Decrease in Enteroviral Meningitis: An Unexpected Benefit of Coronavirus Disease 2019 (COVID-19) Mitigation?

Kies, Kami D; Thomas, A.; Binnicker, Matthew J.; Bashynski, Kelli L; Patel, Robin

doi:10.1093/cid/ciaa1881

Cited by 16 publications

(13 citation statements)

References 15 publications

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“…However, no case of enteroviral meningitis was confirmed, and there were no seasonal variations after the outbreak. These results are similar to those of previous studies that reported a decrease in the incidence of enteroviral meningitis and the disappearance of seasonal changes following the outbreak ( 11 – 13 ). This fact seems more evident in that it shows the same results not only in the patients included in our study but also in the national prevalence data before and after the outbreak ( Figure 4 ).…”

Section: Discussionsupporting

confidence: 92%

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Changes in the Epidemiology and Causative Pathogens of Meningitis in Children After the Outbreak of the Coronavirus Disease 2019: A Multicenter Database Study

et al. 2022

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BackgroundWith the outbreak of the COVID-19 pandemic, non-pharmaceutical interventions such as social distancing have been implemented worldwide, and a decrease in other infectious diseases has been reported as an unexpected benefit. However, to date, studies are lacking regarding the effects of the COVID-19 pandemic on neuroinfectious diseases; therefore, we aimed to determine the effects of the COVID-19 pandemic on the incidence of meningitis, which is the most common infectious disease in children.MethodsThis retrospective study used electronic medical record data from five university hospitals located in the metropolitan cities in Korea. This study included patients aged <18 years who were diagnosed with meningitis between January 2017 and December 2020. We analyzed the clinical characteristics of patients with meningitis and changes in the incidence and causative pathogens of meningitis before and after the COVID-19 outbreak.ResultsThe study included 677 patients with meningitis. Following the outbreak of COVID-19 in Korea in January 2020, the incidence of childhood meningitis significantly decreased and seasonal changes noted yearly disappeared. There was a difference in the age distribution of patients with meningitis. The incidence of meningitis decreased significantly in children aged >5 years, and the incidence in children <5 years of age relatively increased (p < 0.001). In addition, there was a notable decrease in the cases of suspected meningitis (p < 0.001). The incidence of enteroviral meningitis, the most common cause of meningitis, significantly decreased.ConclusionAfter the COVID-19 outbreak, the incidence of childhood meningitis significantly decreased with the implementation of non-pharmaceutical interventions. Absence of enteroviral meningitis and decrease in the proportion of patients aged ≥5 years with meningitis having mild symptoms were noted. Consequently, it can be concluded that the non-pharmaceutical interventions (NPIs) instituted to prevent the spread of COVID-19 had some effect on reducing the incidence of meningitis.

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Section: Discussionsupporting

confidence: 92%

“…Some studies have been conducted on the changes in the incidence of meningitis after the COVID-19 outbreak ( 11 – 14 ). However, previous studies only analyzed changes in the incidence of meningitis caused by specific bacteria or viruses in the entire population.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Epidemiology and Causative Pathogens of Meningitis in Children After the Outbreak of the Coronavirus Disease 2019: A Multicenter Database Study

et al. 2022

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“…Not only the positive rates of respiratory viruses, but also those of enterovirus infection cases, such as HFMD or herpangina, were close to zero in our clinical center, which had never happened for these respiratory viruses in the past 10 years. This phenomenon was demonstrated by a marked decline in the incidence of enterovirus encephalitis following the start of strict COVID-19 quarantine measures, but not only in the incidence of respiratory viruses [ 17 , 18 ]. We also observed a resurgence of cases of respiratory and enterovirus infections after the reopening of schools and communities.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Viruses Causing Pediatric Community Acquired Pneumonia in Shanghai During 2010–2020: What Happened Before and After the COVID-19 Outbreak?

Zhang

Shi

et al. 2021

Infect Dis Ther

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Introduction Since the global outbreak of COVID-19, there has been a significant reduction in pediatric outpatient and emergency visits for infectious diseases. The purpose of this study was to analyze the changes in respiratory viruses in children with community-acquired pneumonia (CAP) in Shanghai in the past 10 years, especially in the first year after COVID-19. Methods We conducted a retrospective, observational study; the results for eight common respiratory viruses (respiratory syncytial virus (RSV), influenza virus A and B, parainfluenza virus 1–3 (PIV), adenovirus (ADV) and human metapneumovirus) tested by direct fluorescent antibody assays in hospitalized CAP cases in Children’s Hospital of Fudan University during 2010–2020 were analyzed. Results Of the 5544 hospitalized CAP patients included in this study, 20.2% (1125/5544) were positive for the eight respiratory viruses. The top three pathogens were RSV, PIV3 and ADV, detected from 9.8% (543/5544), 5.3% (294/5544) and 2.0% (111/5544) of the samples, respectively. RSV had the highest positive rates among children < 2 years old. In 2020, the detection rate of all viruses showed a sharp decline from February to August compared with the previous 9 years. When the Shanghai community reopened in August 2020, the detection rate of eight viruses rebounded significantly in September. Conclusions These eight respiratory viruses, especially RSV and PIV, were important pathogens of CAP in Shanghai children in the past 10 years. The COVID-19 pandemic had a significant impact on the detection rates for eight respiratory viruses in children with CAP in Shanghai.

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“…It has, however, been suggested that the observed decrease in detection of other viruses (including those transmitted via non-respiratory routes such as EVs) might not be the result of reduced surveillance. Rather, it is thought that non-pharmaceutical measures taken to mitigate SARS-CoV-2 transmission have also impacted pathogens transmitted via the fecal–oral route such as EVs [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Wastewater-Based Epidemiology and Long-Read Sequencing to Identify Enterovirus Circulation in Three Municipalities in Maricopa County, Arizona, Southwest United States between June and October 2020

Faleye

Bowes

Driver

et al. 2021

Viruses

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We used wastewater-based epidemiology and amplicon-based long-read high-throughput sequencing for surveillance of enteroviruses (EVs) in Maricopa County, Arizona, Southwest United States. We collected 48 samples from 13 sites in three municipalities between 18 June and 1 October 2020, and filtered (175 mL each; 0.45 µm pore size) and extracted RNA from the filter-trapped solids. The RNA was converted to cDNA and processed through two workflows (Sanger sequencing (SSW) and long-read Illumina sequencing (LRISW)) each including a nested polymerase chain reaction (nPCR) assay. We subjected the ~350 bp amplicon from SSW to Sanger sequencing and the ~1900–2400 bp amplicon from LRISW to Illumina sequencing. We identified EV contigs from 11 of the 13 sites and 41.67% (20/48) of screened samples. Using the LRISW, we detected nine EV genotypes from three species (Enterovirus A (CVA4, EV-A76, EV-A90), Enterovirus B (E14) and Enterovirus C (CVA1, CVA11, CVA13, CVA19 and CVA24)) with Enterovirus C representing approximately 90% of the variants. However, the SSW only detected the five Enterovirus C types. Similarity and phylogenetic analysis showed that multiple Enterovirus C lineages were circulating, co-infecting and recombining in the population during the season despite the SARS-CoV-2 pandemic and the non-pharmaceutical public health measures taken to curb transmission.

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Decrease in Enteroviral Meningitis: An Unexpected Benefit of Coronavirus Disease 2019 (COVID-19) Mitigation?

Cited by 16 publications

References 15 publications

Changes in the Epidemiology and Causative Pathogens of Meningitis in Children After the Outbreak of the Coronavirus Disease 2019: A Multicenter Database Study

Changes in the Epidemiology and Causative Pathogens of Meningitis in Children After the Outbreak of the Coronavirus Disease 2019: A Multicenter Database Study

Epidemiology of Viruses Causing Pediatric Community Acquired Pneumonia in Shanghai During 2010–2020: What Happened Before and After the COVID-19 Outbreak?

Wastewater-Based Epidemiology and Long-Read Sequencing to Identify Enterovirus Circulation in Three Municipalities in Maricopa County, Arizona, Southwest United States between June and October 2020

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