overall burden of MIS-C in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection in pediatric populations.
- School closures were implemented globally to curb SARS-CoV-2 spread, but their impact on MIS-C incidence is unclear.
Purpose of the Study:
- To evaluate the role of educational settings in SARS-CoV-2 transmission among children diagnosed with MIS-C.
- To determine the primary sources of SARS-CoV-2 infection leading to MIS-C in children.
Main Methods:
- A French national prospective surveillance study of MIS-C was conducted from April 2020 to March 2021.
- All children meeting the WHO definition for MIS-C were included, and SARS-CoV-2 transmission sources were traced.
- The proportion of MIS-C cases with educational setting-related infections during school opening periods was the primary outcome.
Main Results:
- 142 children with MIS-C were identified; 104 cases occurred during school opening periods.
- The majority of infections during school opening (60%) were linked to household contacts, with only 5% attributed to educational settings.
- Household transmission remained the predominant source (66%) even during school closure periods.
Conclusions:
- SARS-CoV-2 transmission leading to MIS-C in children predominantly occurs within the family environment.
- Educational settings play a minimal role in the transmission chains resulting in MIS-C.
- Reducing school attendance may not substantially decrease the overall incidence of MIS-C in children.
Abstract:
Background: Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. To reduce the spread of SARS-CoV-2 at the population level, educational setting closure have been implemented in many countries. However, the direct benefit of school closure on the MIS-C burden remains to be explored. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C. Methods: We conducted a French national prospective surveillance of MIS-C, coordinated by Public Health France, from April 2020 to March 2021. During this period, we included all children with MIS-C fulfilling the WHO definition who were reported to Public Health France. For each child, we traced the source of SARS-CoV-2 transmission. The main outcome was the proportion of children with MIS-C, with educational setting-related SARS-CoV-2 infection, during the period of school opening. Results: We included 142 children fulfilling WHO criteria for MIS-C: 104 (70%) cases occurred during school opening periods. In total, 62/104 children (60%, 95%CI [50; 69]) had been contaminated by a household contact and 5/104 in educational settings (5%, 95%CI [2; 11]). Among children with MIS-C occurring during school closure periods, the proportion of household transmission remained similar (66%, 25/38). Conclusion: Children with MIS-C were mainly infected by SARS-CoV-2 within their family environment, and the educational setting played a marginal role in this transmission. This suggests that mitigating school attendance may not reduce substantially the burden of MIS-C.
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