Children aren't at great risk for coronavirus, WHO report says, but some doctors aren't so sure

Adrianna Rodriguez, USA TODAY•March 6, 2020
A report spearheaded by international public health leaders suggests that children aren’t particularly vulnerable to the coronavirus that so far has infected more than 95,000 people and killed more than 3,200 worldwide.

According to a report released last month by the Joint Mission and the World Health Organization-China, individuals under the age of 18 experience a “relatively low attack rate" of the virus, about 2.4%.

Scientists found the virus to be “relatively mild" among individuals under 19 years old, with only 2.5% of the reported cases developing into a severe disease and 0.2% developing into a critical disease, the report said. The Chinese Center for Disease Control and Prevention said in a Feb. 24 report that no children in China under the age of nine have died from the infection.

But some U.S. experts say the report, based on research from the team of health officials who visited virus hot spots in three Chinese provinces, may underestimate the infection rate among children.

Dr. John Williams, chief of pediatric infectious diseases at UPMC Children’s Hospital of Pittsburgh, said a lack of testing among patients with milder symptoms paints a crude picture of the infection.

"Many of us in the field suspect kids are only being found through tracing their sicker adults contacts, but if we were able to test lots of mild disease, we’d probably find that many children are infected," he said.

Williams said it's unlikely children would be less likely to be infected by the new coronavirus.

"There are no data to tell us how likely kids are to contract COVID-19 since almost all the testing is in hospitalized patients" and children are rarely hospitalized for the illness, he said.

Dr. Robert Frenck, medical director of the Division of Infectious Diseases at Cincinnati Children's Hospital Medical Center, agreed with Williams that too much is unknown about the virus to say definitively if children are less likely to be infected.

"The case definition for COVID-19 has been developed for more severe disease," he said. "So, at this time I don't think we know the likelihood of children becoming infected with COVID-19 and developing milder illnesses."

However, Dr. W. Garrett Hunt, a pediatric infectious diseases physician at Nationwide Children’s Hospital, said in an email to USA TODAY that the low infection rate among children seems to be consistent with what is know about MERS, SARS and other related coronaviruses that cause respiratory disease.

In China, human-to-human transmission of the COVID-19 is largely occurring within families, the Joint Mission-WHO findings suggested. Children in the city of Wuhan infected as of Feb. 24 were identified by tracing back to their households.

“Household transmission studies are currently underway, but preliminary studies ongoing in Guangdong (province) estimate the secondary attack rate in households ranges from 3%-10%,” the report said.

Frenck said such secondary infection is common among all respiratory viruses.

"Family spread of any respiratory virus is common due to the close and repeated contact within families," he said. It's also common to spread the virus by having contact with a contaminated surface, like a countertop.

Among the nearly 56,000 laboratory-confirmed cases reported as of Feb. 20, the median age of coronavirus infection is 51 years old with the majority of cases occurring between the ages of 30 to 69 years old.

The demographic with the highest risk for complications and death include people over 60 years old and those with underlying conditions such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer.