Data from the health ministry showed that more children have contracted the coronavirus in the second wave of the pandemic, NDTV reported. In just the five worst-affected states – Maharashtra, Chhattisgarh, Karnataka, Uttar Pradesh and Delhi – 79,688 children have been infected by the virus between March 1 and April 4, according to the channel.

The numbers

In Maharashtra, 60,684 children tested positive between March 1 and April 4, according to NDTV. Of these children, 9,882 are under the age of five.

In Chhattisgarh, 5,940 children were infected by the disease, with 922 of them below five.

In Karnataka, the corresponding figures are slightly higher as 7,327 children have tested positive for Covid-19. As many as 871 of them are less than five years old, the channel reported.

In Uttar Pradesh, 3,004 children have been infected and 471 among them are less than five years of age.

A doctor at Delhi’s Ram Manohar Lohia hospital told NDTV that the Capital too was seeing a similar trend, and health ministry figures showed that Delhi logged 2,733 infections among children, with 441 of them in those below the age of five.

More symptomatic

One positive so far had been that children who contract the virus typically experience mild illness. Most children do not require hospitalisation and very few die from the disease. Some children can develop a severe inflammatory syndrome, but experts say it is rare.

This generally mild picture had contributed to cases in children being overlooked. But emerging evidence suggest children not just play a bigger role in transmission than originally thought, but are increasingly symptomatic too, with some experiencing severe illness.

“Children are definitely more symptomatic now than what we saw in the first wave,” said Tanu Singhal, a paediatrician and infectious disease specialist at Mumbai’s Kokilaben Dhirubhai Ambani Hospital, told the Hindustan Times. “The severity of their illness has gone up.”

Soonu Udani, paediatrician and critical care specialist at SRCC Children’s Hospital in Mumbai, said several children were coming with abdominal pain and severe diarrhoea, which she did not see in the first wave.

More hospitalisations

Experts say that working out how susceptible children are has been difficult. Pre-emptive school closures occurred in many countries, including in India, so fewer children were infected.

Children have also missed out on testing because during the first wave as they typically had mild symptoms, another Mumbai paediatrician, Bakul Parekh, told the Hindustan Times. “We tested children only when someone in the family had a history of Covid-19.” he added. “A small number of children did have mild symptoms, which lasted only for a day or two.”

Parekh said he could not remember if he had referred even a single child who needed hospitalisation during the first wave of the pandemic. But over the last fortnight, the doctor admitted six children between one and seven years – three with severe gastrointestinal infections and fever, and others with breathlessness and fever.

“Those with gastrointestinal infections had to be put on intravenous fluids,” he told the newspaper. “The patients who were breathless required steroids and oxygen support.”

Linked to new strain?

Parekh thinks the greater impact of the coronavirus on children was linked with its emerging new mutations. “The available medical literature shows that the ‘double mutation’ found in Maharashtra [now called B1.617] can be one of the reasons behind it,” he told the Hindustan Times.

In December, a report published by British scientists had said the new variant of the coronavirus, cases of which have also been reported in India, carries mutations that could mean children are as susceptible to becoming infected with it as adults, unlike previous strains.

Subash Rao, consultant paediatrician at Reliance Hospital and Fortis Hospital, Navi Mumbai, made similar observations.

The doctor said the Covid-19 virus has undergone double mutation and that the current strain was “highly infectious infecting many people, especially children”, reported ANI.

“The second wave of Covid is known to affect the children much more than in the first wave,” he said. “Also, a reverse trend is being seen that is, children develop symptoms first, and then adults are getting it from them.”

What should be done?

The doctor urged parents to be mindful of their children’s health, saying they can also act as “silent carriers or super-spreaders” and spread the disease to other children and adults.

He added the in case a parent is tested positive, the “most dangerous” thing to do is to send the child to live with someone else. “Keep in mind your child would already be harbouring the virus even though they have no symptoms,” Rao said. “They can innocently pass on the infection to the elders where you have sent them. Hence it would be wiser to keep them in your home along with you quarantined for 14 days.”

The paediatrician said that if a child is showing symptoms of Covid-19 infection, an RT PCR test should be done by the second day.

“Don’t delay or hesitate out of fear to do the test,” he added. “In case of an asymptomatic child with both parents Covid-19 positive, there is no need for a test but they should be kept in home quarantine for 14 days.”