{
  "abstract": "Objective There has been significant debate about both the role of children in SARS-CoV-2 community transmission as well as the potential harm or lack thereof of the virus in the paediatric population. We aimed to better understand how children are impacted by a SARS-CoV-2 household infection and to identify behavioural and social factors related to infection.Methods A cross-sectional study was conducted on households with children and a recent SARS-CoV-2 infection in Atlanta, GA. Participants were enrolled from December 2020 through November 2021. Salivary IgG against SARS-CoV-2 spike and nucleocapsid antigens was measured and household and infection data collected and analysed.Results 49 households participated, including 121 adults and 57 children with 118 (66%) individuals having been infected with SARS-CoV-2. Mean SARS-CoV-2 secondary infection rate was 0.55 (95% CI 0.41 to 0.69) and median, 0.67 (range 0–1.0). Incidence rate did not differ significantly between households with paediatric versus adult index cases (incidence rate ratio (IRR) 0.97, 95% CI 0.63 to 1.49). However, sharing a bedroom or bathroom was associated with a higher incidence of secondary infection (IRR 2.36, 95% CI 1.49 to 3.74). Neighbourhood deprivation index was associated with higher household SARS-CoV-2 incidence, but this did not reach statistical significance.Conclusions Child index cases appeared as likely to result in household secondary SARS-CoV-2 infections as adult index cases, while sharing rooms was associated with higher incidence of infection. This study highlights the importance of isolation measures to prevent household transmission of SARS-CoV-2 as well as counters common thought that children are less likely to transmit infection.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA",
        "Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"
      ],
      "name": "Jessica K Fairley"
    },
    {
      "affiliations": [
        "Department of Quality and Patient Safety, Southeast Permanente Medical Group Inc, Atlanta, Georgia, USA"
      ],
      "name": "Serena S Leung"
    },
    {
      "affiliations": [
        "Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA",
        "Department of Quality and Patient Safety, Southeast Permanente Medical Group Inc, Atlanta, Georgia, USA"
      ],
      "name": "Brianna A Binion"
    },
    {
      "affiliations": [
        "Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"
      ],
      "name": "Kacy D Nowak"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Morgan A Lane"
    },
    {
      "affiliations": [
        "Department of Quality and Patient Safety, Southeast Permanente Medical Group Inc, Atlanta, Georgia, USA"
      ],
      "name": "Armand Mbanya"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"
      ],
      "name": "Jasmine R Carter"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Daniel O Espinoza"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Matthew H Collins"
    },
    {
      "affiliations": [
        "Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta Inc, Atlanta, Georgia, USA"
      ],
      "name": "Felicia Glover"
    },
    {
      "affiliations": [
        "Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA",
        "Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA",
        "Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Christopher D Heaney"
    },
    {
      "affiliations": [
        "Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Nora Pisanic"
    },
    {
      "affiliations": [
        "Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Kate Kruczynski"
    },
    {
      "affiliations": [
        "Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Kristoffer Spicer"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Tolulope Ojo-Akosile"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"
      ],
      "name": "Robert F Breiman"
    },
    {
      "affiliations": [
        "Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta Inc, Atlanta, Georgia, USA",
        "Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Evan J Anderson"
    },
    {
      "affiliations": [
        "Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA",
        "Department of Quality and Patient Safety, Southeast Permanente Medical Group Inc, Atlanta, Georgia, USA"
      ],
      "name": "Felipe Lobelo"
    }
  ],
  "title": "Roles of children, isolation measures and socioeconomic status in SARS-CoV-2 household transmission: a retrospective cohort study in a southern US city",
  "uid": "3912adb9-0068-5161-a4a2-d6ec58cfe4e9"
}