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If there was any consolation earlier that Covid-19 doesn’t appear to be a major concern for children’s health, the latest study by The Lancet suggests otherwise.
The study published in the medical journal has reaffirmed airborne transmission of Covid-19, making children of all ages equally susceptible to catch infections as their adult counterparts.
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Health authorities in the UAE have subsequently revised guidelines in the country and now suggest that children below three years wear face shields while older kids wear masks to protect themselves from catching the virus.
“The article published in The Lancet has concluded that there is strong, consistent evidence that the primary route of transmission of the novel coronavirus is airborne. This is a game-changer conclusion and, therefore, the public health measures and guidelines were revised accordingly," said Dr Rajshree Ragupathy, Specialist Pediatrician, Aster Clinic, Sheikh Zayed Road.
"Now, more focus will have to be on better-fitting masks, air-filtration, and proper ventilation. Hence, children above three are being advised to wear masks, and children below three years to wear proper face shield. This would hold good especially while indoors where there may not be proper ventilation, air filtration etc,” she added.
“The three Cs to avoid transmission are still: avoid close contact, crowded places, and closed spaces with poor ventilation,” she noted.
Infections in children on the rise
Unlike the initial strain of Sars-CoV-2, in the second wave with mutant strains, more kids are getting infected, said Dr Nilay Nirupam, Specialist Paediatrician, HealthHub Al-Futtaim Clinic. “However, in majority of the cases, symptoms still remain mild. Babies less than a year old and older children with diabetes, asthma, heart disease, obesity, and immunodeficiencies are more vulnerable for severe disease.”
Dr Tanmay Radhakrishnan Amladi, Specialist Peadiatrician, Prime Medical Center, explained: “In the UAE, there has been an increase in the number of children getting infected, especially if one of the family members has been infected with the Covid-19 virus. However, with recent evidence suggesting airborne transmission, only time will tell whether they can also be infected through airborne mutant strains. Until then, it's safer for children, especially the younger ones to be protected even outdoors with the use of masks or face shields.”
Meanwhile, there risk of transmission between mothers and newborns is still low. “Risk of vertical transmission to newborns of mothers who have tested positive near time of delivery is low (1.5-2 per cent)," stated Dr Nirupam. "However, they are more likely to have horizontal transmission from infected mothers/care givers. Therefore, it’s important to maintain appropriate respiratory hygiene when handling babies.”
The doctor added that breastfeeding is supported and encouraged with mothers wearing surgical masks, and washing hands and breasts with soap/water prior to breastfeeding.
Protecting kids in the absence of a vaccination
Making kids follow Covid safety norms, such as wearing masks/face shields, observing social distancing, frequent handwashing, and avoiding crowded areas and parties, are the best options to keep them safe.
“Ensure the regular vaccinations for kids including annual influenza vaccinations are up to date. Diet should contain immunity-boosting nutrients, rich in vitamin B-complex, C, D and Zinc. Parents and caregivers should also ensure plenty of water intake for them, and encourage healthy lifestyle and physical exercise,” said Dr Nirupam.
“The most important way to prevent the infection in children now is vaccinating all eligible adults as early as possible, thereby reducing the incidence of the disease in general population. Vaccines have even proven to protect breast-fed infants from this disease through antibodies from vaccinated mothers,” added Dr Ragupathy.
Get children tested for Covid
Parents should also shed their reluctance to get their children tested for Covid-19 if they display symptoms, UAE docs opined.
“It is not necessary to wait for a certain number of days of a febrile illness before getting the child tested. Also, parents should consider their child's health and safety rather than a few seconds of discomfort of getting the test done. The concept that ‘any way there is no specific treatment, so why do the test?’ can put a child at risk of a severe form of Covid-19 infection known as multisystemic inflammatory syndrome which can be life-threatening,” says Dr Tanmay.
“There have been fresh reports of severe Covid-19 infection in children in India, who presented with pneumonia, respiratory distress and have received intensive care treatment with ventilator support,” he added. Prevention is, therefore, always better than cure.
Typical symptoms in children
Common symptoms of Covid-19 in children are cough and fever. Other symptoms include:
> Shortness of breath
> Sore throat
> Diarrhoea
> Body pain
> Nasal congestion
> Abdominal pain
> Conjunctivitis
> Rashes
> Loss of sense of smell and taste
A very small portion of children infected by Covid tend to develop severe complications like multi-system inflammatory syndrome, or MIS-C — an inflammation of various organs of the body which requires immediate hospitalisation and careful monitoring.
While such cases are still very few, the emergency warning signs of MIS-C are:
> Severe stomach pain
> Difficulty in breathing
> Pale grey or blue coloured skin, lips or nail beds
> New confusion
> Inability to wake up or stay awake
In such situations, it is advised to seek medical help immediately, said Dr Rajshree.
suneeti@khaleejtimes.com
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