Everything was in place for Seema Lakdawala to open her small daycare centre. She found the perfect spot and filled it with toys. There’s food, stuffed animals, balls, and even an air purifier. It also has a sizable cage and several cameras that record the whole thing. In the spring of 2022, it opened in Pittsburgh, Pennsylvania, with its first participants: four healthy ferrets, and one with the flu.
Lakdawala is a virologist at Emory University (although the work was conducted at the University of Pittsburgh). Her goal is to study how influenza viruses spread in day care centers, one of the richest habitats for influenza viruses. “Ferrets have been the standard for studying influenza viruses,” she explains via video conference, “because their respiratory systems are so similar to ours.” However, experiments so far have been conducted in highly controlled environments . Pairs of animals are kept in small cages for several days. The problem is, that’s not how they get infected in the wild, and it’s not how outbreaks occur in preschool groups.
Lakdawala formed an interdisciplinary team with another virologist, two aerosol transmission experts with experience studying real day care centers, and a mathematician. Together they try to replicate an environment that is comfortable for ferrets (and very familiar to anyone with young children). They gather the animals for hours every day in this common space filled with toys. They gave them drinks and offered them snacks. Afterwards, each ferret rested in its own cage.
Once they put the animals together, they realized that not only did ferrets have similar respiratory tracts to ours, but they also had similar behaviors. “They are very sociable animals,” the virologist said. “They run, they play. They chew on toys, they explore spaces, they have brief but intense interactions with each other. I have young children, and… actually, it reminds me a lot of what they do,” she admitted with a smile.
Over the course of several months, Lakdawala and her colleagues observed groups of ferrets playing in a day care center while transmitting viruses to each other. The scientists carefully recorded their movements. They mark the patient’s contaminated surfaces and note the next person who touches them. They recorded their battles and games. Who got sick and when. Their first findings, which will be published in a scientific journal in a few months, come with some surprises.
“For example, we wanted to see how ventilation affects infectious diseases,” the virologist said. “We tried normal air exchange, once an hour, similar to day care centers around here. Then, we did 23 air exchanges an hour.” The results were the same: In both cases, 50 percent of the ferrets ended up Infected. What changes is when. “Those with reduced ventilation become sick very quickly within three days. Those with better ventilation also become infected, but it takes three to seven days.” So in this particular environment, increasing ventilation may only be enough Play a role in delaying infection.
Another time, a sick ferret was playing with four other healthy ferrets, but the fifth ferret didn’t leave. That person was the first to get sick. It seemed counterintuitive, but when they checked the cameras, the scientists saw how the sick ferret kept biting and licking objects and surfaces, and then the other ferret did the same, just like the first ferret A trail of viral breadcrumbs is left for the second ferret to eat. Pick it up.
Ferrets tend to push their faces together, steal food, chew toys, and bite each other. This behavior is also common in childcare centres, but not in places like bars or offices. Therefore, this experiment is meaningful for this case. There are many ways the flu virus can be spread, all of which occur in daycare centers, whether it’s ferrets or children.
Immune system under construction
“Saliva is one of the fundamental routes of transmission in day care centres,” confirms virologist Margarita del Val at the Center for Molecular Biology in Severo Ochoa, Spain, stressing that this is less relevant in adult settings. “That’s why surface cleaning is important in this situation.” Overall, she recommends adopting everything we’ve learned during the Covid-19 pandemic, like ventilation, cleaning and masks. “Coronavirus brings to the fore the transmission pathways of all respiratory pathogens,” she noted. “This applies to influenza, bronchiolitis, and other respiratory-borne viruses and bacteria.”
In this environment, pandemic comparisons make sense. “Covid-19 is the first time in our lives that we are faced with a new virus. This is what happens to children in daycare centers every day: for the first time in their lives they are exposed to viruses, bacteria or viruses that they have never fought against infection,” said Del Val, coordinator of the Global Platform. Spanish National Research Council for Health.
According to a study by the Spanish Society of Primary Care Pediatrics, 30% to 50% of infections in young children may be related to day care centers, with this number generally declining after the first year. Pediatrician Pedro Gorrotxategi, vice president of the association, believes that infections “are inevitable, but that does not mean we should give up.”
Most babies in day care get 8 to 15 colds per year; slightly more than if they were cared for alone at home. However, after the first year, the number of respiratory illnesses decreases. Furthermore, there is reason to think that these initial episodes may have a protective effect in the future.
In a study published in the journal PediatricsA team of researchers in the Netherlands followed a group of children over the first six years of their lives to see how often they developed acute gastroenteritis. Of the 2,220 children studied, 1,344 attended day care in their first year of life. These people had more gastroenteritis initially, but as they got older, others got it more often. By age six, the average number of episodes of gastroenteritis was similar in both groups. Gorrotxategi explains that these studies shouldn’t mislead parents: “People think it’s better to keep kids exposed. Sooner or later, anyway, they’ll catch it. But it’s not the same thing; it’s better to postpone it. Our immune system develops by the age of four More developed than when they were two years old.”
The daycare virus is starting to brew in the office. Parents’ working conditions can affect children’s illnesses and the circumstances under which children are taken to day care. Ideally, children should stay home when they show the first symptoms of illness. “But health advice is one thing, real life is another,” admits Gorrotxategi. “Many parents, when they learn their child is sick, try to see if they can make it to pick up their child after get off work. “The first year of kindergarten is complicated. ” In this sense, measures such as remote working can help. All experts consulted agreed that vaccination is another important weapon. And above all, patience.
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