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February 16, 2023
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COVID-related nonpharmaceutical interventions led to decline in invasive bacterial disease

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Pandemic-related nonpharmaceutical interventions likely contributed to the decline in invasive bacterial disease incidence in the U.S. in 2020, not reductions in testing, according to a study in The Journal of Infectious Diseases.

“Since the start of the COVID-19 pandemic, the epidemiology of other infectious diseases, including that of invasive bacterial disease, has changed dramatically worldwide,” Namrata Prasad, PhD, an Epidemic Intelligence Service officer in the CDC’s Division of Bacterial Diseases, told Healio.

IDN0223Prasad_Graphic_01_WEB
Prasad N, et al. J Infect Dis. 2023;doi:10.1093/infdis/jiad028.

“To date, changes in invasive bacterial disease epidemiology during the pandemic in the U.S. are not well described. Such descriptions are important for informing surveillance and preventive strategies, as well as for contextualizing future trends,” Prasad said.

Prasad and colleagues investigated changes in the incidence of invasive bacterial disease (IBD) due to Streptococcus pneumoniae, Haemophilus influenzae, group A Streptococcus (GAS) and group B Streptococcus (GBS) during the COVID-19 pandemic period, which researchers defined as March 1 through Dec. 31, 2020.

According to the study, the researchers compared observed IBD incidences during the pandemic with expected incidences, consistent with January 2014 through February 2020 trends.

The study showed that overall, the observed incidences of IBD due to S. pneumoniae, H. influenzae, GAS and GBS were 58%, 60%, 28% and 12% lower, respectively, during the pandemic period compared with the expected incidences.

Namrata Prasad

Researchers determined that these declines corresponded closely with the implementations of COVID-19-associated nonpharmaceutical-interventions and that blood and cerebrospinal fluid culture testing rates during the pandemic were comparable to previous years, showing that a decline in testing — seen with many infections — were likely not the cause of the decline.

Additional data from stratified analyses found significantly lower than expected incidences among all age groups for S. pneumoniae and H. influenzae, although there was some variation, with a greater decline from expected incidence seen for S. pneumoniae among children aged 5 to 17 years compared with other age groups, a lower than expected incidences for GAS among all age groups except for adults aged 18 to 49 years and a significantly lower than expected incidence of IBD due to GBS among adults aged 50 years and older.

Similar results were observed among all races, with significantly lower than expected incidences among all race groups for S. pneumoniae, H. influenzae and GAS, whereas S. pneumoniae rates remained highest among Black people.

Declines from expected incidences for GBS were also significant and similar among Black and white people but were not significantly lower than expected among people within the other racial group.

“COVID-19-associated nonpharmaceutical interventions were likely major contributors to the declines in invasive bacterial disease incidence observed during the first year of the COVID-19 pandemic in the U.S.,” Prasad said. “As nonpharmaceutical interventions are eased, close monitoring of changes in invasive bacterial disease incidence and possible resurgence of disease is necessary to inform future preventive measures.”