Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium.
Humans; Pandemics; Streptococcus pneumoniae; Haemophilus influenzae; COVID-19/epidemiology; Bacterial Infections; Neisseria meningitidis; Bacterial disease; Meningitidis; Prospective analysis; Prospectives; Serotypes; Streptococcus agalactiae; Surveillance data; COVID-19; Medicine (miscellaneous); Health Informatics; Decision Sciences (miscellaneous); Health Information Management
Abstract :
[en] [en] BACKGROUND: The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic.
METHODS: For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere.
FINDINGS: Overall, 116 841 cases were analysed: 76 481 in 2018-19, before the pandemic, and 40 360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145-55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories.
INTERPRETATION: COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies.
FUNDING: Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.
Disciplines :
Immunology & infectious disease
Author, co-author :
Shaw, David; Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
Abad, Raquel; National Reference Laboratory for Meningococci, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
Amin-Chowdhury, Zahin; Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
Bautista, Adriana; Instituto Nacional de Salud, Bogotá, Colombia
Bennett, Desiree; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
Broughton, Karen; Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
Cao, Bin; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
Casanova, Carlo; Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
Choi, Eun Hwa; Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
Chu, Yiu-Wai; Department of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China
Claus, Heike; University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
Coelho, Juliana; Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
Corcoran, Mary; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland, Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
Cottrell, Simon; Public Health Wales, Cardiff, Wales, UK
Cunney, Robert; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland, Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
Cuypers, Lize; National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Dalby, Tine; Statens Serum Institut, Department of Infectious Disease Epidemiology & Prevention, Copenhagen, Denmark
Davies, Heather; Meningococcal Reference Laboratory, Institute of Environmental Science and Research, Porirua, New Zealand
de Gouveia, Linda; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
Deghmane, Ala-Eddine; Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
Demczuk, Walter; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
Desmet, Stefanie; National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Domenech, Mirian; National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
Drew, Richard; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland, Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland, Clinical Innovation Unit, Rotunda, Dublin, Ireland
du Plessis, Mignon; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
Duarte, Carolina; Instituto Nacional de Salud, Bogotá, Colombia
Erlendsdóttir, Helga; Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
Fry, Norman K; Immunisation and Vaccine Preventable Diseases Division and Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
Fuursted, Kurt; Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
Hale, Thomas; Blavatnik School of Government, University of Oxford, Oxford, UK
Henares, Desiree; Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain, CIBER of Epidemiology and Public Health, Madrid, Spain
Henriques-Normark, Birgitta; Karolinska Institutet, Karolinska University Hospital, Public Health Agency of Sweden, Stockholm, Sweden
Hilty, Markus; Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
Hoffmann, Steen; Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
Humphreys, Hilary; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland, Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Ip, Margaret; Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
Jacobsson, Susanne; National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Johnson, Christopher; Public Health Wales, Cardiff, Wales, UK
Johnston, Jillian; Public Health Agency, Belfast, UK
Jolley, Keith A; Department of Biology, University of Oxford, Oxford, UK
Kawabata, Aníbal; Laboratorio Central de Salud Pública, Asunción, Paraguay
Kozakova, Jana; National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
Kristinsson, Karl G; Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
Krizova, Pavla; National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
Kuch, Alicja; National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
Ladhani, Shamez; Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
Lâm, Thiên-Trí; University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
León, María Eugenia; Laboratorio Central de Salud Pública, Asunción, Paraguay
Lindholm, Laura; Finnish Institute for Health and Welfare, Helsinki, Finland
Litt, David; Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
Maiden, Martin C J; Department of Biology, University of Oxford, Oxford, UK
Martin, Irene; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
Martiny, Delphine ; Université de Mons - UMONS > Faculté de Médecine et de Pharmac > Service du Doyen de la Faculté de Médecine et Pharmacie
Mattheus, Wesley; Meningococcal National Reference Centre, Sciensano, Belgium
McCarthy, Noel D; Population Health Medicine, Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
Meehan, Mary; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
Meiring, Susan; Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
Mölling, Paula; National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Morfeldt, Eva; Public Health Agency of Sweden, Solna, Sweden
Morgan, Julie; Streptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
Mulhall, Robert; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
Muñoz-Almagro, Carmen; Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain, CIBER of Epidemiology and Public Health, Madrid, Spain, Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
Murdoch, David; University of Otago, Christchurch, New Zealand
Murphy, Joy; Public Health Agency, Belfast, UK
Musilek, Martin; National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
Mzabi, Alexandre; Ministère de la Santé - Direction de la santé, Luxembourg, Luxembourg
Novakova, Ludmila; National Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
Oftadeh, Shahin; NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia
Perez-Argüello, Amaresh; Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain
Pérez-Vázquez, Maria; Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
Perrin, Monique; Laboratoire National de Sante, Dudelange, Luxembourg
Perry, Malorie; Public Health Wales, Cardiff, Wales, UK
Prevost, Benoit; National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium
Roberts, Maria; Public Health Wales, Cardiff, Wales, UK
Rokney, Assaf; Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
Ron, Merav; Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
Sanabria, Olga Marina; Instituto Nacional de Salud, Bogotá, Colombia
Scott, Kevin J; Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK
Sheppard, Carmen; Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
Siira, Lotta; Finnish Institute for Health and Welfare, Helsinki, Finland
Sintchenko, Vitali; NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia, Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia
Skoczyńska, Anna; National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
Sloan, Monica; Public Health Agency, Belfast, UK
Slotved, Hans-Christian; Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
Smith, Andrew J; Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
Steens, Anneke; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
Taha, Muhamed-Kheir; Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
Toropainen, Maija; Finnish Institute for Health and Welfare, Helsinki, Finland
Tzanakaki, Georgina; National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
Vainio, Anni; Finnish Institute for Health and Welfare, Helsinki, Finland
van der Linden, Mark P G; Department of Medical Microbiology, German National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany
van Sorge, Nina M; Department of Medical Microbiology and Infection Prevention, and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Varon, Emmanuelle; Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
Vohrnova, Sandra; National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
von Gottberg, Anne; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
Yuste, Jose; National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
Zanella, Rosemeire; National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
Zhou, Fei; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
Brueggemann, Angela B; Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK. Electronic address: angela.brueggemann@ndph.ox.ac.uk
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