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Tamura K, Shimbashi R, Kasamatsu A, Chang B, Gotoh K, Tanabe Y, Kuronuma K, Oshima K, Maruyama T, Nakamatsu M, Abe S, Kasahara K, Nishi J, Arakawa Y, Kinjo Y, Suzuki M, Akeda Y, Oishi K. Unveiling the role of preceding seasonal influenza in the development of bacteremic pneumococcal pneumonia in older adults before the COVID-19 pandemic in Japan. Int J Infect Dis 2024; 143:107024. [PMID: 38582146 DOI: 10.1016/j.ijid.2024.107024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE We aimed to investigate the impact of preceding seasonal influenza on the clinical characteristics of adult patients with invasive pneumococcal disease (IPD) in Japan. METHODS Data for 1722 adult patients with IPD were analyzed before (2017-2019) and during the COVID-19 pandemic (2020-2022). RESULTS The seasonal influenza epidemic disappeared soon after the emergence of the pandemic. Compared with that before the pandemic (66.7%), we observed a lower bacteremic pneumonia proportion in patients with IPD during the pandemic (55.6%). The clinical presentations of IPD cases significantly differed between those with and without preceding influenza. The proportion of bacteremic pneumonia was higher in IPD patients with preceding influenza than in those without in both younger (44.9% vs 84.2%) and older adults (65.5% vs 87.0%) before the pandemic. The case fatality rate was significantly higher in IPD patients with preceding influenza (28.3%) than in those without (15.3%) in older adults before the pandemic (P = 0.020). Male and aging are high risk factors for death in older patients with IPD who had preceding influenza. CONCLUSION Our study reveals that preceding seasonal influenza plays a role in the development of bacteremic pneumococcal pneumonia, increasing the risk of death in older adults.
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Affiliation(s)
| | | | - Ayu Kasamatsu
- National Institute of Infectious Diseases, Tokyo, Japan
| | - Bin Chang
- National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenji Gotoh
- Kurume University School of Medicine, Fukuoka, Japan
| | | | - Koji Kuronuma
- Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Kengo Oshima
- Tohoku University Graduate School of Medicine, Miyagi, Japan
| | | | - Masashi Nakamatsu
- Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shuichi Abe
- Yamagata Prefectural Central Hospital, Yamagata, Japan
| | | | - Junichiro Nishi
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yu Arakawa
- Kochi Medical School, Kochi University, Kochi, Japan
| | - Yuki Kinjo
- The Jikei University School of Medicine, Tokyo, Japan
| | - Motoi Suzuki
- National Institute of Infectious Diseases, Tokyo, Japan
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Howard LM, Grijalva CG. Impact of respiratory viral infections on nasopharyngeal pneumococcal colonization dynamics in children. Curr Opin Infect Dis 2024; 37:170-175. [PMID: 38437245 DOI: 10.1097/qco.0000000000001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
PURPOSE OF REVIEW Prevention of acute respiratory illnesses (ARI) in children is a global health priority, as these remain a leading cause of pediatric morbidity and mortality throughout the world. As new products and strategies to prevent respiratory infections caused by important pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, respiratory syncytial virus and pneumococcus are advancing, increasing evidence suggests that these and other respiratory viruses and pneumococci may exhibit interactions that are associated with altered colonization and disease dynamics. We aim to review recent data evaluating interactions between respiratory viruses and pneumococci in the upper respiratory tract and their potential impact on pneumococcal colonization patterns and disease outcomes. RECENT FINDINGS While interactions between influenza infection and subsequent increased susceptibility and transmissibility of colonizing pneumococci have been widely reported in the literature, emerging evidence suggests that human rhinovirus, SARS-CoV-2, and other viruses may also exhibit interactions with pneumococci and alter pneumococcal colonization patterns. Additionally, colonizing pneumococci may play a role in modifying outcomes associated with respiratory viral infections. Recent evidence suggests that vaccination with pneumococcal conjugate vaccines, and prevention of colonization with pneumococcal serotypes included in these vaccines, may be associated with reducing the risk of subsequent viral infection and the severity of the associated illnesses. SUMMARY Understanding the direction and dynamics of viral-pneumococcal interactions may elucidate the potential effects of existing and emerging viral and bacterial vaccines and other preventive strategies on the health impact of these important respiratory pathogens.
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Affiliation(s)
- Leigh M Howard
- Department of Pediatrics, Division of Infectious Diseases
| | - Carlos G Grijalva
- Departments of Health Policy and Biomedical Informatics, Division of Pharmacoepidemiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Sudri S, Shitrit S, Ben Amy DP, Dahoud WA, Laviv A, El-Naaj IA. Pediatric Trauma During COVID-19: What Have We Learned? J Oral Maxillofac Surg 2024; 82:546-553. [PMID: 38403270 DOI: 10.1016/j.joms.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND In December 2019, an outbreak of a novel pneumonia-like illness, COVID-19 (C-19), emerged in Wuhan, China. In March 2020, as the incidence of C-19 rose, the Israeli government, like that of other nations, declared a national state of emergency, and a full, general lockdown was announced. PURPOSE The purpose of this study is to determine the incidence and characteristics of pediatric maxillofacial trauma presentation during the 2020 C-19 lockdown restrictions and compare them to periods outside lockdown between 2019 and 2020 (pre-C-19). STUDY DESIGN, SETTING, SAMPLE A retrospective cohort study was conducted and included all pediatric patients (0-18 years) referred to the emergency department (ED) at Tzafon Medical Center, Israel, and diagnosed with maxillofacial injuries. Patients with missing demographic data and patients who did not complete the medical examination were excluded. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE The exposure variable is the date of injury-2020 C-19 lockdown period compared to the previous year (pre-C-19). MAIN OUTCOME VARIABLE(S) The main outcome variable was the number of pediatric maxillofacial trauma ED arrivals out of total pediatric ED arrivals and out of total maxillofacial ED arrivals. COVARIATES Covariates included patient demographics, etiology, and place of injury. ANALYSES The association between categorical variables was tested using the Fisher exact test or χ2 test for binary variables with relative risk when appropriate, logistic regression model used to predict outcome variable. P values were 2-tailed and statistical significance was defined as P < .05. RESULTS The study sample comprised 1174 patients. Relative risk of presenting with oral and maxillofacial trauma out of all pediatric ED patients was 1.85 comparing C-19 period to pre-C-19 period (confidence interval [1.65; 2.073], P < .0001). Most of the injuries recorded during the C-19 restrictions occurred in the domestic environment (56.1% compared to 47.5% in pre-C-19, P < .001). Incidences necessitating treatment increased from 45.8 to 55% during C-19 (P = .002). CONCLUSION AND RELEVANCE During C-19, there was a higher rate of pediatric injuries compared to pre-C-19. The incidence of domestic oral and maxillofacial injuries increased despite the considered home safety.
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Affiliation(s)
- Shiran Sudri
- Resident, Department of Oral and Maxillofacial Surgery, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel.
| | - Shany Shitrit
- Dental Student at the Maurice & Gabriela Goldschlager School of Dental Medicine, Department of Oral and Maxillofacial Surgery, The Maurice & Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Tel Aviv; Senior Lecturer, Department of Oral and Maxillofacial Surgery, The Maurice & Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Tel Aviv
| | - Dalit Porat Ben Amy
- Head of Oral Medicine Unit, Oral Medicine Unit, Tzafon Medical Center, Affiliated with Azrieli Faculty of medicine, Bar Ilan University, Israel
| | - Wadie Abu Dahoud
- Head Department of Oral and Maxillofacial Surgery, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Statical Analysist, Research Institute, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel
| | - Amir Laviv
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, The Maurice & Gabriela Goldschlager School of Dental Medicine, Tel Aviv University, Tel Aviv
| | - Imad Abu El-Naaj
- Resident, Department of Oral and Maxillofacial Surgery, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel; Head Department of Oral and Maxillofacial Surgery, Tzafon Medical Center, Affiliated with Azrieli Faculty of Medicine, Bar Ilan University, Israel
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Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, Ikuta KS, Vongpradith A, Rogowski ELB, Doxey M, Troeger CE, Albertson SB, Ma J, He J, Maass KL, A.F.Simões E, Abdoun M, Abdul Aziz JM, Abdulah DM, Abu Rumeileh S, Abualruz H, Aburuz S, Adepoju AV, Adha R, Adikusuma W, Adra S, Afraz A, Aghamiri S, Agodi A, Ahmadzade AM, Ahmed H, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Alemi H, Al-Gheethi AAS, Ali A, Ali SSS, Alqahtani JS, AlQudah M, Al-Tawfiq JA, Al-Worafi YM, Alzoubi KH, Amani R, Amegbor PM, Ameyaw EK, Amuasi JH, Anil A, Anyanwu PE, Arafat M, Areda D, Arefnezhad R, Atalell KA, Ayele F, Azzam AY, Babamohamadi H, Babin FX, Bahurupi Y, Baker S, Banik B, Barchitta M, Barqawi HJ, Basharat Z, Baskaran P, Batra K, Batra R, Bayileyegn NS, Beloukas A, Berkley JA, Beyene KA, Bhargava A, Bhattacharjee P, Bielicki JA, Bilalaga MM, Bitra VR, Brown CS, Burkart K, Bustanji Y, Carr S, Chahine Y, Chattu VK, Chichagi F, Chopra H, Chukwu IS, Chung E, Dadana S, Dai X, Dandona L, Dandona R, Darban I, Dash NR, Dashti M, Dashtkoohi M, Dekker DM, Delgado-Enciso I, Devanbu VGC, Dhama K, Diao N, Do THP, Dokova KG, Dolecek C, Dziedzic AM, Eckmanns T, Ed-Dra A, Efendi F, Eftekharimehrabad A, Eyre DW, Fahim A, Feizkhah A, Felton TW, Ferreira N, Flor LS, Gaihre S, Gebregergis MW, Gebrehiwot M, Geffers C, Gerema U, Ghaffari K, Goldust M, Goleij P, Guan SY, Gudeta MD, Guo C, Gupta VB, Gupta I, Habibzadeh F, Hadi NR, Haeuser E, Hailu WB, Hajibeygi R, Haj-Mirzaian A, Haller S, Hamiduzzaman M, Hanifi N, Hansel J, Hasnain MS, Haubold J, Hoan NQ, Huynh HH, Iregbu KC, Islam MR, Jafarzadeh A, Jairoun AA, Jalili M, Jomehzadeh N, Joshua CE, Kabir MA, Kamal Z, Kanmodi KK, Kantar RS, Karimi Behnagh A, Kaur N, Kaur H, Khamesipour F, Khan MN, Khan suheb MZ, Khanal V, Khatab K, Khatib MN, Kim G, Kim K, Kitila ATT, Komaki S, Krishan K, Krumkamp R, Kuddus MA, Kurniasari MD, Lahariya C, Latifinaibin K, Le NHH, Le TTT, Le TDT, Lee SW, LEPAPE A, Lerango TL, Li MC, Mahboobipour AA, Malhotra K, Mallhi TH, Manoharan A, Martinez-Guerra BA, Mathioudakis AG, Mattiello R, May J, McManigal B, McPhail SM, Mekene Meto T, Mendez-Lopez MAM, Meo SA, Merati M, Mestrovic T, Mhlanga L, Minh LHN, Misganaw A, Mishra V, Misra AK, Mohamed NS, Mohammadi E, Mohammed M, Mohammed M, Mokdad AH, Monasta L, Moore CE, Motappa R, Mougin V, Mousavi P, Mulita F, Mulu AA, Naghavi P, Naik GR, Nainu F, Nair TS, Nargus S, Negaresh M, Nguyen HTH, Nguyen DH, Nguyen VT, Nikolouzakis TK, Noman EA, Nri-Ezedi CA, Odetokun IA, Okwute PG, Olana MD, Olanipekun TO, Olasupo OO, Olivas-Martinez A, Ordak M, Ortiz-Brizuela E, Ouyahia A, Padubidri JR, Pak A, Pandey A, Pantazopoulos I, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Peprah P, Pham HT, Poddighe D, Pollard A, Ponce-De-Leon A, Prakash PY, Prates EJS, Quan NK, Raee P, Rahim F, Rahman M, Rahmati M, Ramasamy SK, Ranjan S, Rao IR, Rashid AM, Rattanavong S, Ravikumar N, Reddy MMRK, Redwan EMM, Reiner RC, Reyes LF, Roberts T, Rodrigues M, Rosenthal VD, Roy P, Runghien T, Saeed U, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahoo SS, Sahu M, Sakshaug JW, Salami AA, Saleh MA, Salehi omran H, Sallam M, Samadzadeh S, Samodra YL, Sanjeev RK, Sarasmita MA, Saravanan A, Sartorius B, Saulam J, Schumacher AE, Seyedi SA, Shafie M, Shahid S, Sham S, Shamim MA, Shamshirgaran MA, Shastry RP, Sherchan SP, Shiferaw D, Shittu A, Siddig EE, Sinto R, Sood A, Sorensen RJD, Stergachis A, Stoeva TZ, Swain CK, Szarpak L, Tamuzi JL, Temsah MH, Tessema MBT, Thangaraju P, Tran NM, Tran NH, Tumurkhuu M, Ty SS, Udoakang AJ, Ulhaq I, Umar TP, Umer AA, Vahabi SM, Vaithinathan AG, Van den Eynde J, Walson JL, Waqas M, Xing Y, Yadav MK, Yahya G, Yon DK, Zahedi Bialvaei A, Zakham F, Zeleke AM, Zhai C, Zhang Z, Zhang H, Zielińska M, Zheng P, Aravkin AY, Vos T, Hay SI, Mosser JF, Lim SS, Naghavi M, Murray CJL, Kyu HH. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis 2024:S1473-3099(24)00176-2. [PMID: 38636536 DOI: 10.1016/s1473-3099(24)00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020-21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. METHODS We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. FINDINGS Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325-364) incident episodes of LRI, or 4350 episodes (4120-4610) per 100 000 population, and 2·18 million deaths (1·98-2·36), or 27·7 deaths (25·1-29·9) per 100 000. 502 000 deaths (406 000-611 000) were in children younger than 5 years, among which 254 000 deaths (197 000-320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1-104·0) episodes and 505 000 deaths (454 000-555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6-49·3] episodes) and Mycoplasma spp (25·3 million [23·5-27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000-459 000]) and K pneumoniae (176 000 [158 000-194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9-46·9), from 56·5 deaths (51·3-61·9) to 32·9 deaths (29·9-35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1-18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8-78·9) decline in the number of influenza deaths and a 66·7% (56·6-75·3) decline in the number of RSV deaths. INTERPRETATION Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).
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Rybak A, Assad Z, Levy C, Bonarcorsi S, Béchet S, Werner A, Wollner A, Valtuille Z, Kaguelidou F, Angoulvant F, Cohen R, Varon E, Ouldali N. Age-Specific Resurgence in Invasive Pneumococcal Disease Incidence in the COVID-19 Pandemic Era and Its Association With Respiratory Virus and Pneumococcal Carriage Dynamics: A Time-Series Analysis. Clin Infect Dis 2024; 78:855-859. [PMID: 38059538 DOI: 10.1093/cid/ciad746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 12/08/2023] Open
Abstract
Using multiple national surveillance systems, we found an increase in the incidence of invasive pneumococcal disease during after the relaxation of non-pharmaceutical interventions against COVID-19, which strongly varied by age. Age groups with higher incidence of respiratory syncytial virus and influenza also experienced higher increase in invasive pneumococcal disease incidence, with no change in pneumococcal carriage.
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Affiliation(s)
- Alexis Rybak
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Pediatric Emergency Department, Trousseau Hospital, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
- Clinical Epidemiology Unit, Eceve Inserm UMR-S 1123, Robert Debré University Hospital, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
| | - Zein Assad
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Clinical Epidemiology Unit, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, Paris, France
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles (IMRB-GRC GEMINI), Université Paris Est Créteil, France
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Stéphane Bonarcorsi
- Microbiology Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité Paris, France
| | - Stéphane Béchet
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
| | - Andreas Werner
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Alain Wollner
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Zaba Valtuille
- Institut National de la Santé et de la Recherche Médicale, Centre of Clinical Investigations 1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florentia Kaguelidou
- Institut National de la Santé et de la Recherche Médicale, Centre of Clinical Investigations 1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Angoulvant
- Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale (Unité Mixte de Recherche S1138), Sorbonne Université, Université Paris Cité, Paris, France
- Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Créteil, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles (IMRB-GRC GEMINI), Université Paris Est Créteil, France
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Emmanuelle Varon
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Naïm Ouldali
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Nice, France
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Infection, Antimicrobials, Modelling, Evolution (IAME), Inserm UMR 1137, Paris Cité University, Paris, France
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Lyon E, Olarte L. Community-acquired bacterial pneumonia in children: an update on antibiotic duration and immunization strategies. Curr Opin Pediatr 2024; 36:144-149. [PMID: 38169463 DOI: 10.1097/mop.0000000000001325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW This review is structured to update clinicians on the epidemiology, antibiotic treatment, and prevention of pediatric bacterial pneumonia. The review provides information regarding the current research on antibiotic management for bacterial pneumonia and the newest immunization recommendations to prevent pneumococcal pneumonia and other respiratory infections. RECENT FINDINGS The recommended length of antibiotic therapy for bacterial pneumonia has been discrepant between low-income and high-income countries. Recently, randomized controlled trials conducted in high-income countries provided evidence to support a short antibiotic course (3-5 days) for uncomplicated bacterial pneumonia in otherwise healthy children. The negative impact of inaccurate penicillin allergy labels in children with pneumonia has emphasized the importance of prompt allergy de-labeling. Newer pneumococcal vaccines are recommended for children and are expected to have a significant impact on bacterial pneumonia rates. SUMMARY Pediatric bacterial pneumonia is an important contributor to childhood morbidity and mortality. A short antibiotic course seems to be sufficient for the outpatient management of uncomplicated bacterial pneumonia; however, more studies are required in the inpatient setting. Future studies will inform the impact of recently introduced pneumococcal and respiratory syncytial virus vaccines on the epidemiology of bacterial pneumonia.
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Affiliation(s)
- Edward Lyon
- Department of Pediatrics, Division of Infectious Diseases, Children's Mercy Kansas City
| | - Liset Olarte
- Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
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Felix A, Assad Z, Bidet P, Caseris M, Dumaine C, Faye A, Melki I, Kaguelidou F, Valtuille Z, Ouldali N, Meinzer U. Common Seasonal Pathogens and Epidemiology of Henoch-Schönlein Purpura Among Children. JAMA Netw Open 2024; 7:e245362. [PMID: 38578638 PMCID: PMC10998156 DOI: 10.1001/jamanetworkopen.2024.5362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/08/2024] [Indexed: 04/06/2024] Open
Abstract
Importance Henoch-Schönlein purpura (HSP) is the most common type of vasculitis in children. The factors that trigger the disease are poorly understood. Although several viruses and seasonal bacterial infections have been associated with HSP, differentiating the specific associations of these pathogens with the onset of HSP remains a challenge due to their overlapping seasonal patterns. Objective To analyze the role of seasonal pathogens in the epidemiology of HSP. Design, Setting, and Participants This cohort study comprised an interrupted time-series analysis of patient records from a comprehensive national hospital-based surveillance system. Children younger than 18 years hospitalized for HSP in France between January 1, 2015, and March 31, 2023, were included. Exposure Implementation and relaxation of nonpharmaceutical interventions (NPIs) for the COVID-19 pandemic, such as social distancing and mask wearing. Main Outcomes and Measures The main outcomes were the monthly incidence of HSP per 100 000 children, analyzed via a quasi-Poisson regression model, and the estimated percentage of HSP incidence potentially associated with 14 selected common seasonal pathogens over the same period. Results The study included 9790 children with HSP (median age, 5 years [IQR, 4-8 years]; 5538 boys [56.4%]) and 757 110 children with the infectious diseases included in the study (median age, 0.7 years [IQR, 0.2-2 years]; 393 697 boys [52.0%]). The incidence of HSP decreased significantly after implementation of NPIs in March 2020 (-53.6%; 95% CI, -66.6% to -40.6%; P < .001) and increased significantly after the relaxation of NPIs in April 2021 (37.2%; 95% CI, 28.0%-46.3%; P < .001). The percentage of HSP incidence potentially associated with Streptococcus pneumoniae was 37.3% (95% CI, 22.3%-52.3%; P < .001), the percentage of cases associated with Streptococcus pyogenes was 25.6% (95% CI, 16.7%-34.4%; P < .001), and the percentage of cases associated with human rhino enterovirus was 17.1% (95% CI, 3.8%-30.4%; P = .01). Three sensitivity analyses found similar results. Conclusions and Relevance This study found that significant changes in the incidence of HSP simultaneously with major shifts in circulating pathogens after NPIs for the COVID-19 pandemic indicated that approximately 60% of HSP incidence was potentially associated with pneumococcus and group A streptococcus. This finding suggests that preventive measures against these pathogens could reduce the incidence of pediatric HSP.
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Affiliation(s)
- Arthur Felix
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Competence Centre RAISE Antilles-Guyane, EpiCliV Research Unit, Department of General Pediatrics, Martinique University Hospital, University of French West Indies, Martinique, France
| | - Zein Assad
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Infection, Antimicrobials, Modeling, Evolution, Paris Cité University, INSERM UMR 1137, Paris, France
| | - Philippe Bidet
- Infection, Antimicrobials, Modeling, Evolution, Paris Cité University, INSERM UMR 1137, Paris, France
- Department of Microbiology, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marion Caseris
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Dumaine
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Albert Faye
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, INSERM UMR-1123, ECEVE, Paris, France
| | - Isabelle Melki
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Pediatrics, Rheumatology and Pediatric Internal Medicine, Children’s Hospital, Bordeaux, France
| | - Florentia Kaguelidou
- Center of Clinical Investigations, INSERM CIC1426, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Zaba Valtuille
- Center of Clinical Investigations, INSERM CIC1426, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Naïm Ouldali
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Infection, Antimicrobials, Modeling, Evolution, Paris Cité University, INSERM UMR 1137, Paris, France
| | - Ulrich Meinzer
- Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Department of General Pediatrics, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Centre de Recherche sur l’inflammation UMR 1149, Université Paris Cité, INSERM, Paris, France
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8
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Klee B, Diexer S, Horn J, Langer S, Wende M, Ortiz D, Bielecka A, Strowig T, Mikolajczyk R, Gottschick C. The impact of non-pharmaceutical interventions on community non-SARS-CoV-2 respiratory infections in preschool children. BMC Pediatr 2024; 24:231. [PMID: 38561704 PMCID: PMC10985994 DOI: 10.1186/s12887-024-04686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Effects of non-pharmaceutical interventions during the pandemic were mainly studied for severe outcomes. Among children, most of the burden of respiratory infections is related to infections which are not medically attended. The perspective on infections in the community setting is necessary to understand the effects of the pandemic on non-pharmaceutical interventions. METHODS In the unique prospective LoewenKIDS cohort study, we compared the true monthly incidence of self-reported acute respiratory infections (ARI) in about 350 participants (aged 3-4 years old) between October 2019 to March 2020 (pre-pandemic period) and October 2020 to March 2021 (pandemic period). Parents reported children's symptoms using a diary. Parents were asked to take a nasal swab of their child during all respiratory symptoms. We analysed 718 swabs using Multiplex PCR for 25 common respiratory viruses and bacteria. RESULTS During the pre-pandemic period, on average 44.6% (95% CI: 39.5-49.8%) of children acquired at least one ARI per month compared to 19.9% (95% CI: 11.1-28.7%) during the pandemic period (Incidence Rate Ratio = 0.47; 95% CI: 0.41-0.54). The detection of influenza virus decreased absolute by 96%, respiratory syncytial virus by 65%, metapneumovirus by 95%, parainfluenza virus by 100%, human enterovirus by 96% and human bocavirus by 70% when comparing the pre-pandemic to the pandemic period. However, rhinoviruses were nearly unaffected by NPI. Co-detection (detection of more than one virus in a single symptomatic swab) was common in the pre-pandemic period (222 of 390 samples with viral detection; 56.9%) and substantially less common during the pandemic period (46 of 216 samples; 21.3%). CONCLUSION Non-pharmaceutical interventions strongly reduced the incidence of all respiratory infections in preschool children but did not affect rhinovirus.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susan Langer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Marie Wende
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Diego Ortiz
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Agata Bielecka
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Till Strowig
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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9
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Lin GL, Drysdale SB, Snape MD, O'Connor D, Brown A, MacIntyre-Cockett G, Mellado-Gomez E, de Cesare M, Ansari MA, Bonsall D, Bray JE, Jolley KA, Bowden R, Aerssens J, Bont L, Openshaw PJM, Martinon-Torres F, Nair H, Golubchik T, Pollard AJ. Targeted metagenomics reveals association between severity and pathogen co-detection in infants with respiratory syncytial virus. Nat Commun 2024; 15:2379. [PMID: 38493135 PMCID: PMC10944482 DOI: 10.1038/s41467-024-46648-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/23/2024] [Indexed: 03/18/2024] Open
Abstract
Respiratory syncytial virus (RSV) is the leading cause of hospitalisation for respiratory infection in young children. RSV disease severity is known to be age-dependent and highest in young infants, but other correlates of severity, particularly the presence of additional respiratory pathogens, are less well understood. In this study, nasopharyngeal swabs were collected from two cohorts of RSV-positive infants <12 months in Spain, the UK, and the Netherlands during 2017-20. We show, using targeted metagenomic sequencing of >100 pathogens, including all common respiratory viruses and bacteria, from samples collected from 433 infants, that burden of additional viruses is common (111/433, 26%) but only modestly correlates with RSV disease severity. In contrast, there is strong evidence in both cohorts and across age groups that presence of Haemophilus bacteria (194/433, 45%) is associated with higher severity, including much higher rates of hospitalisation (odds ratio 4.25, 95% CI 2.03-9.31). There is no evidence for association between higher severity and other detected bacteria, and no difference in severity between RSV genotypes. Our findings reveal the genomic diversity of additional pathogens during RSV infection in infants, and provide an evidence base for future causal investigations of the impact of co-infection on RSV disease severity.
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Affiliation(s)
- Gu-Lung Lin
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
- NIHR Oxford Biomedical Research Centre, Oxford, UK.
| | - Simon B Drysdale
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Daniel O'Connor
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Anthony Brown
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK
| | | | - Esther Mellado-Gomez
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Wellcome Sanger Institute, Hinxton, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Human Technopole, Milan, Italy
| | - M Azim Ansari
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - David Bonsall
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - James E Bray
- Department of Biology, University of Oxford, Oxford, UK
| | | | - Rory Bowden
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia
| | - Jeroen Aerssens
- Translational Biomarkers, Infectious Diseases Therapeutic Area, Janssen Pharmaceutica NV, Beerse, Belgium
| | - Louis Bont
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- ReSViNET Foundation, Zeist, Netherlands
| | | | - Federico Martinon-Torres
- Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
- Genetics, Vaccines, Infectious Diseases and Pediatrics Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Harish Nair
- Centre for Global Health, Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tanya Golubchik
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Sydney Infectious Diseases Institute, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
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10
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Meyer Sauteur PM. Childhood community-acquired pneumonia. Eur J Pediatr 2024; 183:1129-1136. [PMID: 38112800 PMCID: PMC10950989 DOI: 10.1007/s00431-023-05366-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 12/21/2023]
Abstract
Community-acquired pneumonia (CAP) is a common disease in children, and its aetiological and clinical diagnosis are challenging for physicians in both private practice and hospitals. Over the past three decades, conjugate vaccines have successfully reduced the burden of the former main causes of CAP, Streptococcus pneumoniae and Haemophilus influenzae type b. Today, viruses are by far the most commonly detected pathogens in children with CAP. Conclusion: New insights into the aetiology and treatment of CAP in children in recent years have influenced management and are the focus of this review. In addition to reducing diagnostic uncertainty, there is an urgent need to reduce antibiotic overuse and antimicrobial resistance in children with CAP. What is Known: • Conjugate vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b have shifted the epidemiology of childhood CAP to predominantly viral pathogens and Mycoplasma pneumoniae. • Clinical, laboratory, and radiological criteria cannot reliably distinguish between bacterial and viral aetiology in children with CAP. What is New: • Test results and epidemiological data must be carefully interpreted, as no single diagnostic method applied to non-pulmonary specimens has both high sensitivity and high specificity for determining pneumonia aetiology in childhood CAP. • This review provides a simple and pragmatic management algorithm for children with CAP to aid physicians in providing optimal and safe care and reducing antibiotic prescribing.
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Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032, Zurich, Switzerland.
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11
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Shmueli M, Lendner I, Ben-Shimol S. Effect of the COVID-19 pandemic on the pediatric infectious disease landscape. Eur J Pediatr 2024; 183:1001-1009. [PMID: 37726566 DOI: 10.1007/s00431-023-05210-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
This narrative review aims to present an overview of the COVID-19 pandemic's effects on the landscape of pediatric infectious diseases. While COVID-19 generally results in mild symptoms and a favorable prognosis in children, the pandemic brought forth significant consequences. These included persistent symptoms among infected children ("long COVID"), a profound transformation in healthcare utilization (notably through the widespread adoption of telemedicine), and the implementation of optimization strategies within healthcare settings. Furthermore, the pandemic resulted in alterations in the circulation patterns of respiratory pathogens, including influenza, RSV, and Streptococcus pneumoniae. The possible reasons for those changes are discussed in this review. COVID-19 effect was not limited to respiratory infectious diseases, as other diseases, including urinary tract and gastrointestinal infections, have displayed decreased transmission rates, likely attributable to heightened hygiene measures and shifts in care-seeking behaviors. Finally, the disruption of routine childhood vaccination programs has resulted in reduced immunization coverage and an upsurge in vaccine hesitancy. In addition, the pandemic was associated with issues of antibiotic misuse and over-prescription. Conclusion: In conclusion, the COVID-19 pandemic has left a profound and multifaceted impact on the landscape of pediatric infectious diseases, ranging from the emergence of "long COVID" in children to significant changes in healthcare delivery, altered circulation patterns of various pathogens, and concerning disruptions in vaccination programs and antibiotic usage. What is Known: • COVID-19 usually presents with mild symptoms in children, although severe and late manifestations are possible. • The pandemic resulted in a dramatically increased use of health care services, as well as alterations in the circulation patterns of respiratory pathogens, decreased rates of other, non-respiratory, infections, disruption of routine childhood vaccination programs, and antibiotic misuse. What is New: • Possible strategies to tackle future outbreaks are presented, including changes in health care services utilization, implementation of updated vaccine programs and antibiotic stewardship protocols. • The decline in RSV and influenza circulation during COVID-19 was probably not primarily related to NPI measures, and rather related to other, non-NPI measures implementation, including specific pathogen-host interactions on the level of the biological niche (the nasopharynx).
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Affiliation(s)
- Moshe Shmueli
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Idan Lendner
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Department B, Soroka University Medical Center, Beer-Sheva, Israel
| | - Shalom Ben-Shimol
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel.
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12
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Goretzki SC, van der Linden M, Itzek A, Hühne T, Adelmann RO, Ala Eldin F, Albarouni M, Becker JC, Berghäuser MA, Boesing T, Boeswald M, Brasche M, Brevis Nuñez F, Camara R, Deibert C, Dohle F, Dolgner J, Dziobaka J, Eifinger F, Elting N, Endmann M, Engelmann G, Frenzke H, Gappa M, Gharavi B, Goletz C, Hahn E, Heidenreich Y, Heimann K, Hensel KO, Hoffmann HG, Hoppenz M, Horneff G, Klassen H, Koerner-Rettberg C, Längler A, Lenz P, Lohmeier K, Müller A, Niemann F, Paulussen M, Pentek F, Perez R, Pingel M, Repges P, Rothoeft T, Rübo J, Schade H, Schmitz R, Schonhoff P, Schwade JN, Schwarz T, Seiffert P, Selzer G, Spille U, Thiel C, Thimm A, Urgatz B, van den Heuvel A, van Hop T, Giesen V, Wirth S, Wollbrink T, Wüller D, Felderhoff-Müser U, Dohna-Schwake C, Lâm TT, Claus H, Bruns N. Outbreak of severe community-acquired bacterial infections among children in North Rhine-Westphalia (Germany), October to December 2022. Infection 2024:10.1007/s15010-023-02165-x. [PMID: 38366304 DOI: 10.1007/s15010-023-02165-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/21/2023] [Indexed: 02/18/2024]
Abstract
PURPOSE In late 2022, a surge of severe S. pyogenes infections was reported in several European countries. This study assessed hospitalizations and disease severity of community-acquired bacterial infections with S. pyogenes, S. pneumoniae, N. meningitidis, and H. influenzae among children in North Rhine-Westphalia (NRW), Germany, during the last quarter of 2022 compared to long-term incidences. METHODS Hospital cases due to bacterial infections between October and December 2022 were collected in a multicenter study (MC) from 59/62 (95%) children's hospitals in NRW and combined with surveillance data (2016-2023) from the national reference laboratories for streptococci, N. meningitidis, and H. influenzae. Overall and pathogen-specific incidence rates (IR) from January 2016 to March 2023 were estimated via capture-recapture analyses. Expected annual deaths from the studied pathogens were calculated from national death cause statistics. RESULTS In the MC study, 153 cases with high overall disease severity were reported with pneumonia being most common (59%, n = 91). IRs of bacterial infections declined at the beginning of the COVID-19 pandemic and massively surged to unprecedented levels in late 2022 and early 2023 (overall hospitalizations 3.5-fold), with S. pyogenes and S. pneumoniae as main drivers (18-fold and threefold). Observed deaths during the study period exceeded the expected number for the entire year in NRW by far (7 vs. 0.9). DISCUSSION The unprecedented peak of bacterial infections and deaths in late 2022 and early 2023 was caused mainly by S. pyogenes and S. pneumoniae. Improved precautionary measures are needed to attenuate future outbreaks.
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Affiliation(s)
- Sarah C Goretzki
- Department of Pediatrics I (Neonatology, Pediatric Intensive Care, Pediatric Neurology, and Pediatric Infectious Diseases), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mark van der Linden
- German Reference Laboratory for Streptococci, Department of Medical Microbiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Andreas Itzek
- German Reference Laboratory for Streptococci, Department of Medical Microbiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Tom Hühne
- Department of Pediatrics I (Neonatology, Pediatric Intensive Care, Pediatric Neurology, and Pediatric Infectious Diseases), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Roland O Adelmann
- Department of General Pediatrics, Klinikum Oberberg, Kreiskrankenhaus Gummersbach, Gummersbach, Germany
| | - Firas Ala Eldin
- Department of General Pediatrics, Helios Hospital Schwelm, Schwelm, Germany
| | - Mohamed Albarouni
- Department of General Pediatrics, Marien-Hospital Gelsenkirchen, Gelsenkirchen, Germany
| | | | - Martin A Berghäuser
- Division of Pediatric Intensive Care, Department of Pediatrics, Florence Nightingale Hospital Kaiserswerth, Düsseldorf, Germany
| | - Thomas Boesing
- Division of Pediatric Intensive Care, Department of Pediatrics, Protestant Hospital Bethel, University of Bielefeld, Bielefeld, Germany
| | - Michael Boeswald
- Department of Pediatrics, Sankt Franziskus Hospital Münster, Münster, Germany
| | - Milian Brasche
- Division of Neonatology, Department of Pediatrics, University Hospital, RWTH University of Aachen, Aachen, Germany
| | - Francisco Brevis Nuñez
- Division of Pediatric Intensive Care, Department of Pediatrics, Sana Hospitals Duisburg, Duisburg, Germany
| | - Rokya Camara
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, GFO Hospital Bonn, Bonn, Germany
| | - Clara Deibert
- Department of General Pediatrics, DRK Hospital Kirchen, Kirchen, Germany
| | - Frank Dohle
- Department of Pediatrics, Pediatric Intensive Care Medicine, St. Vinzenz Hospital Paderborn, Paderborn, Germany
| | - Jörg Dolgner
- Department of General Pediatrics, GFO Hospital Dinslaken, Dinslaken, Germany
| | - Jan Dziobaka
- Department of Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Frank Eifinger
- Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital, University of Cologne, Cologne, Germany
| | - Natalie Elting
- Department of General Pediatrics, Evangelical Hospital Oberhausen, Oberhausen, Germany
| | - Matthias Endmann
- Department of General Pediatrics, St. Franziskus-Hospital Ahlen, Ahlen, Germany
| | - Guido Engelmann
- Department of General Pediatrics, Lukas-Hospital Neuss, Neuss, Germany
| | - Holger Frenzke
- Department of General Pediatrics, Märkisch Hospital Lüdenscheid, Lüdenscheid, Germany
| | - Monika Gappa
- Department of General Pediatrics, Evangelical Hospital Düsseldorf, Düsseldorf, Germany
| | - Bahman Gharavi
- Department of General Pediatrics, Marien-Hospital Witten, Witten, Germany
| | - Christine Goletz
- Department of General Pediatrics, Städtische Kliniken Mönchengladbach, Elisabeth-Hospital Rheydt, Mönchengladbach, Germany
| | - Eva Hahn
- Department of Pediatrics and Adolescent Medicine, Sankt Agnes Hospital, Bocholt, Germany
| | | | - Konrad Heimann
- Division of Neonatology, Department of Pediatrics, University Hospital, RWTH University of Aachen, Aachen, Germany
| | - Kai O Hensel
- Division of Pediatric Intensive Care, Department of Pediatrics, Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany
| | | | - Marc Hoppenz
- Division of Pediatric Intensive Care, Department of Pediatrics, Children's Hospital, Amsterdamer Str., Cologne, Germany
| | - Gerd Horneff
- Department of Pediatrics, Asklepios Clinic Sankt Augustin GmbH, Sankt Augustin, Germany
| | - Helene Klassen
- Department of Pediatrics and Adolescent Medicine, Hochsauerland Hospital, Arnsberg, Germany
| | | | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, University of Witten/Herdecke, Herdecke, Germany
| | - Pascal Lenz
- Department of General Pediatrics, Hospital Leverkusen GmbH, Leverkusen, Germany
| | - Klaus Lohmeier
- Division of Neonatology and Pediatric Cardiology, Department of General Pediatrics, Heinrich Heine University, Düsseldorf, Germany
| | - Andreas Müller
- Department of Neonatology and Pediatric Intensive Care Medicine, University of Bonn, Bonn, Germany
| | - Frank Niemann
- Department of General Pediatrics, Marien-Hospital Gelsenkirchen, Gelsenkirchen, Germany
| | - Michael Paulussen
- Division of Oncology and Haematology, Department of General Pediatrics, Hospital of Children and Adolescents, University of Witten/Herdecke, Datteln, Germany
| | - Falk Pentek
- Department of Pediatrics, Elisabeth-Hospital Essen, Essen, Germany
| | - Ruy Perez
- Division of Pediatric Intensive Care, Department of Pediatrics, Helios Hospital Krefeld, Krefeld, Germany
| | - Markus Pingel
- Department of General Pediatrics, DRK Hospital Siegen gGmbH, Siegen, Germany
| | - Philip Repges
- Department of General Pediatrics, Porz, Cologne, Germany
| | - Tobias Rothoeft
- Division of Neonatology and Pediatric Intensive Care, University Children's Hospital, Ruhr University of Bochum, Bochum, Germany
| | - Jochen Rübo
- Department of General Pediatrics, St. Antonius Hospital Kleve, Kleve, Germany
| | - Herbert Schade
- Department of General Pediatrics, Hospital Mechernich GmbH, Mechernich, Germany
| | - Robert Schmitz
- Department of Pediatrics, Helios Clinic Duisburg, Duisburg, Germany
| | - Peter Schonhoff
- Department of Pediatrics, Clemenshospital Münster, Münster, Germany
| | - Jan N Schwade
- Department of General Pediatrics, Evangelical Hospital Lippstadt, Lippstadt, Germany
| | - Tobias Schwarz
- Department of General Pediatrics, Municipal Hospital Solingen, Solingen, Germany
| | - Peter Seiffert
- Department of Pediatrics, Helios Clinic Duisburg, Duisburg, Germany
| | - Georg Selzer
- Division of Neonatology and Pediatric Intensive Care, Evangelical Hospital Hamm, Hamm, Germany
| | - Uwe Spille
- Department of General Pediatrics, Herford, Germany
| | - Carsten Thiel
- Department of Pediatrics, St.-Clemens-Hospital Geldern, Geldern, Germany
| | - Ansgar Thimm
- Department of General Pediatrics, Sana-Hospital Remscheid, Remscheid, Germany
| | | | - Alijda van den Heuvel
- Division of Pediatric Intensive Care, Department of Pediatrics, University Hospital Münster, Münster, Germany
| | - Tan van Hop
- Department of General Pediatrics, Hospital Oberhausen Sterkrade gGmbH, Oberhausen, Germany
| | - Verena Giesen
- Department of General Pediatrics, Bethanien Hospital Moers, Moers, Germany
| | - Stefan Wirth
- Department of Pediatrics, Helios Medical Center Niederberg, Velbert, Germany
| | - Thomas Wollbrink
- Division of Pediatric Intensive Care, Department of Pediatrics, Bergmannsheil Pediatric Hospital Gelsenkirchen Buer, Gelsenkirchen, Germany
| | - Daniel Wüller
- Department of Pediatrics and Adolescent Medicine, Christophorus Hospital, Coesfeld, Germany
| | - Ursula Felderhoff-Müser
- Department of Pediatrics I (Neonatology, Pediatric Intensive Care, Pediatric Neurology, and Pediatric Infectious Diseases), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christian Dohna-Schwake
- Department of Pediatrics I (Neonatology, Pediatric Intensive Care, Pediatric Neurology, and Pediatric Infectious Diseases), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thiên-Trí Lâm
- German National Reference Laboratory for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Heike Claus
- German National Reference Laboratory for Meningococci and Haemophilus Influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - Nora Bruns
- Department of Pediatrics I (Neonatology, Pediatric Intensive Care, Pediatric Neurology, and Pediatric Infectious Diseases), University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Meyer Sauteur PM, Beeton ML. Mycoplasma pneumoniae: delayed re-emergence after COVID-19 pandemic restrictions. Lancet Microbe 2024; 5:e100-e101. [PMID: 38008103 DOI: 10.1016/s2666-5247(23)00344-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Patrick M Meyer Sauteur
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich CH-8032, Switzerland.
| | - Michael L Beeton
- Microbiology and Infection Research Group, Department of Biomedical Sciences, Cardiff Metropolitan University, Cardiff, UK
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Rybak A, Ouldali N, Varon E, Taha MK, Bonacorsi S, Béchet S, Angoulvant F, Cohen R, Levy C. Vaccine-preventable Pediatric Acute Bacterial Meningitis in France: A Time Series Analysis of a 19-Year Prospective National Surveillance Network. Pediatr Infect Dis J 2024; 43:74-83. [PMID: 38108805 PMCID: PMC10723767 DOI: 10.1097/inf.0000000000004134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND In France, vaccination has been implemented against Hi serotype b (Hib), pneumococcus with pneumococcal conjugate vaccines (PCV), and Neisseria meningitidis serogroup C (MenC). These interventions with different coverage and uptake have disrupted the epidemiology of vaccine-preventable acute bacterial meningitis (ABM). METHODS We analyzed data from a French prospective surveillance network of ABM in children ≤15 years old enrolled by 259 pediatric wards (estimated national coverage: 61%). From 2001 to 2020, the effect of vaccine implementation was estimated with segmented linear regression. RESULTS We analyzed 7,186 cases, mainly due to meningococcus (35.0%), pneumococcus (29.8%), and Hi (3.7%). MenC ABM incidence decreased (-0.12%/month, 95% CI: -0.17 to -0.07, P < 0.001) with no change for the overall meningococcal ABM when comparing the pre-MenC vaccination and the post-MenC vaccination trends. Despite a decreasing MenB ABM incidence without a vaccination program (-0.43%/month, 95% CI: -0.53 to -0.34, P < 0.001), 68.3% of meningococcal ABM involved MenB. No change in pneumococcal ABM incidence was observed after the PCV7 recommendation. By contrast, this incidence significantly decreased after the switch to PCV13 (-0.9%/month, 95% CI: -1.6 to -0.2%, P = 0.01). After May 2014, a rebound occurred (0.5%/month, 95% CI: 0.3-0.8%, P < 0.001), with 89.5% of non-PCV13 vaccine serotypes. Hib ABM incidence increased after June 2017. CONCLUSIONS PCV7 and MenC vaccine introduction in France, with slow vaccine uptake and low coverage, had no to little impact as compared to the switch from PCV7 to PCV13, which occurred when coverage was optimal. Our data suggest that MenB and next-generation PCVs could prevent a large part of the ABM incidence in France.
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Affiliation(s)
- Alexis Rybak
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- ECEVE, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables, UMR S-1123, INSERM, Université Paris Cité, Paris, Ile-de-France, France
- Department of Pediatric Emergency, Trousseau University Hospital, Sorbonne Université, Paris, Ile-de-France, France
| | - Naïm Ouldali
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Vaud, Switzerland
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, Ile-de-France, France
| | - Emmanuelle Varon
- Laboratory of Microbiology and National Reference Centre for Pneumococci, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
| | - Muhamed-Kheir Taha
- Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus Influenzae, Institut Pasteur, Paris, Ile-de-France, France
| | - Stéphane Bonacorsi
- Laboratory of Microbiology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, Ile-de-France, France
| | - Stéphane Béchet
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois), Lausanne, Vaud, Switzerland
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Sorbonne Université, Université Paris Cité, Paris, Ile-de-France, France
- HeKA, Inria Paris, Université Paris Cité, Paris, Ile-de-France, France
| | - Robert Cohen
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
- GEMINI, Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Université Paris Est, Créteil, Ile-de-France, France
| | - Corinne Levy
- From the ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, Ile-de-France, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Paris, Ile-de-France, France
- Research Center, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, Ile-de-France, France
- GEMINI, Groupe de Recherche Clinique-Groupe d’Etude des Maladies Infectieuses Néonatales et Infantiles, Institut Mondor de Recherche Biomédicale, Université Paris Est, Créteil, Ile-de-France, France
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15
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Metz C, Schmid A, Veldhoen S. Increase in complicated upper respiratory tract infection in children during the 2022/2023 winter season-a post coronavirus disease 2019 effect? Pediatr Radiol 2024; 54:49-57. [PMID: 37999795 PMCID: PMC10776702 DOI: 10.1007/s00247-023-05808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Upper respiratory tract infections usually peak during winter months. OBJECTIVE The purpose of this study was to evaluate whether imaging of complicated upper airway infection in children increased during the winter season of 2022/2023. MATERIALS AND METHODS In a retrospective study setting, pediatric magnetic resonance imaging (MRI) and computed tomography (CT) scans for evaluation of upper respiratory tract infection performed between October 2022 and April 2023 were analyzed regarding presence of the following complications: mastoiditis, abscess, phlegmon, meningitis, reactive vasculitis, and sinus vein thrombosis. Pathogen detection, surgery, and infection parameters were obtained. Data were compared with MRI and CT scans performed in the same months of the preceding five years, distinguishing between pandemic and pre-pandemic years. RESULTS During the 2022/2023 winter season, the number of MRI and CT scans in children with upper airway infections, the complication rate, the rate of detected streptococcal infections, and the rate of surgery increased significantly compared to expectations based on the five prior winter seasons (all P<0.05). During the first complete pandemic winter season in Europe (2020/2021), the number of MRI and CT scans in children with upper airway infection, the complication rate, and the rates of streptococcal detection and surgery decreased significantly compared to expectations based on the pre-pandemic, the second pandemic, and the post-pandemic winter seasons (all P<0.05). CONCLUSION After a decline during the first pandemic winter season, there was a marked rebound in complicated upper airway infection in children, with a significant increase in cases during the 2022/2023 winter season compared to the pre-pandemic and pandemic years.
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Affiliation(s)
- Corona Metz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Pediatric Radiology, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Andrea Schmid
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Pediatric Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Simon Veldhoen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Pediatric Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
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16
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Hedin K. Sore throat-related infections - lessons learnt from non-pharmacological interventions and non-COVID-19 infections. Clin Microbiol Infect 2024; 30:18-19. [PMID: 37914084 DOI: 10.1016/j.cmi.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Katarina Hedin
- Futurum, Region Jönköping County, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden.
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17
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Olwagen CP, Downs SL, Izu A, Tharasimbi L, Van Der Merwe L, Nunes MC, Madhi SA. Bacterial nasopharyngeal colonisation in children in South Africa before and during the COVID-19 pandemic: an observational study. Lancet Microbe 2024; 5:e34-e42. [PMID: 38048806 PMCID: PMC10789613 DOI: 10.1016/s2666-5247(23)00260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Deployment of non-pharmaceutical interventions such as face masking and physical distancing during the COVID-19 pandemic could have altered the transmission dynamics and carriage of respiratory organisms. We evaluated colonisation with Streptococcus pneumoniae and other upper respiratory tract bacterial colonisers before and during the COVID-19 pandemic. METHODS We did two cross-sectional surveys in Soweto, South Africa from July 3 to Dec 13, 2018 (pre-COVID-19 period) and from Aug 4, 2021, to March 31, 2022 (COVID-19 period) in healthy children (aged ≤60 months) who had recorded HIV status and had not received antibiotics in the 21 days before enrolment. At enrolment, we collected nasopharyngeal swab samples from child participants. Following nucleic acid extraction, nanofluidic quantitative PCR was used to screen all samples for 92 S pneumoniae serotypes and 14 other bacteria. The primary objective was to compare the prevalence and density of pneumococcal nasopharyngeal colonisation, overall and stratified by 13-valent pneumococcal conjugate vaccine (PCV13) serotypes and non-vaccine serotypes. Secondary study objectives included a comparison of serotype-specific pneumococcal colonisation and density, as well as colonisation by the 14 other bacteria in the COVID-19 versus pre-COVID-19 period. We used an adjusted multiple logistic and linear regression model to compare the colonisation prevalence and density between study periods. FINDINGS We analysed nasopharyngeal swabs from 1107 children (n=571 in the pre-COVID-19 period; n=536 in the COVID-19 period). We observed no change in overall pneumococcal colonisation between periods (274 [51%] of 536 in the COVID-19 period vs 282 [49%] of 571 in the pre-COVID-19 period; adjusted odds ratio [aOR] 1·03 [95% CI 0·95-1·12]). The prevalence of PCV13 serotypes was lower in the COVID-19 than in the pre-COVID-19 period (72 [13%] vs 106 [19%]; 0·87 [0·78-0·97]), whereas the prevalence of non-typeable S pneumoniae was higher (34 [6%] vs 63 [12%]; 1·30 [1·12-1·50]). The mean log10 density for overall pneumococcal colonisation was lower in the COVID-19 period than in the pre-COVID-19 period (3·96 [95% CI 3·85-4·07] vs 4·72 [4·63-4·80] log10 genome equivalents per mL; p<0·0001). A lower density of non-vaccine serotypes (3·63 [3·51-3·74] vs 4·08 [3·95-4·22] log10 genome equivalents per mL; p<0·0001) and non-typeable S pneumoniae (3·11 [2·94-3·29] vs 4·41 [4·06-4·75] log10 genome equivalents per mL; p<0·00001) was also observed in the COVID-19 period. There was no difference in the density of PCV13 serotypes between the periods. The prevalence of colonisation during the COVID-19 versus pre-COVID-19 period was lower for non-typeable Haemophilus influenzae (280 [49%] vs 165 [31%]; aOR 0·77 [95% CI 0·71-0·84]), Moraxella catarrhalis (328 [57%] vs 242 [45%]; 0·85 [0·79-0·92]), and Neisseria lactamica (51 [9%] vs 13 [2%]; 0·64 [0·52-0·78]), but higher for Acinetobacter baumannii (34 [6%] vs 102 [19%]; 1·55 [1·35-1·77]) and Staphylococcus aureus (29 [5%] vs 52 [10%]; 1·28 [1·10-1·50]). INTERPRETATION There were variable effects on the colonisation prevalence and density of bacterial organisms during the COVID-19 compared with the pre-COVID-19 period. The lower prevalence of PCV13 serotype together with other respiratory organisms including non-typeable H influenzae and M catarrhalis could have in part contributed to a decrease in all-cause lower respiratory tract infections observed in South Africa during the initial stage of the COVID-19 pandemic. The pathophysiological mechanism for the increase in A baumannii and S aureus colonisation warrants further investigation, as does the clinical relevance of these findings. FUNDING The Bill & Melinda Gates Foundation.
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Affiliation(s)
- Courtney P Olwagen
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa
| | - Sarah L Downs
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa
| | - Alane Izu
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa
| | - Lebohang Tharasimbi
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa
| | - Lara Van Der Merwe
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa
| | - Marta C Nunes
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Centre of Excellence in Respiratory Pathogens, Hospices Civils de Lyon, and Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, Lyon, France
| | - Shabir A Madhi
- South Africa Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Department of Science-National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Wits Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa.
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18
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Yildirim I, Lapidot R, Shaik-Dasthagirisaheb YB, Hinderstein S, Lee H, Klevens M, Grant L, Arguedas Mohs AG, Cane A, Madoff L, Johnson H, Ivanof C, Burns M, Pelton S. Invasive Pneumococcal Disease After 2 Decades of Pneumococcal Conjugate Vaccine Use. Pediatrics 2024; 153:e2023063039. [PMID: 38087952 DOI: 10.1542/peds.2023-063039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 01/02/2024] Open
Abstract
OBJECTIVES We sought to describe the evolving epidemiology of invasive pneumococcal disease (IPD) among children in Massachusetts, United States, over the last 2 decades during which sequential 7-valent pneumococcal conjugate vaccines (PCV7) and 13-valent PCVs (PCV13) were implemented. METHODS Cases of IPD in children aged <18 years were detected between 2002 and 2021 through an enhanced population-based, statewide surveillance system. Streptococcus pneumoniae isolates from normally sterile sites were serotyped and evaluated for antimicrobial susceptibility. IPD incidence rates and rate ratios with 95% confidence intervals (CIs) were calculated. RESULTS We identified 1347 IPD cases. Incidence of IPD in children aged <18 years declined 72% over 2 decades between 2002 and 2021 (incidence rate ratios 0.28, 95% CI 0.18-0.45). IPD rates continued to decline after replacement of PCV7 with PCV13 (incidence rate ratios 0.25, 95% CI 0.16-0.39, late PCV7 era [2010] versus late PCV13 era [2021]). During the coronavirus disease 2019 pandemic years, 2020 to 2021, the rate of IPD among children aged <18 years reached 1.6 per 100 000, the lowest incidence observed over the 20 years. In PCV13 era, approximately one-third of the IPD cases in children aged >5 years had at least 1 underlying condition (98, 30.3%). Serotypes 19A and 7F contributed 342 (48.9%) of all cases before implementation of PCV13 (2002-2010). Serotype 3 (31, 8.6%), and non-PCV13 serotypes 15B/C (39, 10.8%), 33F (29, 8.0%), 23B (21, 0.8%), and 35B (17, 4.7%) were responsible for 37.8% of cases in PCV13 era (2011-2021). Penicillin nonsusceptibility continued to decline (9.8% vs 5.3% in pre-/late PCV13 era, P = .003), however has become more common among non-PCV13 serotypes compared with vaccine serotypes (14.8% vs 1.4%, P < .001). CONCLUSIONS Robust ongoing surveillance networks are critical for identifying emerging serotypes and development of next-generation vaccine formulations.
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Affiliation(s)
- Inci Yildirim
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, New Haven, Connecticut
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
- Yale Institute for Global Health, Yale University, New Haven; Connecticut
- Yale Center for Infection and Immunity, Yale University, New Haven, Connecticut
| | - Rotem Lapidot
- Division of Pediatric Infectious Diseases, Rambam Health Care Campus, Haifa, Israel
- Department of Pediatrics, Section of Infectious Diseases, Boston University, Chobanian and Averdisian School of Medicine, Boston, Massachusetts
| | - Yazdani Basha Shaik-Dasthagirisaheb
- Department of Pediatrics, Section of Infectious Diseases, Boston University, Chobanian and Averdisian School of Medicine, Boston, Massachusetts
| | - Sarah Hinderstein
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Hanna Lee
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, New Haven, Connecticut
| | - Monina Klevens
- Massachusetts Department of Public Health, Boston, Massachusetts
| | | | | | | | - Larry Madoff
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Hillary Johnson
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Caryn Ivanof
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Meagan Burns
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Stephen Pelton
- Department of Pediatrics, Section of Infectious Diseases, Boston University, Chobanian and Averdisian School of Medicine, Boston, Massachusetts
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19
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Sugimoto S, Kawase M, Suwa R, Kakizaki M, Kume Y, Chishiki M, Ono T, Okabe H, Norito S, Hosoya M, Hashimoto K, Shirato K. Development of a duplex real-time RT-PCR assay for the detection and identification of two subgroups of human metapneumovirus in a single tube. J Virol Methods 2023; 322:114812. [PMID: 37741464 DOI: 10.1016/j.jviromet.2023.114812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/25/2023]
Abstract
Human metapneumovirus (hMPV) is a common cause of respiratory infections in children. Many genetic diagnostic assays have been developed, but most detect hMPV regardless of the subgroup. In this study, we developed a real-time RT-PCR assay that can detect and identify the two major subgroups of hMPV (A and B) in one tube. Primers and probes were designed based on the sequences of recent clinical isolates in Japan. The assay showed comparable analytical sensitivity to a previously reported real-time RT-PCR assay and specific reactions to hMPV subgroups. The assay also showed no cross-reactivity to clinical isolates of 19 species of other respiratory viruses. In a validation assay using post-diagnosed clinical specimens, 98% (167/170) positivity was confirmed for the duplex assay, and the three specimens not detected were of low copy number. The duplex assay also successfully distinguished the two major subgroups for all 12 clinical specimens, for which the subgroup had already been determined by genomic sequencing analysis. The duplex assay described here will contribute to the rapid and accurate identification and surveillance of hMPV infections.
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Affiliation(s)
- Satoko Sugimoto
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan; Management Department of Biosafety, Laboratory Animals, and Pathogen Bank, National Institute of Infectious Disease, Musashimurayama, Tokyo, Japan
| | - Miyuki Kawase
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Reiko Suwa
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Masatoshi Kakizaki
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Yohei Kume
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Ono
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hisao Okabe
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Sakurako Norito
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Koichi Hashimoto
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kazuya Shirato
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan.
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Fleming JA, Baral R, Higgins D, Khan S, Kochar S, Li Y, Ortiz JR, Cherian T, Feikin D, Jit M, Karron RA, Limaye RJ, Marshall C, Munywoki PK, Nair H, Newhouse LC, Nyawanda BO, Pecenka C, Regan K, Srikantiah P, Wittenauer R, Zar HJ, Sparrow E. Value profile for respiratory syncytial virus vaccines and monoclonal antibodies. Vaccine 2023; 41 Suppl 2:S7-S40. [PMID: 37422378 DOI: 10.1016/j.vaccine.2022.09.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 07/10/2023]
Abstract
Respiratory syncytial virus (RSV) is the predominant cause of acute lower respiratory infection (ALRI) in young children worldwide, yet no licensed RSV vaccine exists to help prevent the millions of illnesses and hospitalizations and tens of thousands of young lives taken each year. Monoclonal antibody (mAb) prophylaxis exists for prevention of RSV in a small subset of very high-risk infants and young children, but the only currently licensed product is impractical, requiring multiple doses and expensive for the low-income settings where the RSV disease burden is greatest. A robust candidate pipeline exists to one day prevent RSV disease in infant and pediatric populations, and it focuses on two promising passive immunization approaches appropriate for low-income contexts: maternal RSV vaccines and long-acting infant mAbs. Licensure of one or more candidates is feasible over the next one to three years and, depending on final product characteristics, current economic models suggest both approaches are likely to be cost-effective. Strong coordination between maternal and child health programs and the Expanded Program on Immunization will be needed for effective, efficient, and equitable delivery of either intervention. This 'Vaccine Value Profile' (VVP) for RSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations, and in collaboration with stakeholders from the WHO headquarters. All contributors have extensive expertise on various elements of the RSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- Jessica A Fleming
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Ranju Baral
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Deborah Higgins
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Sadaf Khan
- Maternal, Newborn, Child Health and Nutrition, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Sonali Kochar
- Global Healthcare Consulting and Department of Global Health, University of Washington, Hans Rosling Center, 3980 15th Ave NE, Seattle, WA 98105, United States.
| | - You Li
- School of Public Health, Nanjing Medical University, No. 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province 211166, PR China.
| | - Justin R Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 West Baltimore Street, Baltimore, MD 21201-1509, United States.
| | - Thomas Cherian
- MMGH Consulting GmbH, Kuerbergstrasse 1, 8049 Zurich, Switzerland.
| | - Daniel Feikin
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
| | - Mark Jit
- London School of Hygiene & Tropical Medicine, University of London, Keppel St, London WC1E 7HT, United Kingdom.
| | - Ruth A Karron
- Center for Immunization Research, Johns Hopkins University, Department of International Health, 624 N. Broadway, Rm 117, Baltimore, MD 21205, United States.
| | - Rupali J Limaye
- International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, United States.
| | - Caroline Marshall
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
| | - Patrick K Munywoki
- Center for Disease Control and Prevention, KEMRI Complex, Mbagathi Road off Mbagathi Way, PO Box 606-00621, Village Market, Nairobi, Kenya.
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, United Kingdom.
| | - Lauren C Newhouse
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Bryan O Nyawanda
- Kenya Medical Research Institute, Hospital Road, P.O. Box 1357, Kericho, Kenya.
| | - Clint Pecenka
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Katie Regan
- Center for Vaccine Innovation and Access, PATH, 2201 Westlake Ave Suite 200, Seattle, WA 98121, United States.
| | - Padmini Srikantiah
- Bill & Melinda Gates Foundation, 500 5th Ave N, Seattle, WA 98109, United States.
| | - Rachel Wittenauer
- Department of Pharmacy, University of Washington, Health Sciences Building, 1956 NE Pacific St H362, Seattle, WA 98195, United States.
| | - Heather J Zar
- Department of Paediatrics & Child Health and SA-MRC Unit on Child & Adolescent Health, Red Cross Children's Hospital, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town 7700, South Africa.
| | - Erin Sparrow
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
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21
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Abstract
The large global burden of respiratory syncytial virus (RSV) respiratory tract infections in young children and older adults has gained increased recognition in recent years. Recent discoveries regarding the neutralization-specific viral epitopes of the pre-fusion RSV glycoprotein have led to a shift from empirical to structure-based design of RSV therapeutics, and controlled human infection model studies have provided early-stage proof of concept for novel RSV monoclonal antibodies, vaccines and antiviral drugs. The world's first vaccines and first monoclonal antibody to prevent RSV among older adults and all infants, respectively, have recently been approved. Large-scale introduction of RSV prophylactics emphasizes the need for active surveillance to understand the global impact of these interventions over time and to timely identify viral mutants that are able to escape novel prophylactics. In this Review, we provide an overview of RSV interventions in clinical development, highlighting global disease burden, seasonality, pathogenesis, and host and viral factors related to RSV immunity.
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Affiliation(s)
- Annefleur C Langedijk
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Louis J Bont
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands.
- ReSViNET Foundation, Zeist, the Netherlands.
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22
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Engstrom EE, Plattner AS, McNeil JC, Hulten KG, Reich PJ, Boyle MG, Dunn JJ, Fritz SA, Kaplan SL. Invasive Community-Onset Gram-Positive Infections From July 2018 Through December 2022 at 2 Children's Hospitals. Open Forum Infect Dis 2023; 10:ofad563. [PMID: 38023538 PMCID: PMC10681712 DOI: 10.1093/ofid/ofad563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Invasive infections caused by Streptococcus pyogenes (invasive group A streptococcus [iGAS]) and Streptococcus pneumoniae (invasive pneumococcal disease [IPD]) decreased substantially at the beginning of the COVID-19 pandemic. Our study sought to evaluate the extent of this decrease and the trends of these infections since reversion of societal adjustments incident to the pandemic. We also wanted to compare the frequency of these infections with invasive community-onset Staphylococcus aureus (I-CO-SA) infections and common respiratory viral infections in this period. Methods Cases of iGAS, IPD, and I-CO-SA infections were identified prospectively and retrospectively at 2 large US children's hospitals by positive cultures from July 2018 through December 2022. Admission data were used to estimate frequency. For comparison, rates of respiratory syncytial virus (RSV), influenza, and SARS-CoV-2 were estimated by the number of positive viral test results at each institution. Results I-CO-SA infections showed little variation in the study period. Rates of iGAS infection and IPD decreased by 46% and 44%, respectively, from 2019 to 2020, coinciding with a substantial decrease in RSV and influenza. In 2022, RSV and influenza infection rates increased to prepandemic winter season rates, coinciding with a return to prepandemic rates of IPD (225% increase from 2021 to 2022) and a surge above prepandemic rates of iGAS infections (543% increase from 2021 to 2022). Conclusions The COVID-19 pandemic had an unexpected influence on IPD and iGAS infections that was temporally related to changes in rates of viral infections.
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Affiliation(s)
- Eric E Engstrom
- Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Alexander S Plattner
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis and St Louis Children's Hospital, St Louis, Missouri, USA
| | - J Chase McNeil
- Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Kristina G Hulten
- Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Patrick J Reich
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis and St Louis Children's Hospital, St Louis, Missouri, USA
| | - Mary G Boyle
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis and St Louis Children's Hospital, St Louis, Missouri, USA
| | - James J Dunn
- Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Stephanie A Fritz
- Department of Pediatrics, Division of Infectious Diseases, Washington University in St Louis and St Louis Children's Hospital, St Louis, Missouri, USA
| | - Sheldon L Kaplan
- Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
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23
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Kobayashi M, Pilishvili T, Farrar JL, Leidner AJ, Gierke R, Prasad N, Moro P, Campos-Outcalt D, Morgan RL, Long SS, Poehling KA, Cohen AL. Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023. MMWR Recomm Rep 2023; 72:1-39. [PMID: 37669242 PMCID: PMC10495181 DOI: 10.15585/mmwr.rr7203a1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
This report compiles and summarizes all published recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP) for use of pneumococcal vaccines in adults aged ≥19 years in the United States. This report also includes updated and new clinical guidance for implementation from CDC Before 2021, ACIP recommended 23-valent pneumococcal polysaccharide vaccine (PPSV23) alone (up to 2 doses), or both a single dose of 13-valent pneumococcal conjugate vaccine (PCV13) in combination with 1–3 doses of PPSV23 in series (PCV13 followed by PPSV23), for use in U.S. adults depending on age and underlying risk for pneumococcal disease. In 2021, two new pneumococcal conjugate vaccines (PCVs), a 15-valent and a 20-valent PCV (PCV15 and PCV20), were licensed for use in U.S. adults aged ≥18 years by the Food and Drug Administration ACIP recommendations specify the use of either PCV20 alone or PCV15 in series with PPSV23 for all adults aged ≥65 years and for adults aged 19–64 years with certain underlying medical conditions or other risk factors who have not received a PCV or whose vaccination history is unknown. In addition, ACIP recommends use of either a single dose of PCV20 or ≥1 dose of PPSV23 for adults who have started their pneumococcal vaccine series with PCV13 but have not received all recommended PPSV23 doses. Shared clinical decision-making is recommended regarding use of a supplemental PCV20 dose for adults aged ≥65 years who have completed their recommended vaccine series with both PCV13 and PPSV23 Updated and new clinical guidance for implementation from CDC includes the recommendation for use of PCV15 or PCV20 for adults who have received PPSV23 but have not received any PCV dose. The report also includes clinical guidance for adults who have received 7-valent PCV (PCV7) only and adults who are hematopoietic stem cell transplant recipients
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24
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Williams PC, Howard-Jones A, Butters C, Koirala A, Britton PN, Duguid R, Wijeratne P, Johnson N, Jayasinghe S. Clinical and Epidemiologic Profile of Invasive Pneumococcal Disease in Australian Children Following the Relaxation of Nonpharmaceutical Interventions Against SARS-COV-2. Pediatr Infect Dis J 2023; 42:e341-e342. [PMID: 37200512 PMCID: PMC10627390 DOI: 10.1097/inf.0000000000003972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
Abstract
A global resurgence of invasive pneumococcal disease (IPD) has been noted in children. We provide a detailed clinical and epidemiological analysis of IPD in Australian children following relaxation of nonpharmaceutical interventions against coronavirus disease 2019, revealing significant morbidity and mortality-even in vaccinated children without known predisposing risk factors. Almost half of the IPD cases were caused by serotypes not covered by the 13-valent pneumococcal conjugate vaccine.
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Affiliation(s)
- Phoebe C.M. Williams
- From the National Centre for Immunisation Research and Surveillance, New South Wales, Australia
- School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales, Australia
- Department of Infectious Diseases, Sydney Children’s Hospital Network, New South Wales, Australia
- Department of Clinical Microbiology, Sydney Institute of Infectious Diseases (Sydney ID), New South Wales, Australia
| | - Annaleise Howard-Jones
- School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales, Australia
- Department of Clinical Microbiology, Sydney Institute of Infectious Diseases (Sydney ID), New South Wales, Australia
- New South Wales Health Pathology, Institute of Clinical Pathology and Medical Research (ICPMR), New South Wales, Australia
| | - Coen Butters
- Department of Paediatrics, John Hunter Children’s Hospital, Newcastle, New South Wales, Australia
| | - Archana Koirala
- From the National Centre for Immunisation Research and Surveillance, New South Wales, Australia
- School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales, Australia
- Department of Infectious Diseases, Sydney Children’s Hospital Network, New South Wales, Australia
- Department of Clinical Microbiology, Sydney Institute of Infectious Diseases (Sydney ID), New South Wales, Australia
| | - Philip N. Britton
- From the National Centre for Immunisation Research and Surveillance, New South Wales, Australia
- School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales, Australia
- Department of Infectious Diseases, Sydney Children’s Hospital Network, New South Wales, Australia
- Department of Clinical Microbiology, Sydney Institute of Infectious Diseases (Sydney ID), New South Wales, Australia
| | - Robert Duguid
- Department of Infectious Diseases, Sydney Children’s Hospital Network, New South Wales, Australia
| | - Priyali Wijeratne
- Department of Infectious Diseases, Sydney Children’s Hospital Network, New South Wales, Australia
| | - Niall Johnson
- Department of Paediatrics, John Hunter Children’s Hospital, Newcastle, New South Wales, Australia
| | - Sanjay Jayasinghe
- From the National Centre for Immunisation Research and Surveillance, New South Wales, Australia
- School of Public Health, Faculty of Medicine, The University of Sydney, New South Wales, Australia
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25
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Shaw D, Abad R, Amin-Chowdhury Z, Bautista A, Bennett D, Broughton K, Cao B, Casanova C, Choi EH, Chu YW, Claus H, Coelho J, Corcoran M, Cottrell S, Cunney R, Cuypers L, Dalby T, Davies H, de Gouveia L, Deghmane AE, Demczuk W, Desmet S, Domenech M, Drew R, du Plessis M, Duarte C, Erlendsdóttir H, Fry NK, Fuursted K, Hale T, Henares D, Henriques-Normark B, Hilty M, Hoffmann S, Humphreys H, Ip M, Jacobsson S, Johnson C, Johnston J, Jolley KA, Kawabata A, Kozakova J, Kristinsson KG, Krizova P, Kuch A, Ladhani S, Lâm TT, León ME, Lindholm L, Litt D, Maiden MCJ, Martin I, Martiny D, Mattheus W, McCarthy ND, Meehan M, Meiring S, Mölling P, Morfeldt E, Morgan J, Mulhall R, Muñoz-Almagro C, Murdoch D, Murphy J, Musilek M, Mzabi A, Novakova L, Oftadeh S, Perez-Argüello A, Pérez-Vázquez M, Perrin M, Perry M, Prevost B, Roberts M, Rokney A, Ron M, Sanabria OM, Scott KJ, Sheppard C, Siira L, Sintchenko V, Skoczyńska A, Sloan M, Slotved HC, Smith AJ, Steens A, Taha MK, Toropainen M, Tzanakaki G, Vainio A, van der Linden MPG, van Sorge NM, Varon E, Vohrnova S, von Gottberg A, Yuste J, Zanella R, Zhou F, Brueggemann AB. 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. Lancet Digit Health 2023; 5:e582-e593. [PMID: 37516557 PMCID: PMC10914672 DOI: 10.1016/s2589-7500(23)00108-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/22/2023] [Accepted: 05/25/2023] [Indexed: 07/31/2023]
Abstract
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.
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Affiliation(s)
- David Shaw
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Raquel Abad
- National Reference Laboratory for Meningococci, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Zahin Amin-Chowdhury
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | | | - Desiree Bennett
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Karen Broughton
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Bin Cao
- 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
| | - Carlo Casanova
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yiu-Wai Chu
- Department of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China
| | - Heike Claus
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | - Juliana Coelho
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Mary Corcoran
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Robert Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lize Cuypers
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Tine Dalby
- Statens Serum Institut, Department of Infectious Disease Epidemiology & Prevention, Copenhagen, Denmark
| | - Heather Davies
- Meningococcal Reference Laboratory, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Ala-Eddine Deghmane
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | - Walter Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Stefanie Desmet
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Mirian Domenech
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Richard Drew
- 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
| | - Mignon du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Helga Erlendsdóttir
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Norman K Fry
- Immunisation and Vaccine Preventable Diseases Division and Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Kurt Fuursted
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Thomas Hale
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Desiree Henares
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Birgitta Henriques-Normark
- Karolinska Institutet, Karolinska University Hospital, Public Health Agency of Sweden, Stockholm, Sweden
| | - Markus Hilty
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Steen Hoffmann
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Hilary Humphreys
- Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Susanne Jacobsson
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | | | | | | | - Jana Kozakova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Karl G Kristinsson
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alicja Kuch
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Shamez Ladhani
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | - Thiên-Trí Lâm
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | | | - Laura Lindholm
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | | | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Delphine Martiny
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium; Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | | | - Noel D McCarthy
- Population Health Medicine, Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Mary Meehan
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Susan Meiring
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Paula Mölling
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Julie Morgan
- Streptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
| | - Robert Mulhall
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Carmen Muñoz-Almagro
- 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
| | | | | | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alexandre Mzabi
- Ministère de la Santé - Direction de la santé, Luxembourg, Luxembourg
| | - Ludmila Novakova
- National Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Shahin Oftadeh
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia
| | - Amaresh Perez-Argüello
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Maria Pérez-Vázquez
- 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
| | | | | | - Benoit Prevost
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium
| | | | - Assaf Rokney
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Merav Ron
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | | | - Kevin J Scott
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK
| | - Carmen Sheppard
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Lotta Siira
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Vitali Sintchenko
- 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
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | | | | | - Andrew J Smith
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Anneke Steens
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Muhamed-Kheir Taha
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Anni Vainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mark P G van der Linden
- Department of Medical Microbiology, German National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany
| | - Nina M van Sorge
- Department of Medical Microbiology and Infection Prevention, and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Emmanuelle Varon
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Sandra Vohrnova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jose Yuste
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosemeire Zanella
- National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
| | - Fei Zhou
- 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
| | - Angela B Brueggemann
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
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Izu A, Nunes MC, Solomon F, Baillie V, Serafin N, Verwey C, Moore DP, Laubscher M, Ncube M, Olwagen C, Dangor Z, Madhi SA. All-cause and pathogen-specific lower respiratory tract infection hospital admissions in children younger than 5 years during the COVID-19 pandemic (2020-22) compared with the pre-pandemic period (2015-19) in South Africa: an observational study. Lancet Infect Dis 2023; 23:1031-1041. [PMID: 37141913 PMCID: PMC10151031 DOI: 10.1016/s1473-3099(23)00200-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Non-pharmaceutical interventions affected the circulation of and illness due to endemic respiratory pathogens during the COVID-19 pandemic. We investigated the incidence of admissions to hospital for overall and specific pathogen-associated lower respiratory tract infection (LRTI) during the COVID-19 pandemic compared with incidence in the pre-pandemic period. METHODS In this observational study, we analysed surveillance data for children younger than 5 years from two public hospitals in Soweto, South Africa, for all-cause LRTI, respiratory syncytial virus (RSV), influenza, human metapneumovirus, and Bordetella pertussis from Jan 1, 2015 to Dec 31, 2022. Data were obtained from an electronic database that includes information for all admissions to the general paediatric wards at the two hospitals, automatically identified by a computer program. We excluded children admitted to hospital with incidental SARS-CoV-2 infection or COVID-19 without LRTI diagnosis. Incidence during COVID-19 pandemic years (2020, 2021, and 2022) were compared with pre-pandemic rates (2015-19). FINDINGS Overall, there were 42 068 all-cause hospital admissions, including 18 303 all-cause LRTI hospital admissions, from Jan 1, 2015, to Dec 31, 2022, 17 822 (42·4%) of whom were female, 23 893 (57·0%) were male, and 353 (0·8%) had missing data. All-cause LRTI incidence risk ratio (IRR) was 30% lower in 2020 (IRR 0·70, 95% CI 0·67-0·74) and 13% lower in 2021 (0·87, 0·83-0·91), but 16% higher in 2022 (1·16, 1·11-1·21) compared with the pre-pandemic period. Furthermore, compared with the pre-pandemic period, incidence of RSV-associated LRTI (0·52, 0·45-0·58), influenza-associated LRTI (0·05, 0·02-0·11), and pulmonary tuberculosis (0·52, 0·41-0·65) were lower in 2020, with similar trends observed for human-metapneumovirus-associated LRTI, pertussis, and invasive pneumococcal disease (IPD). Compared with the pre-pandemic period, by 2022, RSV-associated LRTI incidence was similar (1·04, 0·95-1·14) and influenza-associated LRTI showed a non-significant increase (1·14, 0·92-1·39), whereas incidence remained lower for tuberculosis (0·79, 0·65-0·94) and IPD (0·51, 0·24-0·99). In 2022, the incidence of COVID-19-associated LRTI hospital admission (65 per 100 000 children younger than 5 years) was lower than pre-pandemic RSV-associated LRTI (0·23, 0·19-0·27) but higher than pre-pandemic influenza-associated LRTI (1·19, 0·97-1·45), although the difference was not significant. All-cause LRTI death in 2022 (57 per 100 000 children younger than 5 years) was 28% higher than in the pre-pandemic period (1·28, 1·03-1·58). INTERPRETATION The higher incidence of all-cause LRTI admissions to hospital in 2022 compared with the pre-pandemic period is partly due to ongoing COVID-19 admission to hospital, and could worsen if other endemic respiratory pathogens revert to pre-pandemic incidence. Interventions, including the introduction of vaccines for people who are pregnant that aim to prevent RSV and possibly COVID-19 in young children, are warranted. FUNDING The Bill & Melinda Gates Foundation.
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Affiliation(s)
- Alane Izu
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Marta C Nunes
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa; Center of Excellence in Respiratory Pathogens, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Université Claude Bernard Lyon, Lyon, France
| | - Fatima Solomon
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Vicky Baillie
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Natali Serafin
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Charl Verwey
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - David P Moore
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Marius Laubscher
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Musawenkosi Ncube
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Courtney Olwagen
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Ziyaad Dangor
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Infectious Diseases and Oncology Research Institute, University of the Witwatersrand, Johannesburg, South Africa; Faculty of Health Science, National Research Foundation: Vaccine Preventable Diseases, Department of Science, University of the Witwatersrand, Johannesburg, South Africa.
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Tinggaard M, Slotved HC, Petersen RF, Hovmand N, Benfield T. Decreased Pneumococcal Carriage Among Older Adults in Denmark During the COVID-19 Lockdown. Open Forum Infect Dis 2023; 10:ofad365. [PMID: 37559754 PMCID: PMC10407463 DOI: 10.1093/ofid/ofad365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Abstract
Background COVID-19 containment measures reduced the burden of invasive pneumococcal disease. Data on pneumococcal carriage rates among adults during the pandemic are scarce. Methods Naso- and oropharyngeal swabs and questionnaires were collected during January 2019 to December 2021 from adults ≥64 years of age. Carriage was determined by lytA/piaB PCR. Results A total of 1556 participants provided paired naso- and oropharyngeal swabs. Their median age was 74 years (IQR, 70-79). Streptococcus pneumoniae DNA was detected in 146 (9.4%) oropharyngeal swabs and 34 (2.2%) nasopharyngeal. The carriage rate decreased from 12.9% (95% CI, 10.1%-16.1%, n = 66/511) prelockdown (January 2019-February 2020) to 4.2% (95% CI, 2.0%-7.5%, n = 10/240) during lockdown (March 2020-February 2021) and increased to 12.1% (95% CI, 9.8%-14.7%, n = 87/719) with the reopening of society (March 2021-December 2021; P = .0009). Conclusions Pneumococcal carriage prevalence declined significantly during pandemic mitigation measures and rebounded to prepandemic levels as measures were lifted.
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Affiliation(s)
- Michaela Tinggaard
- Department of Infectious Diseases, Copenhagen University Hospital—Amager and Hvidovre, Hvidovre, Denmark
| | - Hans-Christian Slotved
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Randi Føns Petersen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Nichlas Hovmand
- Department of Infectious Diseases, Copenhagen University Hospital—Amager and Hvidovre, Hvidovre, Denmark
| | - Thomas Benfield
- Department of Infectious Diseases, Copenhagen University Hospital—Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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28
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Parellada CI, de Abreu ADJL, Birck MG, Dias CZ, Moreira TDNF, Julian GS, Batista PDM, Orengo JC, Bierrenbach AL. Trends in Pneumococcal and Bacterial Meningitis in Brazil from 2007 to 2019. Vaccines (Basel) 2023; 11:1279. [PMID: 37631847 PMCID: PMC10459388 DOI: 10.3390/vaccines11081279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
The pneumococcal conjugate vaccination (PCV) was introduced into the Brazilian Childhood National Immunization Program in 2010; however, universal pneumococcal vaccination for older adults has not been implemented yet. Our aim is to evaluate the trends in pneumococcal meningitis incidence and case fatality rate (CFR) across all age groups from 2007 to 2019 using data from the National Surveillance System. The pre-PCV (2007-2009) and post-PCV (2011-2019) periods were compared; changes in incidence and CFR were assessed by joinpoint regression. Additional analyses of bacterial meningitis were performed to compare the patterns and trends. Over the 13-year period, 81,203 and 13,837 cases were classified as bacterial and pneumococcal meningitis, respectively. S. pneumoniae was the main etiological agent of bacterial meningitis in adults aged ≥50 years and the most lethal in all age groups. In the post-PCV period, a 56.5% reduction in the average incidence was seen in pneumococcal meningitis in the pediatric population. In contrast, there was an increasing trend among adults. The CFR for pneumococcal and bacterial meningitis remained stable in most age groups during the study period. These findings highlight the value of expanding pneumococcal vaccination policies, including vaccines that provide better indirect protection from children to adults and broadening vaccination to older adults.
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Affiliation(s)
| | | | - Marina G. Birck
- IQVIA Brazil, São Paulo 04719-002, Brazil; (A.d.J.L.d.A.); (M.G.B.); (C.Z.D.)
| | | | | | | | | | | | - Ana Luiza Bierrenbach
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo 01308-050, Brazil;
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29
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Bennett JC, Emanuels A, Heimonen J, O'Hanlon J, Hughes JP, Han PD, Chow EJ, Ogokeh CE, Rolfes MA, Lockwood CM, Pfau B, Uyeki TM, Shendure J, Hoag S, Fay K, Lee J, Sibley TR, Rogers JH, Starita LM, Englund JA, Chu HY. Streptococcus pneumoniae nasal carriage patterns with and without common respiratory virus detections in households in Seattle, WA, USA before and during the COVID-19 pandemic. Front Pediatr 2023; 11:1198278. [PMID: 37484765 PMCID: PMC10361771 DOI: 10.3389/fped.2023.1198278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background Respiratory viruses might influence Streptococcus pneumoniae nasal carriage and subsequent disease risk. We estimated the association between common respiratory viruses and semiquantitative S. pneumoniae nasal carriage density in a household setting before and during the COVID-19 pandemic. Methods From November 2019-June 2021, we enrolled participants in a remote household surveillance study of respiratory pathogens. Participants submitted weekly reports of acute respiratory illness (ARI) symptoms. Mid-turbinate or anterior nasal swabs were self-collected at enrollment, when ARI occurred, and, in the second year of the study only, from household contacts after SARS-CoV-2 was detected in a household member. Specimens were tested using multiplex reverse-transcription PCR for respiratory pathogens, including S. pneumoniae, rhinovirus, adenovirus, common human coronavirus, influenza A/B virus, respiratory syncytial virus (RSV) A/B, human metapneumovirus, enterovirus, and human parainfluenza virus. We estimated differences in semiquantitative S. pneumoniae nasal carriage density, estimated by the inverse of S. pneumoniae relative cycle threshold (Crt) values, with and without viral detection for any virus and for specific respiratory viruses using linear generalized estimating equations of S. pneumoniae Crt values on virus detection adjusted for age and swab type and accounting for clustering of swabs within households. Results We collected 346 swabs from 239 individuals in 151 households that tested positive for S. pneumoniae (n = 157 with and 189 without ≥1 viruses co-detected). Difficulty breathing, cough, and runny nose were more commonly reported among individuals with specimens with viral co-detection compared to without (15%, 80% and 93% vs. 8%, 57%, and 51%, respectively) and ear pain and headache were less commonly reported (3% and 26% vs. 16% and 41%, respectively). For specific viruses among all ages, semiquantitative S. pneumoniae nasal carriage density was greater with viral co-detection for enterovirus, RSV A/B, adenovirus, rhinovirus, and common human coronavirus (P < 0.01 for each). When stratified by age, semiquantitative S. pneumoniae nasal carriage density was significantly greater with viral co-detection among children aged <5 (P = 0.002) and 5-17 years (P = 0.005), but not among adults aged 18-64 years (P = 0.29). Conclusion Detection of common respiratory viruses was associated with greater concurrent S. pneumoniae semiquantitative nasal carriage density in a household setting among children, but not adults.
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Affiliation(s)
- Julia C. Bennett
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Anne Emanuels
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Jessica Heimonen
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Jessica O'Hanlon
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - James P. Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, United States
| | - Peter D. Han
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, United States
- Military and Health Research Foundation, Laurel, MD, United States
| | - Eric J. Chow
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- Communicable Disease Epidemiology and Immunizations Section, Prevention Division, Public Health – Seattle & King County, Seattle, WA, United States
| | - Constance E. Ogokeh
- Military and Health Research Foundation, Laurel, MD, United States
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Melissa A. Rolfes
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Christine M. Lockwood
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, United States
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - Brian Pfau
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, United States
- Department of Genome Sciences, University of Washington, Seattle, WA, United States
| | - Timothy M. Uyeki
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, United States
- Department of Genome Sciences, University of Washington, Seattle, WA, United States
| | - Samara Hoag
- Student Health Services, Seattle Public Schools, Seattle, WA, United States
| | - Kairsten Fay
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Thomas R. Sibley
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Julia H. Rogers
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Lea M. Starita
- Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA, United States
- Department of Genome Sciences, University of Washington, Seattle, WA, United States
| | - Janet A. Englund
- Seattle Children’s Research Institute, Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Helen Y. Chu
- Department of Medicine, University of Washington, Seattle, WA, United States
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30
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Miellet WR, Pluister G, Sikking M, Tappel M, Karczewski J, Visser LJ, Bosch T, Trzciński K, Mariman R. Surveillance of Neisseria meningitidis carriage four years after menACWY vaccine implementation in the Netherlands reveals decline in vaccine-type and rise in genogroup e circulation. Vaccine 2023:S0264-410X(23)00781-8. [PMID: 37423800 DOI: 10.1016/j.vaccine.2023.06.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
Carriage of Neisseria meningitidisis an accepted endpoint in monitoring meningococcal vaccine effects. We applied molecular methods to assess the impact of menACWY vaccine implementation on meningococcal carriage and genogroup-specific prevalence in young adults in Fall of 2022, four years after the introduction of the tetravalent vaccine in the Netherlands. The overall carriage rate of genogroupable meningococci was not significantly different compared to a pre-menACWY cohort investigated in 2018 (20.8 % or 125 of 601 versus 17.4 % or 52 of 299 individuals, p = 0.25). Of 125 carriers of genogroupable meningococci, 122 (97.6 %) were positive for either vaccine-types menC, menW, menY or genogroups, menB, menE, and menX, which are not targeted by the menACWY vaccine. Compared with a pre-vaccine-implementation cohort, there was 3.8-fold reduction (p < 0.001) in vaccine-type carriage rates and 9.0-fold increase (p < 0.0001) in non-vaccine type menE prevalence. We observe a reduction in menW and menY and an increase in menE, which suggest that implementation of menACWY vaccine affected carriage.
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Affiliation(s)
- Willem R Miellet
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Gerlinde Pluister
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Meike Sikking
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Marcia Tappel
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Linda J Visser
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Thijs Bosch
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Krzysztof Trzciński
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Rob Mariman
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
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31
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Yang MC, Su YT, Chen PH, Tsai CC, Lin TI, Wu JR. Changing patterns of infectious diseases in children during the COVID-19 pandemic. Front Cell Infect Microbiol 2023; 13:1200617. [PMID: 37457965 PMCID: PMC10339349 DOI: 10.3389/fcimb.2023.1200617] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Each infectious disease has had its own epidemic pattern and seasonality for decades. However, public health mitigation measures during the coronavirus disease 2019 (COVID-19) pandemic have resulted in changing epidemic patterns of infectious diseases. Stringent measures resulted in low incidences of various infectious diseases during the outbreak of COVID-19, including influenza, respiratory syncytial virus, pneumococcus, enterovirus, and parainfluenza. Owing to the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and subsequent immunity development, decreasing virulence of SARS-CoV-2, and worldwide immunization against SARS-CoV-2 in children beyond 6 months of age, mitigation measures are lifted country by country. Consequently, the immunity debt to infectious respiratory viruses other than SARS-CoV-2 contributed to the "off-season," "see-saw," and "upsurge" patterns of various infectious diseases in children. Moreover, apart from the persistence of SARS-CoV-2, the coexistence of other circulating viruses or bacterial outbreaks may lead to twindemics or tripledemics during the following years. Therefore, it is necessary to maintain hand hygiene and immunization policies against various pathogens to alleviate the ongoing impact of infectious diseases on children.
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Affiliation(s)
- Ming-Chun Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ping-Hong Chen
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Chung Tsai
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ting-I Lin
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jiunn-Ren Wu
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
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Cunningham S, Zar HJ. New Interventions to Prevent Respiratory Syncytial Virus Disease in Infants-Time for Equitable Global Access. Am J Respir Crit Care Med 2023; 207:1556-1557. [PMID: 37104655 PMCID: PMC10273123 DOI: 10.1164/rccm.202303-0568vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/21/2023] [Indexed: 04/29/2023] Open
Affiliation(s)
- Steve Cunningham
- Department of Child Life and Health, Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Heather J. Zar
- Department of Paediatrics and Child Health and
- South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
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33
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Wyllie AL, Mbodj S, Thammavongsa DA, Hislop MS, Yolda-Carr D, Waghela P, Nakahata M, Stahlfeld AE, Vega NJ, York A, Allicock OM, Wilkins G, Ouyang A, Siqueiros L, Strong Y, Anastasio K, Alexander-Parrish R, Arguedas A, Gessner BD, Weinberger DM. Persistence of Pneumococcal Carriage among Older Adults in the Community despite COVID-19 Mitigation Measures. Microbiol Spectr 2023; 11:e0487922. [PMID: 37036377 PMCID: PMC10269788 DOI: 10.1128/spectrum.04879-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/20/2023] [Indexed: 04/11/2023] Open
Abstract
Reported rates of invasive pneumococcal disease were markedly lower than normal during the 2020/2021 winter in the Northern Hemisphere, the first year after the start of the COVID-19 pandemic. However, little is known about rates of carriage of pneumococcus among adults during this period. Between October 2020-August 2021, couples in the Greater New Haven Area, USA, were enrolled if both individuals were aged 60 years and above and did not have any individuals under the age of 60 years living in the household. Saliva samples and questionnaires regarding social activities and contacts and medical history were obtained every 2 weeks for a period of 10 weeks. Following culture-enrichment, extracted DNA was tested using qPCR for pneumococcus-specific sequences piaB and lytA. Individuals were considered positive for pneumococcal carriage when Ct values for piaB were ≤40. Results. We collected 567 saliva samples from 95 individuals (47 household pairs and 1 singleton). Of those, 7.1% of samples tested positive for pneumococcus, representing 22/95 (23.2%) individuals and 16/48 (33.3%) households. Study participants attended few social events during this period. However, many participants continued to have regular contact with children. Individuals who had regular contact with preschool and school-aged children (i.e., 2 to 9 year olds) had a higher prevalence of carriage (15.9% versus 5.4%). Despite COVID-19-related disruptions, a large proportion of older adults continued to carry pneumococcus. Prevalence was particularly high among those who had contact with school-aged children, but carriage was not limited to this group. IMPORTANCE Carriage of Streptococcus pneumoniae (pneumococcus) in the upper respiratory tract is considered a prerequisite to invasive pneumococcal disease. During the first year of the COVID-19 pandemic, markedly lower rates of invasive pneumococcal disease were reported worldwide. Despite this, by testing saliva samples with PCR, we found that older adults continued to carry pneumococcus at pre-pandemic levels. Importantly, this study was conducted during a period when transmission mitigation measures related to the COVID-19 pandemic were in place. However, our observations are in line with reports from Israel and Belgium where carriage was also found to persist in children. In line with this, we observed that carriage prevalence was particularly high among the older adults in our study who maintained contact with school-aged children.
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Affiliation(s)
- Anne L. Wyllie
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Sidiya Mbodj
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Darani A. Thammavongsa
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Maikel S. Hislop
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Devyn Yolda-Carr
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Pari Waghela
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Maura Nakahata
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Anne E. Stahlfeld
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Noel J. Vega
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Anna York
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Orchid M. Allicock
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Geisa Wilkins
- Yale Center for Clinical Investigation, New Haven, Connecticut, USA
| | - Andrea Ouyang
- Yale Center for Clinical Investigation, New Haven, Connecticut, USA
| | - Laura Siqueiros
- Yale Center for Clinical Investigation, New Haven, Connecticut, USA
| | - Yvette Strong
- Yale Center for Clinical Investigation, New Haven, Connecticut, USA
| | - Kelly Anastasio
- Yale Center for Clinical Investigation, New Haven, Connecticut, USA
| | | | - Adriano Arguedas
- Medical and Scientific Affairs, Pfizer Inc, Collegeville, Pennsylvania, USA
| | | | - Daniel M. Weinberger
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
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Rybak A, Levy C, Ouldali N, Bonacorsi S, Béchet S, Delobbe JF, Batard C, Donikian I, Goldrey M, Assouline J, Cohen R, Varon E. Dynamics of Antibiotic Resistance of Streptococcus pneumoniae in France: A Pediatric Prospective Nasopharyngeal Carriage Study from 2001 to 2022. Antibiotics (Basel) 2023; 12:1020. [PMID: 37370339 DOI: 10.3390/antibiotics12061020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Epidemiological surveillance of nasopharyngeal pneumococcal carriage is important for monitoring serotype distribution and antibiotic resistance, particularly before and after the implementation of pneumococcal conjugate vaccines (PCVs). With a prospective surveillance study in France, we aimed to analyze the dynamics of pneumococcal carriage, antibiotic susceptibility and serotype distribution in children aged 6 to 24 months who had acute otitis media between 2001 and 2022 with a focus on the late PCV13 period from May 2014 to July 2022. Trends were analyzed with segmented linear regression with autoregressive error. For the 17,136 children enrolled, overall pneumococcal carriage was stable during the study. During the late PCV13 period, the five most frequent serotypes were all non-PCV13 serotypes: 15B/C (14.3%), 23B (11.0%), 11A (9.6%), 15A (7.4%) and 35B (6.5%). During the same period, we observed a rebound of penicillin non-susceptibility (+0.15% per month, 95% confidence interval, +0.08 to 0.22, p < 0.001). Five serotypes accounted for 64.4% of the penicillin non-susceptible strains: 11A (17.5%), 35B (14.9%), 15A (13.9%), 15B/C (9.9%) and 19F (8.2%); non-PCV13/PCV15 accounted for <1%, and non-PCV15/PCV20 accounted for 28%. The next generation PCVs, particularly PCV20, may disrupt nasopharyngeal carriage and contribute to decreasing the rate of antibiotic resistance among pneumococci.
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Affiliation(s)
- Alexis Rybak
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
- Pediatric Emergency Department, Trousseau Hospital, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
- Clinical Epidemiology Unit, Eceve Inserm UMR-S 1123, Robert Debré University Hospital, Université de Paris, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
| | - Corinne Levy
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
- IMRB-GRC GEMINI, Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, 94000 Créteil, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, 06200 Nice, France
- CRC, Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
| | - Naïm Ouldali
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France
- IAME, Infection, Antimicrobials, Modelling, Evolution, Inserm UMR 1137, Paris University, 75018 Paris, France
| | - Stéphane Bonacorsi
- Microbiology Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, 75019 Paris, France
| | - Stéphane Béchet
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
| | | | - Christophe Batard
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Isabelle Donikian
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Marie Goldrey
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Jessica Assouline
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
| | - Robert Cohen
- Activ, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France
- Afpa, Association Française de Pédiatrie Ambulatoire, 45000 Orléans, France
- IMRB-GRC GEMINI, Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, 94000 Créteil, France
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, 06200 Nice, France
- CRC, Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
| | - Emmanuelle Varon
- IMRB-GRC GEMINI, Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Etude des Maladie Infectieuses Néonatales et Infantiles, Université Paris Est, 94000 Créteil, France
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, 94000 Créteil, France
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Noffel Z, Dobrovolny HM. Quantifying the effect of defective viral genomes in respiratory syncytial virus infections. Math Biosci Eng 2023; 20:12666-12681. [PMID: 37501460 DOI: 10.3934/mbe.2023564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Defective viral genomes (DVGs) are viral genomes that contain only a partial viral RNA and so cannot replicate within cells on their own. If a cell containing DVGs is subsequently infected with a complete viral genome, the DVG can then use the missing proteins expressed by the full genome in order to replicate itself. Since the cell is producing defective genomes, it has less resources to produce fully functional virions and thus release of complete virions is often suppressed. Here, we use data from challenge studies of respiratory syncytial virus (RSV) in healthy adults to quantify the effect of DVGs. We use a mathematical model to fit the data, finding that late onset of DVGs and prolonged DVG detection are associated with lower infection rates and higher clearance rates. This result could have implications for the use of DVGs as a therapeutic.
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Affiliation(s)
- Zakarya Noffel
- Department of Computer Science, University of Texas at Austin, Austin, TX, US
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, US
| | - Hana M Dobrovolny
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, US
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Ricketson LJ, Kellner JD. Changes in the Incidence of Invasive Pneumococcal Disease in Calgary, Canada, during the SARS-CoV-2 Pandemic 2020-2022. Microorganisms 2023; 11:1333. [PMID: 37317307 DOI: 10.3390/microorganisms11051333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 06/16/2023] Open
Abstract
We describe the impact of non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic on invasive pneumococcal disease (IPD) in Calgary. IPD declined significantly worldwide during 2020 and 2021. This may be due to the reduced transmission of and decrease in circulating viruses that often co-infect with the opportunistic pneumococcus. Pneumococcus has not been shown to frequently co-infect or cause secondary infection with SARS-CoV-2. We examined and compared incidence rates in Calgary per quarter in the pre-vaccine, post-vaccine, 2020 and 2021 (pandemic) and 2022 (late pandemic) eras. We also conducted a time series analysis from 2000-2022 allowing for change in trend at introduction of vaccines and for initiation of NPIs during the COVID-19 pandemic. Incidence declined in 2020/2021 but by the end of 2022 had begun to rapidly recover to near pre-vaccine rates. This recovery may be related to the high rates of viral activity in the winter of 2022 along with childhood vaccines being delayed during the pandemic. However, a large proportion of the IPD caused in the last quarter of 2022 was serotype 4, which has caused outbreaks in the homeless population of Calgary in the past. Further surveillance will be important to understand IPD incidence trends in the post-pandemic landscape.
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Affiliation(s)
- Leah J Ricketson
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - James D Kellner
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB T3B 6A8, Canada
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Principi N, Autore G, Ramundo G, Esposito S. Epidemiology of Respiratory Infections during the COVID-19 Pandemic. Viruses 2023; 15:v15051160. [PMID: 37243246 DOI: 10.3390/v15051160] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
To face the COVID-19 outbreak, a wide range of non-pharmaceutical interventions (NPIs) aimed at limiting the spread of the virus in communities, such as mask-wearing, hand hygiene, social distancing, travel restrictions, and school closures, were introduced in most countries. Thereafter, a significant reduction of new asymptomatic and symptomatic COVID-19 cases occurred, although there were differences between countries according to the type and duration of the NPIs. In addition, the COVID-19 pandemic has been accompanied by significant variations in the global incidence of diseases due to the most common non-SARS-CoV-2 respiratory viruses and some bacteria. In this narrative review, the epidemiology of the most common non-SARS-CoV-2 respiratory infections during the COVID-19 pandemic is detailed. Moreover, factors that could have had a role in modifying the traditional circulation of respiratory pathogens are discussed. A literature analysis shows that NPIs were the most important cause of the general reduction in the incidence of influenza and respiratory syncytial virus infection in the first year of the pandemic, although the different sensitivity of each virus to NPIs, the type and duration of measures used, as well as the interference among viruses may have played a role in modulating viral circulation. Reasons for the increase in the incidences of Streptococcus pneumoniae and group A Streptococcus infections seem strictly linked to immunity debt and the role played by NPIs in reducing viral infections and limiting bacterial superimposed infections. These results highlight the importance of NPIs during pandemics, the need to monitor the circulation of infectious agents that cause diseases similar to those caused by pandemic agents, and the need to make efforts to improve coverage with available vaccines.
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Affiliation(s)
| | - Giovanni Autore
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Greta Ramundo
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
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Schley K, Kowalik JC, Sullivan SM, Vyse A, Czudek C, Tichy E, Findlow J. Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection? Vaccines (Basel) 2023; 11:vaccines11050940. [PMID: 37243043 DOI: 10.3390/vaccines11050940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
A combined Haemophilus influenzae type b (Hib)/meningococcal serogroup C (MenC) vaccine will soon be unavailable in the UK immunisation schedule due to discontinuation by the manufacturer. An interim statement by the Joint Committee on Vaccination and Immunisation (JCVI) advises stopping MenC immunisation at 12 months of age when this occurs. We undertook an analysis of the public health impact of various potential meningococcal vaccination strategies in the UK in the absence of the Hib/MenC vaccine. A static population-cohort model was developed evaluating the burden of IMD (using 2005-2015 epidemiological data) and related health outcomes (e.g., cases, cases with long-term sequelae, deaths), which allows for the comparison of any two meningococcal immunisation strategies. We compared potential strategies that included different combinations of infant and/or toddler MenACWY immunisations with the anticipated future situation in which a 12-month MenC vaccine is not used, but the MenACWY vaccine is routinely given in adolescents. The most effective strategy is combining MenACWY immunisation at 2, 4, and 12 months of age with the incumbent adolescent MenACWY immunisation programme, resulting in the prevention of an additional 269 IMD cases and 13 fatalities over the modelling period; of these cases, 87 would be associated with long-term sequelae. Among the different vaccination strategies, it was observed that those with multiple doses and earlier doses provided the greatest protection. Our study provides evidence suggesting that the removal of the MenC toddler immunisation from the UK schedule would potentially increase the risk of unnecessary IMD cases and have a detrimental public health impact if not replaced by an alternate infant and/or toddler programme. This analysis supports that infant and toddler MenACWY immunisation can provide maximal protection while complementing both infant/toddler MenB and adolescent MenACWY immunisation programmes in the UK.
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Affiliation(s)
| | - Jack C Kowalik
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
| | | | - Andrew Vyse
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
| | - Carole Czudek
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
| | - Eszter Tichy
- Evidera/PPD, Bocskai ut 134-144, Dorottya Udvar, Building E, Floor 2, H-1113 Budapest, Hungary
| | - Jamie Findlow
- Pfizer Ltd., Walton Oaks, Dorking Rd., Tadworth KT20 7NS, UK
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Ben-Shimol S, Ramilo O, Leber AL, van der Beek BA, Everhart K, Mertz S, Mejias A, Dagan R. A Hypothesis-Generating Prospective Longitudinal Study to Assess the Relative Contribution of Common Respiratory Viruses to Severe Lower Respiratory Infections in Young Children. Pediatr Infect Dis J 2023; 42:396-404. [PMID: 36917029 DOI: 10.1097/inf.0000000000003865] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Respiratory viruses such as respiratory syncytial virus (RSV), influenza, parainfluenza and human metapneumovirus are well-established etiologies of acute lower respiratory tract infections (ALRIs; LRI-viruses). In contrast, adenovirus (AdV), rhinovirus/enterovirus (RV/EV) and seasonal human coronaviruses (CoV), collectively termed AdV/RV/CoV, are detected both in healthy children and children with ALRI. METHODS The methods include a prospective longitudinal case-control study, assessing the prevalence of LRI-viruses versus AdV/RV/CoV in ALRI [community-acquired alveolar pneumonia (CAAP) and bronchiolitis] during hospitalization (visit 1), 7-14 days (visit 2) and 28-35 days (visit 3) in 2-17-month-old children. Controls were 2-27-month-old children hospitalized for elective surgery during the same respiratory seasons. RESULTS We enrolled 99 infants (37 CAAP, 38 bronchiolitis and 24 controls) and obtained 211 nasopharyngeal swabs. Overall, 163 (77%) had greater than or equal to 1 viruses detected; RV/EV (n = 94; 45%) and RSV (n = 71; 34%) were the most frequently detected viruses. In CAAP, the overall LRI-virus prevalence was 78.4%, 32.4% and 5.4% in visits 1, 2 and 3, respectively; the respective rates in bronchiolitis were 73.7%, 34.5% and 8.0%. In controls, no LRI-viruses were detected. In contrast, the overall AdV/RV/CoV prevalence was high among controls (70.8%) and similar among CAAP (48.6%, 40.5% and 40.5%) and bronchiolitis (47.4, 58.6% and 64.0%) across visits. CONCLUSIONS Among ALRI cases, LRI-viruses dominated during the acute disease, with prevalence declining within 28-35 days, suggesting their causative role. In contrast, AdV/RV/CoV prevalence was similar during all 3 visits and in controls, suggesting that carriage of these viruses is common during the viral respiratory season. The current study is relatively small and of short duration; however, the findings are supported by other recent studies.
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Affiliation(s)
- Shalom Ben-Shimol
- From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Octavio Ramilo
- Division of Pediatric Infectious Diseases and Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- The Ohio State University, Columbus, Ohio
| | - Amy L Leber
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Bart Adriaan van der Beek
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Kathy Everhart
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Sara Mertz
- Division of Pediatric Infectious Diseases and Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- The Ohio State University, Columbus, Ohio
| | - Asuncion Mejias
- Division of Pediatric Infectious Diseases and Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- The Ohio State University, Columbus, Ohio
| | - Ron Dagan
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Tashiro M, Sato S, Endo A, Hamashima R, Ito Y, Ashizawa N, Takeda K, Iwanaga N, Ide S, Fujita A, Takazono T, Yamamoto K, Tanaka T, Furumoto A, Yanagihara K, Mukae H, Fushimi K, Izumikawa K. Decreased community-acquired pneumonia coincided with rising awareness of precautions before governmental containment policy in Japan. PNAS Nexus 2023; 2:pgad153. [PMID: 37234205 PMCID: PMC10208112 DOI: 10.1093/pnasnexus/pgad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/18/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023]
Abstract
The effectiveness of population-wide compliance to personal precautions (mask-wearing and hand hygiene) in preventing community-acquired pneumonia has been unknown. In Japan, different types of nonpharmaceutical interventions from personal precautions to containment and closure policies (CACPs, e.g. stay-at-home requests) were sequentially introduced from late January to April 2020, allowing for separate analysis of the effects of personal precautions from other more stringent interventions. We quantified the reduction in community-acquired pneumonia hospitalizations and deaths and assessed if it coincided with the timing of increased public awareness of personal precautions before CACPs were implemented. A quasi-experimental interrupted time-series design was applied to non-COVID-19 pneumonia hospitalization and 30-day death data from April 2015 to August 2020 across Japan to identify any trend changes between February and April 2020. We also performed a comparative analysis of pyelonephritis and biliary tract infections to account for possible changes in the baseline medical attendance. These trend changes were then compared with multiple indicators of public awareness and behaviors related to personal precautions, including keyword usage in mass media coverage and sales of masks and hand hygiene products. Hospitalizations and 30-day deaths from non-COVID-19 pneumonia dropped by 24.3% (95% CI 14.8-32.8) and 16.1% (5.5-25.5), respectively, in February 2020, before the implementation of CACPs, whereas pyelonephritis and biliary tract infections did not suggest a detectable change. These changes coincided with increases in indicators related to personal precautions rather than those related to contact behavior changes. Community-acquired pneumonia could be reduced by population-wide compliance to moderate precautionary measures.
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Affiliation(s)
| | | | | | - Ryosuke Hamashima
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Nobuyuki Ashizawa
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Shotaro Ide
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Akitsugu Furumoto
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
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Jagne I, von Mollendorf C, Wee-Hee A, Ortika B, Satzke C, Russell FM. A systematic review of pneumococcal conjugate vaccine impact on pneumococcal nasopharyngeal colonisation density in children under 5 years of age. Vaccine 2023; 41:3028-3037. [PMID: 37032228 DOI: 10.1016/j.vaccine.2023.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/18/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND High pneumococcal carriage density has been associated with severe pneumonia in some settings. The impact of pneumococcal conjugate vaccines (PCVs) on pneumococcal carriage density has been variable. The aim of this systematic literature review is to describe the effect of PCV7, PCV10 and PCV13 on pneumococcal colonisation density in children under five years old. METHODS We included peer reviewed English literature published between 2000 and 2021 to identify relevant articles using Embase, Medline and PubMed. Original research articles of any study design in countries where PCV has been introduced/studied were included. Quality (risk) assessment was performed using tools developed by the National Heart Brain and Lung Institute for inclusion in this review. We used a narrative synthesis to present results. RESULTS Ten studies were included from 1941 articles reviewed. There were two randomised controlled trials, two cluster randomised trials, one case control study, one retrospective cohort study and four cross sectional studies. Three studies used semiquantitative culture methods to determine density while the remaining studies used quantitative molecular techniques. Three studies reported an increase in density and three studies found a decrease in density among vaccinated compared with unvaccinated children. Four studies found no effect. There was considerable heterogeneity in the study populations, study design and laboratory methods. CONCLUSION There was no consensus regarding the impact of PCV on pneumococcal nasopharyngeal density. We recommend the use of standardised methods to evaluate PCV impact on density.
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Affiliation(s)
- Isatou Jagne
- Asia-Pacific Health, Infection & Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
| | - Claire von Mollendorf
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; New Vaccines, Infection & Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Ashleigh Wee-Hee
- Translational Microbiology, Infection & Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Belinda Ortika
- Translational Microbiology, Infection & Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Catherine Satzke
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Translational Microbiology, Infection & Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Fiona M Russell
- Asia-Pacific Health, Infection & Immunity, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Le H, Gidding H, Blyth CC, Richmond P, Moore HC. Pneumococcal Conjugate Vaccines Are Protective Against Respiratory Syncytial Virus Hospitalizations in Infants: A Population-Based Observational Study. Open Forum Infect Dis 2023; 10:ofad199. [PMID: 37125230 PMCID: PMC10135427 DOI: 10.1093/ofid/ofad199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023] Open
Abstract
Background Pneumococcal conjugate vaccines (PCV) reduced the risk of respiratory syncytial virus (RSV) in a randomized clinical trial. We aimed to assess the real-world effectiveness of PCV on RSV-hospitalizations among Western Australian infants. Methods We conducted a population-based cohort study of births during 2000-2012, using probabilistically linked individual-level immunization, hospitalization, respiratory microbiology testing, and perinatal data. We performed Cox proportional hazard models with time-varying exposure (receipt of infant PCV doses) against the first RSV-confirmed hospitalization 0-12 months adjusted for perinatal and sociodemographic factors. Results From 360 994 children, 3-dose PCV coverage in Aboriginal infants ranged from 29% to 51% in 2001-2004 when PCV was funded for Aboriginal children only. Following universal funding in 2005, coverage increased to 85% for Aboriginal and 73% for non-Aboriginal infants. RSV-hospitalization rates were highest in young infants aged 0-5 months (22.5/1000 child-years) and >2 times higher in Aboriginal infants than in non-Aboriginal infants. Receipt of ≥3 PCV doses in the universal funded period was associated with a 30% reduction in RSV-hospitalization in Aboriginal infants (adjusted hazard ratio, aHR 0.70 [95% confidence interval, CI 0.46-1.06]) and 21% reduction in non-Aboriginal infants (aHR 0.79 [95% CI 0.63-0.99]) compared with unvaccinated infants. Conclusions Prior to the introduction of RSV vaccines, our study suggests that universal childhood PCV vaccination may result in a reduction in severe RSV infections in children and may be important for countries that are yet to consider PCV programs.
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Affiliation(s)
- Huong Le
- Correspondence: Hannah Moore, PhD, Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, PO Box 855 West Perth, Perth, WA 6872, Australia (); Huong Le, PhD, Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, PO Box 855 West Perth, Perth, WA 6872, Australia ()
| | - Heather Gidding
- Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
- Women and Babies Research, Kolling Institute, St Leonards, New South Wales, Australia
- School of Population Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, New South Wales, Australia
| | - Christopher C Blyth
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Australia
- PathWest Laboratory Medicine, Perth, Australia
- School of Medicine, University of Western Australia, Perth, Australia
| | - Peter Richmond
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
- School of Medicine, University of Western Australia, Perth, Australia
| | - Hannah C Moore
- Correspondence: Hannah Moore, PhD, Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, PO Box 855 West Perth, Perth, WA 6872, Australia (); Huong Le, PhD, Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, PO Box 855 West Perth, Perth, WA 6872, Australia ()
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43
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Tiley KS, Ratcliffe H, Voysey M, Jefferies K, Sinclair G, Carr M, Colin-Jones R, Smith D, Bowman J, Hart T, Kandasamy R, Hinds J, Gould K, Berbers G, Tcherniaeva I, Robinson H, Plested E, Aley P, Snape MD. Nasopharyngeal Carriage of Pneumococcus in Children in England up to 10 Years After 13-Valent Pneumococcal Conjugate Vaccine Introduction: Persistence of Serotypes 3 and 19A and Emergence of 7C. J Infect Dis 2023; 227:610-621. [PMID: 36130327 PMCID: PMC9978316 DOI: 10.1093/infdis/jiac376] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/22/2022] [Accepted: 09/12/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Monitoring changes in pharyngeal carriage of pneumococcus in children following 13-valent pneumococcal conjugate vaccine (PCV13) introduction in the United Kingdom in 2010 informs understanding of patterns of invasive pneumococcal disease (IPD) incidence. METHODS Nasopharyngeal swabs from healthy children vaccinated with PCV13 according to schedule (2, 4, and 12 months) were cultured and serotyped. Results for children aged 13-48 months were compared between 2014-2015 and 2017-2019 and with children aged 6-12 months (2017-2020). Blood was obtained from a subset of children for pneumococcal serotype-specific immunoglobulin G (IgG). RESULTS Total pneumococcal carriage at 13-48 months was 47.9% (473/988) in 2014-2015 and 51.8% (412/795) in 2017-2019 (P = .10); at age 6-12 months this value was 44.6% (274/615). In 2017-2019, 2.9% (95% confidence interval, 1.8%-4.3%) of children aged 13-48 months carried PCV13 serotypes (mainly 3 [1.5%] and 19A [0.8%]) and >20% carried the additional 20-valent PCV (PCV20) serotypes. Similar proportions of children had IgG ≥0.35 IU/mL for each serotype in 2014-2015 and 2017-2019. Serotype 7C carriage increased significantly (P < .01) between 2014-2015 and 2017-2019. Carriage of PCV20 serotypes 8 and 12F, both major causes of IPD, was rare. CONCLUSIONS Introduction of PCV20, if licensed for children, could significantly change the composition of pneumococcal serotypes carried in the pharynx of UK children. CLINICAL TRIALS REGISTRATION NCT03102840.
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Affiliation(s)
- Karen S Tiley
- Correspondence: Karen Tiley, PhD, Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK ()
| | - Helen Ratcliffe
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Kimberley Jefferies
- Present affiliations: University Hospital Southampton NHS Foundation Trust, Princess Anne Hospital, Southampton, United Kingdom
| | - Gemma Sinclair
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | | | - Rachel Colin-Jones
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | - Jason Hinds
- Institute for Infection and Immunity, St George’s University, London, United Kingdom
- BUGS Bioscience, London Bioscience Innovation Centre, London, United Kingdom
| | - Katherine Gould
- Institute for Infection and Immunity, St George’s University, London, United Kingdom
- BUGS Bioscience, London Bioscience Innovation Centre, London, United Kingdom
| | - Guy Berbers
- Immunology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Irina Tcherniaeva
- Immunology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hannah Robinson
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom, and
- National Institute for Health Research Clinical Research Network Thames Valley and South Midlands, Oxford, United Kingdom
| | - Emma Plested
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom, and
- National Institute for Health Research Clinical Research Network Thames Valley and South Midlands, Oxford, United Kingdom
| | - Parvinder Aley
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom, and
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Cohen R, Levy C, Rybak A, Angoulvant F, Ouldali N, Grimprel E. Immune debt: Recrudescence of disease and confirmation of a contested concept. Infect Dis Now 2023; 53:104638. [PMID: 36535583 PMCID: PMC9756601 DOI: 10.1016/j.idnow.2022.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Robert Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - Corinne Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
| | - Alexis Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Robert Debré Hospital, Paris University Hospital, Paris, France
| | - François Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Département femme-mère-enfant, CHU, Centre hospitalier universitaire vaudois, Lausanne, Suisse
| | - Naim Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Robert Debré Hospital, Paris University Hospital, Paris, France
| | - Emmanuel Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Department of Pediatric, Trousseau Hospital, APHP Paris, France, Sorbonne University, France
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45
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Klugman KP, Rodgers GL. Pneumococcal Carriage and Seroepidemiology Studies to Measure Current and Future Pneumococcal Conjugate Vaccine Effectiveness. J Infect Dis 2023; 227:608-609. [PMID: 36130329 DOI: 10.1093/infdis/jiac377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Keith P Klugman
- Pneumonia, Surveillance and Epidemic Control Programs, Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Gail L Rodgers
- Pneumonia, Surveillance and Epidemic Control Programs, Bill & Melinda Gates Foundation, Seattle, Washington, USA
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46
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Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused substantial global morbidity and deaths, leading governments to turn to non-pharmaceutical interventions to slow down the spread of infection and lessen the burden on health care systems. These policies have evolved over the course of the COVID-19 pandemic, including after the availability of COVID-19 vaccines, with regional and country-level differences in their ongoing use. The COVID-19 pandemic has been associated with changes in respiratory virus infections worldwide, which have differed between virus types. Reductions in respiratory virus infections, including by influenza virus and respiratory syncytial virus, were most notable at the onset of the COVID-19 pandemic and continued in varying degrees through subsequent waves of SARS-CoV-2 infections. The decreases in community infection burden have resulted in reduced hospitalizations and deaths associated with non-SARS-CoV-2 respiratory infections. Respiratory virus evolution relies on the maintaining of a diverse genetic pool, but evidence of genetic bottlenecking brought on by case reduction during the COVID-19 pandemic has resulted in reduced genetic diversity of some respiratory viruses, including influenza virus. By describing the differences in these changes between viral species across different geographies over the course of the COVID-19 pandemic, we may better understand the complex factors involved in community co-circulation of respiratory viruses.
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Affiliation(s)
- Eric J Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
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47
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David SC. Technologies and therapeutics for ongoing prevention of respiratory infections. Clin Transl Immunology 2023; 12:e1442. [PMID: 36861031 PMCID: PMC9969962 DOI: 10.1002/cti2.1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 03/03/2023] Open
Affiliation(s)
- Shannon C David
- Environmental Chemistry Laboratory, School of Architecture, Civil and Environmental EngineeringEcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
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48
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Stein RT, Zar HJ. RSV through the COVID-19 pandemic: Burden, shifting epidemiology, and implications for the future. Pediatr Pulmonol 2023; 58:1631-1639. [PMID: 36811330 DOI: 10.1002/ppul.26370] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/20/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
Respiratory syncytial virus (RSV) represents a major global healthcare burden, particularly in those under 5 years of age. There is no available vaccine, with treatment limited to supportive care or palivizumab for high-risk children. Additionally, although a causal relationship has not been established, RSV has been associated with the development of asthma or wheezing in some children. The COVID-19 pandemic and the introduction of nonpharmaceutical interventions (NPIs) have caused substantial changes to RSV seasonality and epidemiology. Many countries have experienced an absence of RSV during the time of a typical season, followed by an out-of-season surge upon relaxation of NPI use. These dynamics have disrupted traditional RSV disease patterns and assumptions, but also provide a unique opportunity to learn more about the transmission of RSV and other respiratory viruses, as well as inform future approaches to RSV preventive strategies. Here, we review the RSV burden and epidemiology through the COVID-19 pandemic and discuss how new data may affect future decisions regarding RSV prevention.
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Affiliation(s)
- Renato T Stein
- Infant Center, Department of Pediatrics, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Heather J Zar
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.,SA-MRC Unit for Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
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49
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Levy R, Cohen R, Lev-Shalem L, Eisenkraft A, Yosef TF. A Retrospective Database Analysis of Before and After Social Distancing in Relation to Pediatric Infection Rate and Healthcare Services Usage During the Coronavirus Disease 2019 Pandemic. Clin Infect Dis 2023; 76:713-719. [PMID: 35724239 PMCID: PMC9278179 DOI: 10.1093/cid/ciac502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Social distancing policy was introduced in Israel in 2020 to reduce the spread of coronavirus disease 2019 (COVID-19). The aim of this study was to analyze the effect of social distancing on other infections in children, by comparing disease rate and healthcare utilization before and after social distancing. METHODS This was a before-and-after study. Within this retrospective database analysis of parallel periods in 2019 (periods 1 and 2) and 2020 (periods 3 [prelockdown period] and 4 [lockdown period]) we included all pediatric population registered in the electronic medical records of the Maccabi Healthcare Services, Israel, looking at the occurrence of non-COVID-19 infections, antibiotic purchasing, physician visits, ambulatory emergency care center visits, emergency department visits, and hospitalizations. RESULTS A total of 776 828 children were included from 2019, and 777 729 from 2020. We found a lower infection rate in 2020 versus 2019. We did not find a difference in infection rate between periods 1 and 2, while there was a significant difference between periods 3 and 4. We found a significant difference between periods 2 and 4, with a higher RR than for the comparison between periods 1 and 3. There was a modest decrease in ambulatory emergency care center visits in 2020, and lower increases in emergency department visits and hospital admissions. We found decreases in antibiotic purchasing between periods 1 and 3 and between periods 2 and 4, more pronounced in 2020 than in 2019. CONCLUSIONS Analysis of findings before and after social distancing and masking showed reduced prevalence of non-COVID-19 pediatric infections and reduced consumption of healthcare services and antibiotics related with the lockdown period.
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Affiliation(s)
- Ran Levy
- Maccabi Healthcare Services, Israel
| | - Regev Cohen
- Ruth and Bruce Rappaport Faculty of Medicine, Technion University, Haifa, Israel.,Infectious Diseases Unit, Laniado Medical Center, Netanya, Israel.,Infectious Diseases Unit, Hillel-Yaffe Medical Center, Hadera, Israel
| | - Liat Lev-Shalem
- Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Arik Eisenkraft
- Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, and the IDF Medical Corps, Jerusalem, Israel
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50
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Ouldali N, Deceuninck G, Lefebvre B, Gilca R, Quach C, Brousseau N, Tapiero B, De Wals P. Increase of invasive pneumococcal disease in children temporally associated with RSV outbreak in Quebec: a time-series analysis. Lancet Reg Health Am 2023; 19:100448. [PMID: 36852331 PMCID: PMC9958468 DOI: 10.1016/j.lana.2023.100448] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
Background Respiratory viruses have been previously suspected to trigger invasive pneumococcal disease (IPD). After progressive non-pharmaceutical interventions (NPI) lifting, an unusual RSV outbreak has been observed in the Fall 2021, raising concerns about the possible consequences on IPD. We aimed to analyse the evolution of IPD incidence across age-groups since NPI lifting, and its temporal association with respiratory viral infections. Methods We conducted a time-series analysis using 1) population-based IPD surveillance data and 2) statistics from the laboratory surveillance network of respiratory viruses in the province of Quebec, Canada, from January 2013 to January 2022. The monthly IPD incidence was analysed by quasi-Poisson regression models across age-groups. The fraction of IPD incidence change potentially attributable to different viruses in 2021-2022 was estimated. Findings A total of 7712 IPD cases were included. After a major decrease in IPD incidence from April 2020, IPD rate started to increase in <5-year-old children in October 2021, exceeding the pre-NPI trend (+62%). This was temporally associated with an unusual surge in RSV cases (+53% versus pre-NPI trend). During this 2021-22 surge, the fraction of IPD attributable to RSV dynamics in children was 77% (95% CI [33-100]). By contrast, the IPD incidence in older age-groups remained low, and was temporally associated with influenza dynamics. Interpretation These results provide new evidence on the role of respiratory viruses in driving IPD dynamics, with possible differences between children and adults. In the coming future, the potential benefit of interventions targeting RSV, such as vaccines, for IPD prevention should be considered. Funding The study was supported by a grant from the Quebec Ministry of Health and Social Services ('ministère de la Santé et des Services sociaux du Québec'). Publication was supported by a grant from "Fondation de l'Assistance Publique - Hôpitaux de Paris et de l'Alliance « Tous Unis contre le Virus » (Fondation de France/Institut Pasteur/APHP)". N.O. was supported by the ESPID (European Society of Pediatric Infectious Diseases) 2021-2023 Fellowship Award and the 2022 ISPPD (International Symposium on Pneumococci and Pneumococcal Diseases) Robert Austrian Research award.
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Affiliation(s)
- Naïm Ouldali
- Division of Infectious Diseases, Department of Pediatric Infectious Diseases, Sainte Justine University Hospital, University of Montreal, Quebec, Canada,Infection, Antimicrobials, Modelling, Evolution, Inserm UMR 1137, Paris University, Paris, France,Association Clinique et Thérapeutique Infantile du Val-de-Marne, St Maur-des-Fossés, France,Corresponding author. Department of Pediatric Infectious Diseases, Sainte Justine University Hospital, Montreal University, QC H3T 1C5, Montreal, Quebec, Canada.
| | | | - Brigitte Lefebvre
- Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Canada
| | - Rodica Gilca
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, Canada,Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
| | - Caroline Quach
- Division of Infectious Diseases, Department of Pediatric Infectious Diseases, Sainte Justine University Hospital, University of Montreal, Quebec, Canada,Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Quebec, Canada
| | - Nicholas Brousseau
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, Canada,Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
| | - Bruce Tapiero
- Division of Infectious Diseases, Department of Pediatric Infectious Diseases, Sainte Justine University Hospital, University of Montreal, Quebec, Canada
| | - Philippe De Wals
- Centre de recherche du CHU de Québec-Université Laval, Québec, Canada,Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, Canada,Direction des risques biologiques, Institut national de santé publique du Québec, Québec, Canada
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