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Children’s warts primarily transmitted via family, classmates

Schoolchildren had a high incidence of warts, with responsible cutaneous human papillomavirus strains transmitted mainly via the family and classmates, according to recent study results.

“Current recommendations mainly focus on prevention of [human papillomavirus] transmission in public places such as swimming pools,” researcher Sjoerd C. Bruggink, MD, of Leiden University Medical Center, told Healio.com. “However, our study shows that transmission mostly takes place in families and schools.”

 

Sjoerd C. Bruggink

Bruggink and colleagues conducted a 12-month prospective cohort study, examining the hands and feet for warts of all children (aged 4 to 12 years) in grades 1 to 7 at three Dutch schools. Data on human papillomavirus (HPV) exposure was based on results from parental questionnaires, pre-existing warts, warts among family members, prevalence of warts at baseline in class and use of public places, including swimming pools.

Ninety-seven percent of 1,134 eligible children participated. Thirty-three percent of the students had warts at baseline. Developing new warts had an incidence rate of 29 per 100 person-years (95% CI, 26-32). Incidence rates were 14 per 100 person-years (95% CI, 12-16) for plantar warts, 9 per 100 person-years (95% CI, 7-11) for common warts and 5 per 100 person-years for plantar and common warts combined (95% CI, 4-7).

There was an increased risk for developing warts in the children with a white skin type (HR=2.3; 95% CI, 1.3-3.9) using multivariate analysis. Independent environmental risk factors for developing warts included having family members with warts (HR=2.08; 95% CI, 1.52-2.86) and the prevalence of warts spread at school (HR=1.2 per 10% increase; 95% CI, 1.03-1.41).

There was a nonsignificant risk for warts among children using public pools (HR=1.17; 95% CI, 0.75-1.83).

“Current preventive recommendations mainly focus on limiting the personal spread of HPV (“Avoid scratching lesions”) and reducing the risk of transmission in public places (“Wear flip-flops in communal showers”),” the researchers concluded “Our findings suggest that recommendations should shift toward reducing transmission among families and school classes.”