Children catch respiratory viruses often, and they spend most of their waking hours at school — yet apart from SARS-CoV-2, few schools have ever been checked for which viruses are circulating. In the 2022–23 school year, a large district in Kansas City, Missouri, with 33 schools from pre-kindergarten to grade 12, tried.
How it worked
- Anyone in the district — student or staff — could opt in, whether or not they felt sick.
- Once a month, participants swabbed the front of their own nose; the swabs were tested by multiplex PCR for adenovirus, human metapneumovirus, influenza A and B, parainfluenza 1–4, rhinovirus/enterovirus, RSV, SARS-CoV-2 and the four seasonal coronaviruses.
- 36 hours before each test, a survey asked about symptoms in the previous week — fever, cough, congestion, runny nose, sore throat, wheezing, shortness of breath.
Who took part
| Students | Staff | |
|---|---|---|
| Participants | 639 — 3.0% of the district's 21,419 students | 255 — 7.1% of its 3,577 full-time staff |
| Median age | 10.1 | 42.2 |
| Male | 45.2% | 8.2% |
| White | 63.5% | 83.9% |
| Hispanic or Latino | 12.5% | 4.7% |
| Multiracial | 7.7% | 2.7% |
| Black | 7.2% | 2.0% |
Participants were more often female (60.7%) than the district as a whole, and fewer students qualified for free or reduced-price meals (31.3%, against 38.0% district-wide).
What the swabs found
From November 2, 2022, to April 19, 2023, 3,232 swabs were tested — a median of four per person — and 805 (24.9%) found at least one virus. More than one virus turned up in 81 swabs.
| Swabs from | Share positive |
|---|---|
| Pre-K students | 40.0% |
| Staff | 14.1% |
| Virus | Share of all swabs |
|---|---|
| Rhinovirus/enterovirus — the most common | 12.1% |
| Seasonal coronaviruses (NL63, HKU1, OC43, 229E) | 5.6% |
| Most frequent | Pre-K | Elementary | Staff |
|---|---|---|---|
| Rhinovirus/enterovirus | 14.4% | 17.1% | 4.8% |
| Adenovirus | 12.2% | 3.3% | — |
| Seasonal coronaviruses | 6.7% | 8.1% | 3.8% |
| Human metapneumovirus | 4.4% | 3.7% | — |
| SARS-CoV-2 | — | — | 3.3% |
Influenza and RSV were rare — possibly because testing began after their early-season peaks.
Of the 3,232 symptom surveys, 2,393 (74.0%) came back. Pre-K students were the most likely to report symptoms (41.1%), high school students the least (14.0%).
What it means
The COVID-19 pandemic exposed how little was known about respiratory viruses in children and schools, and this surveillance begins to fill the gap. To keep schools healthy, the authors point to:
- staying up to date with vaccines, including COVID-19 and influenza;
- hand hygiene and covering coughs and sneezes;
- staying home when sick;
- better indoor ventilation.
The final results were to help shape guidance on preventing respiratory viruses in schools.
Limits
- Taking part was voluntary, so participants may not represent the whole school population.
- Swabs were self-collected, and about 25% had no symptom information because the survey went unanswered.
- The results describe positive tests, not a student's or staff member's chance of testing positive over the year; enrollment was still going on.
Sources
Based on Goldman JL, Lee BR, Porter J, et al., "Notes from the Field: Multipathogen Respiratory Virus Testing Among Primary and Secondary School Students and Staff Members in a Large Metropolitan School District — Missouri, November 2, 2022–April 19, 2023," MMWR Morbidity and Mortality Weekly Report volume 72, number 28, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report's footnote on all participants' race and ethnicity does not match its separate figures for students and staff, and it gives the district's female share as both 51.1% and 51.0%, so those figures are left out; the stock photo in its visual abstract is left out too.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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