Viral Dynamics of Influenza, RSV and SARS-CoV-2 in Children and Secondary Transmission within Households and Schools

Viral respiratory tract infections are very common in children. They contribute to missed time in school, work disruption for caregivers and can also cause severe illness requiring hospitalization and rarely death. In the 2022-2023, influenza, RSV and SARS-CoV-2 viruses infected a large number of children which strained the pediatric healthcare system in many jurisdictions. Unfortunately, there continues to be limited data on duration of infectiousness and transmission risk of these viruses to inform public health decisions during times when there is significant circulation of these viruses. In the proposed study, we will assess the infectiousness of children with influenza, RSV and SARS-CoV-2 in children by examining the viral load changes over the course of illness to inform return to school (and other activities) guidance. Furthermore, determining which household and school contacts develop infection is important to understand factors that may contribute to transmission. These results will contribute essential data to help: 1) prevent spread in households and schools through refinement of case management and health and safety measures, 2) develop protocols around contact management in households and classrooms, and 3) inform policy decisions in the event of future pandemics with related viruses.