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Mele-Casas M, Launes C, de Sevilla MF, Hernandez-Garcia M, Pons-Tomas G, Bassat Q, Fumado V, Fortuny C, Garcia-Miquel A, Bonet-Carne E, Prats C, Ajanovic S, Cubells M, Claverol J, Penela-Sanchez D, Jou C, Arias S, Balanza N, Baro B, Millat-Martinez P, Alonso S, Alvarez-Lacalle E, Catala M, Cuadras D, Muñoz-Almagro C, Gratacos E, Jordan I, Garcia-Garcia JJ. Low transmission of SARS-CoV-2 derived from children in family clusters: An observational study of family households in the Barcelona Metropolitan Area, Spain. PLoS One 2022; 17:e0277754. [PMID: 36395194 PMCID: PMC9671318 DOI: 10.1371/journal.pone.0277754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 11/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Family clusters offer a good opportunity to study viral transmission in a stable setting. We aimed to analyze the specific role of children in transmission of SARS-CoV-2 within households. METHODS A prospective, longitudinal, observational study, including children with documented acute SARS-CoV-2 infection attending 22 summer-schools in Barcelona, Spain, was performed. Moreover, other patients and families coming from other school-like environments that voluntarily accessed the study were also studied. A longitudinal follow-up (5 weeks) of the family clusters was conducted to determine whether the children considered to be primary cases were able to transmit the virus to other family members. The household reproduction number (Re*) and the secondary attack rate (SAR) were calculated. RESULTS 1905 children from the summer schools were screened for SARS-CoV-2 infection and 22 (1.15%) tested positive. Moreover, 32 additional children accessed the study voluntarily. Of these, 37 children and their 26 households were studied completely. In half of the cases (13/26), the primary case was considered to be a child and secondary transmission to other members of the household was observed in 3/13, with a SAR of 14.2% and a Re* of 0.46. Conversely, the SAR of adult primary cases was 72.2% including the kids that gave rise to the contact tracing study, and 61.5% without them, and the estimated Re* was 2.6. In 4/13 of the paediatric primary cases (30.0%), nasopharyngeal PCR was persistently positive > 1 week after diagnosis, and 3/4 of these children infected another family member (p<0.01). CONCLUSIONS Children may not be the main drivers of the infection in household transmission clusters in the study population. A prolonged positive PCR could be associated with higher transmissibility.
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Affiliation(s)
- Maria Mele-Casas
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Cristian Launes
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mariona F. de Sevilla
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- * E-mail:
| | - Maria Hernandez-Garcia
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Gemma Pons-Tomas
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Quique Bassat
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
| | - Victoria Fumado
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Claudia Fortuny
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Aleix Garcia-Miquel
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
| | - Elisenda Bonet-Carne
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Clara Prats
- Department of Physics, Computational Biology and Complex Systems (BIOCOM-SC), Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Sara Ajanovic
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Marta Cubells
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Fundació Sant Joan de Déu, Barcelona, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Fundació Sant Joan de Déu, Barcelona, Spain
| | - Daniel Penela-Sanchez
- Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Cristina Jou
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Department of Pathology and Biobank, Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERER, Instituto de Salud Carlos III, Barcelona, Spain
| | - Sara Arias
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Nuria Balanza
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Barbara Baro
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | | | - Sergio Alonso
- Department of Physics, Computational Biology and Complex Systems (BIOCOM-SC), Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Enric Alvarez-Lacalle
- Department of Physics, Computational Biology and Complex Systems (BIOCOM-SC), Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Marti Catala
- Centre for Comparative Medicine and Bioimage (CMCiB), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Daniel Cuadras
- Statistics Department, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Eduard Gratacos
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBERER, Instituto de Salud Carlos III, Barcelona, Spain
| | - Iolanda Jordan
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Juan Jose Garcia-Garcia
- Pediatric Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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2
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Alonso S, Català M, López D, Álvarez-Lacalle E, Jordan I, García-García JJ, Fumadó V, Muñoz-Almagro C, Gratacós E, Balanza N, Varo R, Millat P, Baro B, Ajanovic S, Arias S, Claverol J, de Sevilla MF, Bonet-Carne E, Garcia-Miquel A, Coma E, Medina-Peralta M, Fina F, Prats C, Bassat Q. Individual prevention and containment measures in schools in Catalonia, Spain, and community transmission of SARS-CoV-2 after school re-opening. PLoS One 2022; 17:e0263741. [PMID: 35171936 PMCID: PMC8849486 DOI: 10.1371/journal.pone.0263741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Despite their clear lesser vulnerability to COVID-19, the extent by which children are susceptible to getting infected by SARS-CoV-2 and their capacity to transmit the infection to other people remains inadequately characterized. We aimed to evaluate the role of school reopening and the preventive strategies in place at schools in terms of overall risk for children and community transmission, by comparing transmission rates in children as detected by a COVID-19 surveillance platform in place in Catalonian Schools to the incidence at the community level. METHODS AND FINDINGS Infections detected in Catalan schools during the entire first trimester of classes (September-December 2020) were analysed and compared with the ongoing community transmission and with the modelled predicted number of infections. There were 30.486 infections (2.12%) documented among the circa 1.5M pupils, with cases detected in 54.0% and 97.5% of the primary and secondary centres, respectively. During the entire first term, the proportion of "bubble groups" (stable groups of children doing activities together) that were forced to undergo confinement ranged between 1 and 5%, with scarce evidence of substantial intraschool transmission in the form of chains of infections, and with ~75% of all detected infections not leading to secondary cases. Mathematical models were also used to evaluate the effect of different parameters related to the defined preventive strategies (size of the bubble group, number of days of confinement required by contacts of an index case). The effective reproduction number inside the bubble groups in schools (R*), defined as the average number of schoolmates infected by each primary case within the bubble, was calculated, yielding a value of 0.35 for primary schools and 0.55 for secondary schools, and compared with the outcomes of the mathematical model, implying decreased transmissibility for children in the context of the applied measures. Relative homogenized monthly cumulative incidence ([Formula: see text]) was assessed to compare the epidemiological dynamics among different age groups and this analysis suggested the limited impact of infections in school-aged children in the context of the overall community incidence. CONCLUSIONS During the fall of 2020, SARS-CoV-2 infections and COVID-19 cases detected in Catalan schools closely mirrored the underlying community transmission from the neighbourhoods where they were set and maintaining schools open appeared to be safe irrespective of underlying community transmission. Preventive measures in place in those schools appeared to be working for the early detection and rapid containment of transmission and should be maintained for the adequate and safe functioning of normal academic and face-to-face school activities.
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Affiliation(s)
- Sergio Alonso
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Martí Català
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Daniel López
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | | | - Iolanda Jordan
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan José García-García
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Victoria Fumadó
- Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Núria Balanza
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Rosauro Varo
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Pere Millat
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Bàrbara Baro
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Sara Ajanovic
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Sara Arias
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Fundació Sant Joan de Déu, Barcelona, Spain
| | - Mariona Fernández de Sevilla
- Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Elisenda Bonet-Carne
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Universitat Politècnica de Catalunya BarcelonaTech, Barcelona, Spain
| | - Aleix Garcia-Miquel
- BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
| | - Ermengol Coma
- Sistema d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Manuel Medina-Peralta
- Sistema d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Francesc Fina
- Sistema d’Informació dels Serveis d’Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Spain
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Quique Bassat
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- ICREA, Catalan Institution for Research and Advanced Studies, Barcelona, Spain
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3
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Dobaño C, Alonso S, Fernández de Sevilla M, Vidal M, Jiménez A, Pons Tomas G, Jairoce C, Melé Casas M, Rubio R, Hernández García M, Ruiz-Olalla G, Girona-Alarcón M, Barrios D, Santano R, Mitchell RA, Puyol L, Mayer L, Chi J, Rodrigo Melero N, Carolis C, Garcia-Miquel A, Bonet-Carne E, Claverol J, Cubells M, Fortuny C, Fumadó V, Jou C, Muñoz-Almagro C, Izquierdo L, Bassat Q, Gratacós E, Aguilar R, García-García JJ, Moncunill G, Jordan I. Antibody conversion rates to SARS-CoV-2 in saliva from children attending summer schools in Barcelona, Spain. BMC Med 2021; 19:309. [PMID: 34809617 PMCID: PMC8608564 DOI: 10.1186/s12916-021-02184-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/09/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Surveillance tools to estimate viral transmission dynamics in young populations are essential to guide recommendations for school opening and management during viral epidemics. Ideally, sensitive techniques are required to detect low viral load exposures among asymptomatic children. We aimed to estimate SARS-CoV-2 infection rates in children and adult populations in a school-like environment during the initial COVID-19 pandemic waves using an antibody-based field-deployable and non-invasive approach. METHODS Saliva antibody conversion defined as ≥ 4-fold increase in IgM, IgA, and/or IgG levels to five SARS-CoV-2 antigens including spike and nucleocapsid constructs was evaluated in 1509 children and 396 adults by high-throughput Luminex assays in samples collected weekly in 22 summer schools and 2 pre-schools in 27 venues in Barcelona, Spain, from June 29th to July 31st, 2020. RESULTS Saliva antibody conversion between two visits over a 5-week period was 3.22% (49/1518) or 2.36% if accounting for potentially cross-reactive antibodies, six times higher than the cumulative infection rate (0.53%) assessed by weekly saliva RT-PCR screening. IgG conversion was higher in adults (2.94%, 11/374) than children (1.31%, 15/1144) (p=0.035), IgG and IgA levels moderately increased with age, and antibodies were higher in females. Most antibody converters increased both IgG and IgA antibodies but some augmented either IgG or IgA, with a faster decay over time for IgA than IgG. Nucleocapsid rather than spike was the main antigen target. Anti-spike antibodies were significantly higher in individuals not reporting symptoms than symptomatic individuals, suggesting a protective role against COVID-19. CONCLUSION Saliva antibody profiling including three isotypes and multiplexing antigens is a useful and user-friendlier tool for screening pediatric populations to detect low viral load exposures among children, particularly while they are not vaccinated and vulnerable to highly contagious variants, and to recommend public health policies during pandemics.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain. .,CIBER de Enfermedades Infecciosas, Madrid, Spain. .,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Mariona Fernández de Sevilla
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Pons Tomas
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Chenjerai Jairoce
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - María Melé Casas
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - María Hernández García
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Gemma Ruiz-Olalla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Mònica Girona-Alarcón
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Leonie Mayer
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular Screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Aleix Garcia-Miquel
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Elisenda Bonet-Carne
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat Politècnica de Catalunya, BarcelonaTech, Barcelona, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Marta Cubells
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Claudia Fortuny
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Victoria Fumadó
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristina Jou
- Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Department of Pathology and Biobank Hospital Sant Joan de Déu, Barcelona, Spain.,CIBERER, Instituto de Salud Carlos III, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain.,Molecular Microbiology Department, Hospital Sant Joan de Déu, Esplugues, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - Eduard Gratacós
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Juan José García-García
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain.,CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Iolanda Jordan
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Institut de Recerca Sant Joan de Déu, Esplugues, Barcelona, Spain. .,Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
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4
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Jordan I, de Sevilla MF, Fumado V, Bassat Q, Bonet-Carne E, Fortuny C, Garcia-Miquel A, Jou C, Adroher C, Casas MM, Girona-Alarcon M, Garcia MH, Tomas GP, Ajanovic S, Arias S, Balanza N, Baro B, Millat-Martinez P, Varo R, Alonso S, Álvarez-Lacalle E, López D, Claverol J, Cubells M, Brotons P, Codina A, Cuadras D, Bruijning-Verhagen P, Faust S, Munro A, Muñoz-Almagro C, Català M, Prats C, Garcia-Garcia JJ, Gratacós E. Transmission of SARS-CoV-2 infection among children in summer schools applying stringent control measures in Barcelona, Spain. Clin Infect Dis 2021; 74:66-73. [PMID: 33709138 PMCID: PMC7989514 DOI: 10.1093/cid/ciab227] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Understanding the role of children in SARS-CoV-2 transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools. METHODS During July 2020 we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through: (1) surveillance program in 22 summer schools' of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 RT-PCR during 2-5 weeks; (2)cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centres followed prevention protocols: bubble groups, hand washing, facemasks and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and effective reproduction number in summer schools(R*) were calculated. RESULTS Among the over 2000 repeatedly screened participants, 30children and 9adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median 9 (IQR 5-10) for each primary case), among which twelve new cases (4.7%) were positive for SARS-CoV-2. The R* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9. CONCLUSIONS The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission and supports current recommendations for school opening.
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Affiliation(s)
- Iolanda Jordan
- Paediatric Intensive Care Unit. Hospital Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Victoria Fumado
- Infectious Diseases Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Quique Bassat
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatric Service. Hospital Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,ICREA, Pg. Lluís Companys 23, 08010 Barcelona, Spain
| | - Elisenda Bonet-Carne
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat Politècnica de Catalunya • BarcelonaTech
| | - Claudia Fortuny
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Aleix Garcia-Miquel
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain
| | - Cristina Jou
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Department of Pathology and Biobank Hospital Sant Joan de Deu.,CIBERER, Instituto de Salud Carlos III. Barcelona, Spain
| | - Cristina Adroher
- Deputy Director of Strategic Planning and Management Control- Hospital Sant Joan de Déu (Barcelona)
| | - María Melé Casas
- Pediatric Service. Hospital Sant Joan de Déu, University of Barcelona. Barcelona, Spain
| | - Mònica Girona-Alarcon
- Paediatric Intensive Care Unit. Hospital Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain
| | | | - Gemma Pons Tomas
- Pediatric Service. Hospital Sant Joan de Déu, University of Barcelona. Barcelona, Spain
| | - Sara Ajanovic
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sara Arias
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Núria Balanza
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Bárbara Baro
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Pere Millat-Martinez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Rosauro Varo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sergio Alonso
- Computational Biology and Complex Systems (BIOCOM-SC). Department of Physics. Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Enric Álvarez-Lacalle
- Computational Biology and Complex Systems (BIOCOM-SC). Department of Physics. Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Daniel López
- Computational Biology and Complex Systems (BIOCOM-SC). Department of Physics. Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Joana Claverol
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Marta Cubells
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Fundació Sant Joan de Déu, Barcelona, Spain
| | - Pedro Brotons
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Anna Codina
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Department of Pathology and Biobank Hospital Sant Joan de Deu
| | - Daniel Cuadras
- Statistics Department, Fundació Sant Joan de Déu, Barcelona, Spain
| | - Patricia Bruijning-Verhagen
- Julius Centre for Health Sciences, department of infectious diseases epidemiology, University Medical Center Utrecht
| | - Saul Faust
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital NHS Foundation Trust; and Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Alasdair Munro
- NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital NHS Foundation Trust; and Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Carmen Muñoz-Almagro
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Martí Català
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Clara Prats
- Computational Biology and Complex Systems (BIOCOM-SC). Department of Physics. Universitat Politècnica de Catalunya, Castelldefels, Spain
| | - Juan José Garcia-Garcia
- Institut de Recerca Sant Joan de Déu, University of Barcelona. Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatric Service. Hospital Sant Joan de Déu, University of Barcelona. Barcelona, Spain
| | - Eduard Gratacós
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
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Curto S, Garcia-Miquel A, Suh M, Vidal N, Lopez-Villegas JM, Prakash P. Design and characterisation of a phased antenna array for intact breast hyperthermia. Int J Hyperthermia 2017; 34:250-260. [PMID: 28605946 DOI: 10.1080/02656736.2017.1337935] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Currently available hyperthermia technology is not well suited to treating cancer malignancies in the intact breast. This study investigates a microwave applicator incorporating multiple patch antennas, with the goal of facilitating controllable power deposition profiles for treating lesions at diverse locations within the intact breast. MATERIALS AND METHODS A 3D-computational model was implemented to assess power deposition profiles with 915 MHz applicators incorporating a hemispheric groundplane and configurations of 2, 4, 8, 12, 16 and 20 antennas. Hemispheric breast models of 90 mm and 150 mm diameter were considered, where cuboid target volumes of 10 mm edge length (1 cm3) and 30 mm edge length (27 cm3) were positioned at the centre of the breast, and also located 15 mm from the chest wall. The average power absorption (αPA) ratio expressed as the ratio of the PA in the target volume and in the full breast was evaluated. A 4-antenna proof-of-concept array was fabricated and experimentally evaluated. RESULTS Computational models identified an optimal inter-antenna spacing of 22.5° along the applicator circumference. Applicators with 8 and 12 antennas excited with constant phase presented the highest αPA at centrally located and deep-seated targets, respectively. Experimental measurements with a 4-antenna proof-of-concept array illustrated the potential for electrically steering power deposition profiles by adjusting the relative phase of the signal at antenna inputs. CONCLUSIONS Computational models and experimental results suggest that the proposed applicator may have potential for delivering conformal thermal therapy in the intact breast.
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Affiliation(s)
- Sergio Curto
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA.,b Department of Radiation Oncology , Erasmus MC Cancer Institute , Rotterdam , The Netherlands
| | | | - Minyoung Suh
- d Department of Textile and Apparel, Technology and Management, College of Textiles , North Carolina State University , Raleigh , NC , USA
| | - Neus Vidal
- c Electronics Department , University of Barcelona , Barcelona , Spain
| | | | - Punit Prakash
- a Department of Electrical and Computer Engineering , Kansas State University , Manhattan , KS , USA
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