Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data
Authors: Angela B Brueggemann, Melissa J Jansen van Rensburg, David Shaw, Noel D McCarthy, Keith A Jolley, Martin C J Maiden, Mark P G van der Linden, Zahin Amin-Chowdhury, Désirée E Bennett, Ray Borrow, Maria-Cristina C Brandileone, Karen Broughton, Ruth Campbell, Bin Cao, Carlo Casanova, Eun Hwa Choi, Yiu Wai Chu, Stephen A Clark, Heike Claus, Juliana Coelho, Mary Corcoran, Simon Cottrell, Robert J Cunney, Tine Dalby, Heather Davies, Linda de Gouveia, Ala-Eddine Deghmane, Walter Demczuk, Stefanie Desmet, Richard J Drew, Mignon du Plessis, Helga Erlendsdottir, Norman K Fry, Kurt Fuursted, Steve J Gray, Birgitta Henriques-Normark, Thomas Hale, Markus Hilty, Steen Hoffmann, Hilary Humphreys, Margaret Ip, Susanne Jacobsson, Jillian Johnston, Jana Kozakova, Karl G Kristinsson, Pavla Krizova, Alicja Kuch, Shamez N Ladhani, Thiên-Trí Lâm, Vera Lebedova, Laura Lindholm, David J Litt, Irene Martin, Delphine Martiny, Wesley Mattheus, Martha McElligott, Mary Meehan, Susan Meiring, Paula Mölling, Eva Morfeldt, Julie Morgan, Robert M Mulhall, Carmen Muñoz-Almagro, David R Murdoch, Joy Murphy, Martin Musilek, Alexandre Mzabi, Amaresh Perez-Argüello, Monique Perrin, Malorie Perry, Alba Redin, Richard Roberts, Maria Roberts, Assaf Rokney, Merav Ron, Kevin J Scott, Carmen L Sheppard, Lotta Siira, Anna Skoczyńska, Monica Sloan, Hans-Christian Slotved, Andrew J Smith, Joon Young Song, Muhamed-Kheir Taha, Maija Toropainen, Dominic Tsang, Anni Vainio, Nina M van Sorge, Emmanuelle Varon, Jiri Vlach, Ulrich Vogel, Sandra Vohrnova, Anne von Gottberg, Rosemeire C Zanella, Fei Zhou
Journal: The Lancet Digital Health (2021)

Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, which are typically transmitted via respiratory droplets, are leading causes of invasive diseases, including bacteraemic pneumonia and meningitis, and of secondary infections subsequent to post-viral respiratory disease. The aim of this study was to investigate the incidence of invasive disease due to these pathogens during the early months of the COVID-19 pandemic.In this prospective analysis of surveillance data, laboratories in 26 countries and territories across six continents submitted data on cases of invasive disease due to S pneumoniae, H influenzae, and N meningitidis from Jan 1, 2018, to May, 31, 2020, as part of the Invasive Respiratory Infection Surveillance (IRIS) Initiative. Numbers of weekly cases in 2020 were compared with corresponding data for 2018 and 2019. Data for invasive disease due to Streptococcus agalactiae, a non-respiratory pathogen, were collected from nine laboratories for comparison. The stringency of COVID-19 containment measures was quantified using the Oxford COVID-19 Government Response Tracker. Changes in population movements were assessed using Google COVID-19 Community Mobility Reports. Interrupted time-series modelling quantified changes in the incidence of invasive disease due to S pneumoniae, H influenzae, and N meningitidis in 2020 relative to when containment measures were imposed.27 laboratories from 26 countries and territories submitted data to the IRIS Initiative for S pneumoniae (62 837 total cases), 24 laboratories from 24 countries submitted data for H influenzae (7796 total cases), and 21 laboratories from 21 countries submitted data for N meningitidis (5877 total cases). All countries and territories had experienced a significant and sustained reduction in invasive diseases due to S pneumoniae, H influenzae, and N meningitidis in early 2020 (Jan 1 to May 31, 2020), coinciding with the introduction of COVID-19 containment measures in each country. By contrast, no significant changes in the incidence of invasive S agalactiae infections were observed. Similar trends were observed across most countries and territories despite differing stringency in COVID-19 control policies. The incidence of reported S pneumoniae infections decreased by 68% at 4 weeks (incidence rate ratio 0·32 [95% CI 0·27-0·37]) and 82% at 8 weeks (0·18 [0·14-0·23]) following the week in which significant changes in population movements were recorded.The introduction of COVID-19 containment policies and public information campaigns likely reduced transmission of S pneumoniae, H influenzae, and N meningitidis, leading to a significant reduction in life-threatening invasive diseases in many countries worldwide.Wellcome Trust (UK), Robert Koch Institute (Germany), Federal Ministry of Health (Germany), Pfizer, Merck, Health Protection Surveillance Centre (Ireland), SpID-Net project (Ireland), European Centre for Disease Prevention and Control (European Union), Horizon 2020 (European Commission), Ministry of Health (Poland), National Programme of Antibiotic Protection (Poland), Ministry of Science and Higher Education (Poland), Agencia de Salut Pública de Catalunya (Spain), Sant Joan de Deu Foundation (Spain), Knut and Alice Wallenberg Foundation (Sweden), Swedish Research Council (Sweden), Region Stockholm (Sweden), Federal Office of Public Health of Switzerland (Switzerland), and French Public Health Agency (France).