On Sept. 11, 2020, the U.S. Centers for Disease Control and Prevention (CDC) reported that twelve children acquired COVID-19 in child care facilities. Transmission was documented from these children to at least 12 (26%) of 46 nonfacility contacts (confirmed or probable cases). One parent was hospitalized. Transmission was observed from two of three children with confirmed, asymptomatic COVID-19.

SARS-CoV-2 Infections among young children acquired in child care settings were transmitted to their household members. Testing of contacts of laboratory-confirmed COVID-19 cases in child care settings, including children who might not have symptoms, could improve control of transmission from child care attendees to family members.

Contact tracing data collected during April 1–July 10, 2020 through Utah’s National Electronic Disease Surveillance System (EpiTrax) were used to retrospectively construct transmission chains from reported COVID-19 child care facility outbreaks, defined as two or more laboratory-confirmed COVID-19 cases within 14 days among staff members or attendees at the same facility. EpiTrax maintains records of epidemiologic linkage between index patients and contacts (defined as anyone who was within 6 feet of a person with COVID-19 for at least 15 minutes ≤2 days before the patient’s symptom onset) and captures data on demographic characteristics, symptoms, exposures, testing, and the monitoring/isolation period.

Analysis of contact tracing data in Salt Lake County, Utah, identified outbreaks of COVID-19 in three small to large child care facilities linked to index cases in adults and associated with transmission from children to household and nonhousehold contacts. In these three outbreaks, 54% of the cases linked to the facilities occurred in children. Transmission likely occurred from children with confirmed COVID-19 in a child care facility to 25% of their nonfacility contacts.

Mitigation strategies could have helped limit SARS-CoV-2 transmission in these facilities. To help control the spread of COVID-19, the use of masks is recommended for persons aged ≥2 years. Although masks likely reduce the transmission risk, some children are too young to wear masks but can transmit SARS-CoV-2, as was seen in facility B when a child aged 8 months transmitted SARS-CoV-2 to both parents.