Coronavirus: How babies and kids are affected by COVID-19

Getty Images/iStockphoto
Getty Images/iStockphoto 

All schools in Japan will remain closed from Monday until the end of April in an attempt to contain the spread of coronavirus across the country - leaving many local parents to wonder how they will care for their children while continuing to work for the next two months.  

While the drastic move ahead of the Tokyo Olympics is unlikely to be replicated in Australia, what do parents here need to know about the coronavirus and children?

Fortunately the news relating to children and babies and coronavirus is surprisingly good, with children infected by the virus in locations around the world typically displaying only mild symptoms. Just one child has tested positive in Australia - an eight-year-old boy from Wuhan, China.

Graphic: Tara Blancato / Nine
Graphic: Tara Blancato / Nine  

And research published in The New England Journal of Medicine, which looked at early cases of COVID-19 in Wuhan, China, found no instances of the infection in children under 15.

"It is notable that few of the early cases occurred in children, and almost half the 425 cases were in adults 60 years of age or older ..." the authors wrote at the time. "Furthermore, children might be less likely to become infected or, if infected, may show milder symptoms."

A second study of cases, published in The Lancet  on 20 February, found that only three per cent of patients were younger than 15 years.

"We found a heavy skew of infection towards older age groups, with substantially fewer children infected," the authors wrote, adding that the pattern could reflect age-related differences in susceptibility to infection, severe outcomes, or simply behaviour (such as adults travelling more).

Even cases in babies have been mild.

Research published in JAMA on February 14 looked at cases of coronavirus in infants under the age of one in China. Nine babies were infected between December 8, 2019, and February 6, 2020. The youngest was just one month old and the oldest was 11 months. All babies were hospitalised. One baby had no symptoms but tested positive for the illness. None of the infants became seriously unwell.

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"Given the number of infections reported, the number of infected infants identified was small," the authors wrote. "This may be due to a lower risk of exposure or incomplete identification due to mild or asymptomatic disease, rather than resistance to infection."

But while fewer children have been infected and cases have been mild, what's their role in transmitting the virus?

Currently, that's less clear.

In an interview with the Harvard Gazette on Thursday, Marc Lipsitch an epidemiologist and head of the Harvard TH Chan School of Public Health's Center for Communicable Disease Dynamics, said this remains one of the most important "unanswered questions" particularly in light of school closures.

"The go-to intervention in flu pandemic planning is closing schools, and that may be very effective or it may be totally ineffective," Lipsitch said.

"It's a costly and disruptive thing to do ... So we really need evidence that closing schools would help. We need detailed studies in households of children who are exposed to an infected person. We need to find out if the children get infected, if they shed virus, and if that virus is infectious."

In an article for STAT, Helen Branswell and Megan Thielking also highlight that while the evidence to date suggests the virus doesn't inflict severe disease on children, "there's reason to think kids may be helping to amplify transmission".

"It's a role they play to devastating effect during flu season, becoming ill and passing flu viruses on to their parents, grandparents, teachers, and caregivers," they note. "While the new virus is from a different viral family, its behaviour is more like influenza than its coronavirus cousins, SARS and MERS, making experts wonder if it is doing the same."

Current information from the US Centre for Disease Control (CDC) reiterates there is no evidence that children are more susceptible to the illness. The CDC also notes that those affected in china have presented with "cold-like symptoms", such as fever, runny nose and cough. "Limited reports suggest that children with confirmed COVID-19 have generally presented with mild symptoms, and though severe complications (e.g., acute respiratory distress syndrome, septic shock) have been reported, they appear to be uncommon."

The CDC's current advice to parents is clear: "Children should engage in usual preventive actions to avoid infection, including cleaning hands often using soap and water or alcohol-based hand sanitizer, avoiding people who are sick, and staying up to date on vaccinations, including influenza vaccine."