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The Invasive Respiratory Infection Surveillance (IRIS) Initiative reveals significant reductions in invasive bacterial infections during the COVID-19 pandemic

By Angela B Brueggemann, Melissa J Jansen van Rensburg, David Shaw, Noel McCarthy, Keith A Jolley, Martin C.J. Maiden, Mark 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 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 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

Posted 20 Nov 2020
medRxiv DOI: 10.1101/2020.11.18.20225029

BackgroundStreptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis are leading causes of invasive diseases including bacteraemic pneumonia and meningitis, and of secondary infections post-viral respiratory disease. They are typically transmitted via respiratory droplets. We investigated rates of invasive disease due to these pathogens during the early phase of the COVID-19 pandemic. MethodsLaboratories in 26 countries across six continents submitted data on cases of invasive disease due to S pneumoniae, H influenzae and N meningitidis from 1 January 2018 to 31 May 2020. Weekly cases in 2020 vs 2018-2019 were compared. Streptococcus agalactiae data were collected from nine laboratories for comparison to a non-respiratory pathogen. The stringency of COVID-19 containment measures was quantified by the Oxford COVID-19 Government Response Tracker. Changes in population movements were assessed by Google COVID-19 Community Mobility Reports. Interrupted time series modelling quantified changes in rates of invasive disease in 2020 relative to when containment measures were imposed. FindingsAll countries experienced a significant, sustained reduction in invasive diseases due to S pneumoniae, H influenzae and N meningitidis, but not S agalactiae, in early 2020, which coincided with the introduction of COVID-19 containment measures in each country. Similar impacts were observed across most countries despite differing stringency in COVID-19 control policies. There was no evidence of a specific effect due to enforced school closures. InterpretationThe introduction of COVID-19 containment policies and public information campaigns likely reduced transmission of these bacterial respiratory pathogens, leading to a significant reduction in life-threatening invasive diseases in many countries worldwide.

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