University of Wisconsin–Madison Medical College of Wisconsin

Evidence of Early Household Transmission of SARS-CoV-2 Involving a School-Aged Child

Jonathan L. Temte, MD, PhD; Shari Barlow, BA; Emily Temte, BA; Maureen Goss, MPH; Kelsey Florek, PhD, MPH; Katarina M. Braun, MD; Thomas C. Friedrich, PhD; Erik Reisdorf, MS; Allen C. Bateman, PhD, MPH; Amra Uzicanin, MD, MPH

WMJ. 2021;120(3):233-236.

Download full text pdf.


Introduction: Little is known about the role of school-aged children and household transmission at the start of the SARS-CoV-2 pandemic. To evaluate for SARS-CoV-2 in school-aged children and assess household transmission, we performed reverse transcription polymerase chain reaction on 670 archived specimens that were collected between September 1, 2019 and June 30, 2020 as part of a community-based study.

Case Presentation: A single SARS-CoV-2 case was detected in an 11-year-old girl on March 18, 2020, resulting in very low prevalence (0.15% [95% CI, 0.03–0.84]) in this population. This case was associated with SARS-CoV-2 detection in all other household members. Symptoms were reported as mild to moderate. Whole genome sequencing supported household transmission of near-identical viruses within the 19B clade.

Discussion: This case represents the earliest known household cluster of SARS-CoV2 in Wisconsin.

Conclusion: This case suggests that household transmission associated with school-aged children may have contributed to wide seeding across populations.

Author Affiliations: University of Wisconsin School of Medicine and Public Health, Department of Family Medicine and Community Health, Madison, Wisconsin (Temte J, Barlow, Temte E, Goss); Wisconsin State Laboratory of Hygiene, Madison, Wisconsin (Florek, Reisdorf, Bateman); University of Wisconsin School of Veterinary Medicine, Department of Pathobiological Sciences, Madison, Wisconsin (Braun, Friedrich); US Centers for Disease Control and Prevention, Atlanta, Georgia (Uzicanin).
Corresponding Author: Jonathan Temte, MD, PhD, University of Wisconsin School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplain Court, Madison, WI 53715; phone 608.263.3111; email
Acknowledgments: We are indebted to the families of the Oregon School District for participation in ORCHARDS and the district’s administration and staff for their ongoing support. We thank Anna Kocharian, MS, with the Wisconsin Department of Health Services for providing SARS-CoV-2 cases data for Wisconsin.
Financial Disclosures: Dr Temte reports a conflict of interest in that he received in-kind research support from Quidel Corporation for the ORCHARDS study. The other authors have no conflicts of interest to disclose relevant to this article. Quidel Corporation did not direct or exert any influence over this manuscript.
Funding/Support: This study has been supported by Centers for Disease Control and Prevention through cooperative agreement # 5U01CK000542-02-00. Dr Temte received the award.
Role of Funder/Sponsor: Centers for Disease Control and Prevention project officer (AU) assisted with study design, interpretation of data, writing of this report, and in the decision to submit the paper for publication. The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Share WMJ