{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:21:39Z","timestamp":1763018499814,"version":"3.40.5"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002141","name":"Public Health England","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002141","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6\/60) in primary and 3.9% (4\/102) in secondary school students, compared to 6.3% (1\/16) and 0% (0\/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12\/183) and 3.7% (1\/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11\/317) and 0% (0\/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Interpretation<\/jats:title>\n<jats:p>Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0262515","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T18:23:56Z","timestamp":1645035836000},"page":"e0262515","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England"],"prefix":"10.1371","volume":"17","author":[{"given":"Annabel 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County, Wisconsin, August 31-November 29, 2020.","volume":"70","author":"A Falk","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"5","key":"pone.0262515.ref014","first-page":"e2021050605","article-title":"COVID-19 Infections Among Students and Staff in New York City Public Schools.","volume":"147","author":"JK Varma","year":"2021"},{"issue":"4","key":"pone.0262515.ref015","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-048090","article-title":"Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools.","volume":"147","author":"KO Zimmerman","year":"2021","journal-title":"Pediatrics"},{"unstructured":"COVID-19 Schools Infection Survey 2020 [Available from: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/949467\/SIS_protocol_v1.1_13102020.pdf].","key":"pone.0262515.ref016"},{"unstructured":"When to self-isolate and what to do 2021 [Available from: https:\/\/www.nhs.uk\/conditions\/coronavirus-covid-19\/self-isolation-and-treatment\/when-to-self-isolate-and-what-to-do\/].","key":"pone.0262515.ref017"},{"issue":"5","key":"pone.0262515.ref018","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMc2016321","article-title":"Swabs Collected by Patients or Health Care Workers for SARS-CoV-2 Testing","volume":"383","author":"Y-P Tu","year":"2020","journal-title":"The New England journal of medicine"},{"issue":"25","key":"pone.0262515.ref019","doi-asserted-by":"crossref","first-page":"453","DOI":"10.46234\/ccdcw2020.116","article-title":"Three Novel Real-Time RT-PCR Assays for Detection of COVID-19 Virus.","volume":"2","author":"P Niu","year":"2020","journal-title":"China CDC Wkly."},{"key":"pone.0262515.ref020","doi-asserted-by":"crossref","DOI":"10.1101\/2021.07.07.21260121","article-title":"SARS-CoV-2 IgG detection in human oral fluids.","author":"K Hoschler","year":"2021"},{"issue":"11","key":"pone.0262515.ref021","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/S2352-4642(20)30251-0","article-title":"Transmission of SARS-CoV-2 in Australian educational settings: a prospective cohort study","volume":"4","author":"K Macartney","year":"2020","journal-title":"The Lancet Child & Adolescent Health"},{"key":"pone.0262515.ref022","doi-asserted-by":"crossref","first-page":"100597","DOI":"10.1016\/j.eclinm.2020.100597","article-title":"High prevalence of SARS-CoV-2 antibodies in care homes affected by COVID-19: Prospective cohort study, England.","volume":"28","author":"SN Ladhani","year":"2020","journal-title":"EClinicalMedicine"},{"issue":"6","key":"pone.0262515.ref023","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jinf.2021.02.027","article-title":"Disproportionate impact of SARS-CoV-2 on ethnic minority and frontline healthcare workers: A cross-sectional seroprevalence survey at a North London hospital","volume":"82","author":"EM Martyn","year":"2021","journal-title":"The Journal of infection"},{"issue":"3","key":"pone.0262515.ref024","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1177\/0033354921999385","article-title":"COVID-19 in the New York City Jail System: Epidemiology and Health Care Response, March-April 2020","volume":"136","author":"J Chan","year":"2021","journal-title":"Public health reports (Washington, DC: 1974)."},{"issue":"1","key":"pone.0262515.ref025","first-page":"153","article-title":"COVID-19 Outbreaks in US Immigrant Detention Centers: The Urgent Need to Adopt CDC Guidelines for Prevention and Evaluation","volume":"72","author":"JJ Openshaw","year":"2021","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"3","key":"pone.0262515.ref026","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1371\/journal.pmed.0050074","article-title":"Social contacts and mixing patterns relevant to the spread of infectious diseases.","volume":"5","author":"J Mossong","year":"2008","journal-title":"PLoS medicine."},{"key":"pone.0262515.ref027","article-title":"Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Setting-specific Transmission Rates: A Systematic Review and Meta-analysis.","author":"HA Thompson","year":"2021","journal-title":"Clinical Infectious Diseases"},{"unstructured":"Department for Education. Attendance in education and early years settings during the coronavirus (COVID-19) outbreak 2021 [Available from: https:\/\/explore-education-statistics.service.gov.uk\/find-statistics\/attendance-in-education-and-early-years-settings-during-the-coronavirus-covid-19-outbreak].","key":"pone.0262515.ref028"},{"unstructured":"Public Health England. New national surveillance of possible COVID-19 reinfection, published by PHE 2021 [Available from: https:\/\/www.gov.uk\/government\/news\/new-national-surveillance-of-possible-covid-19-reinfection-published-by-phe].","key":"pone.0262515.ref029"},{"unstructured":"The Office for National Statistics (ONS). Coronavirus (COVID-19) Infection Survey, UK: 11 December 2020 2020 [Available from: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/bulletins\/coronaviruscovid19infectionsurveypilot\/11december2020].","key":"pone.0262515.ref030"},{"year":"2021","author":"BC Young","article-title":"A cluster randomised trial of the impact of a policy of daily testing for contacts of COVID-19 cases on attendance and COVID-19 transmission in English secondary schools and colleges.","key":"pone.0262515.ref031"},{"unstructured":"Everything you need to know about the UKs COVID-19 vaccination programme 2021 [Available from: https:\/\/pharmaceutical-journal.com\/article\/feature\/everything-you-need-to-know-about-the-uks-covid-19-vaccination-programme].","key":"pone.0262515.ref032"},{"unstructured":"NHS invites all adults to get a COVID jab in final push 2021 [Available from: https:\/\/www.england.nhs.uk\/2021\/06\/nhs-invites-all-adults-to-get-a-covid-jab-in-final-push\/].","key":"pone.0262515.ref033"},{"unstructured":"JCVI issues updated advice on COVID-19 vaccination of young people aged 16 to 17 [press release]. 4th September 2021.","key":"pone.0262515.ref034"},{"unstructured":"JCVI issues updated advice on COVID-19 vaccination of children aged 12 to 15 [press release]. 2021.","key":"pone.0262515.ref035"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T18:24:33Z","timestamp":1645035873000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262515"}},"subtitle":[],"editor":[{"given":"Etsuro","family":"Ito","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,16]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0262515","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,2,16]]}}}