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.
Highlights
Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening emerging disease associated with SARS-CoV2 infection
All children fulfilling World Health Organization (WHO) criteria for MIS-C up to March 30, 2021 and for whom an electronic case report was completed were included in this study
Among the 172 pediatric patients reported to the French National Public Health Agency with WHO criteria for MIS-C and a completed case report form, 30 children were not included because the source of infection was not investigated or had missing data; 142 children were included (Figure 1)
Summary
Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening emerging disease associated with SARS-CoV2 infection. Several non-pharmaceutical interventions implemented during the COVID-19 pandemic included school closure in more than 150 countries [2]. After simulation studies [3], several countries including the United Kingdom, Germany and Italy closed educational institutions to mitigate the new wave of COVID-19 in winter 2020-21, and France again in April 2021. This intervention is likely to be discussed again to fight further waves of epidemics. Multisystem inflammatory syndrome in children (MIS-C) is the most severe form associated with SARS-CoV-2 infection in children. We aimed to assess the role of educational settings in SARS-CoV-2 transmission among children with MIS-C.
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