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

Summary: Background: 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...

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Main Authors:	Angela B Brueggemann, ProfDPhil, Melissa J Jansen van Rensburg, ProfDPhil, David Shaw, MD, Noel D McCarthy, ProfDPhil, Keith A Jolley, PhD, Martin C J Maiden, ProfPhD, Mark P G van der Linden, PhD, Zahin Amin-Chowdhury, BSc, Désirée E Bennett, PhD, Ray Borrow, PhD, Maria-Cristina C Brandileone, PhD, Karen Broughton, MSc, Ruth Campbell, Bin Cao, ProfMD, Carlo Casanova, PhD, Eun Hwa Choi, ProfMD, Yiu Wai Chu, PhD, Stephen A Clark, PhD, Heike Claus, PhD, Juliana Coelho, PhD, Mary Corcoran, PhD, Simon Cottrell, PhD, Robert J Cunney, MD, Tine Dalby, PhD, Heather Davies, NZCS, Linda de Gouveia, NatDipMicro, Ala-Eddine Deghmane, PhD, Walter Demczuk, BSc, Stefanie Desmet, PharmD, Richard J Drew, MD, Mignon du Plessis, PhD, Helga Erlendsdottir, ProfMSc, Norman K Fry, PhD, Kurt Fuursted, MD, Steve J Gray, PhD, Birgitta Henriques-Normark, ProfMD, Thomas Hale, PhD, Markus Hilty, PhD, Steen Hoffmann, MD, Hilary Humphreys, ProfMD, Margaret Ip, MD, Susanne Jacobsson, PhD, Jillian Johnston, MBBS, Jana Kozakova, MD, Karl G Kristinsson, ProfMD, Pavla Krizova, MD, Alicja Kuch, PhD, Shamez N Ladhani, MD, Thiên-Trí Lâm, MD, Vera Lebedova, MD, Laura Lindholm, MSc, David J Litt, PhD, Irene Martin, BSc, Delphine Martiny, ProfPhD, Wesley Mattheus, PhD, Martha McElligott, PhD, Mary Meehan, PhD, Susan Meiring, MBChB, Paula Mölling, PhD, Eva Morfeldt, PhD, Julie Morgan, HND, Robert M Mulhall, PhD, Carmen Muñoz-Almagro, ProfMD, David R Murdoch, ProfMD, Joy Murphy, BA Hons, Martin Musilek, PhD, Alexandre Mzabi, MD, Amaresh Perez-Argüello, MLT, Monique Perrin, MD, Malorie Perry, MSc, Alba Redin, BSc, Richard Roberts, MPH, Maria Roberts, BSc, Assaf Rokney, PhD, Merav Ron, PhD, Kevin J Scott, PhD, Carmen L Sheppard, PhD, Lotta Siira, PhD, Anna Skoczyńska, ProfPhD, Monica Sloan, Hans-Christian Slotved, PhD, Andrew J Smith, ProfPhD, Joon Young Song, MD, Muhamed-Kheir Taha, MD, Maija Toropainen, PhD, Dominic Tsang, MD, Anni Vainio, PhD, Nina M van Sorge, PhD, Emmanuelle Varon, MD, Jiri Vlach, PhD, Ulrich Vogel, ProfMD, Sandra Vohrnova, MD, Anne von Gottberg, PhD, Rosemeire C Zanella, PhD, Fei Zhou, PhD
Format:	Article
Language:	English
Published:	Elsevier 2021-06-01
Series:	The Lancet: Digital Health
Online Access:	http://www.sciencedirect.com/science/article/pii/S2589750021000777

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language	English
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author	Angela B Brueggemann, ProfDPhil Melissa J Jansen van Rensburg, ProfDPhil David Shaw, MD Noel D McCarthy, ProfDPhil Keith A Jolley, PhD Martin C J Maiden, ProfPhD Mark P G van der Linden, PhD Zahin Amin-Chowdhury, BSc Désirée E Bennett, PhD Ray Borrow, PhD Maria-Cristina C Brandileone, PhD Karen Broughton, MSc Ruth Campbell Bin Cao, ProfMD Carlo Casanova, PhD Eun Hwa Choi, ProfMD Yiu Wai Chu, PhD Stephen A Clark, PhD Heike Claus, PhD Juliana Coelho, PhD Mary Corcoran, PhD Simon Cottrell, PhD Robert J Cunney, MD Tine Dalby, PhD Heather Davies, NZCS Linda de Gouveia, NatDipMicro Ala-Eddine Deghmane, PhD Walter Demczuk, BSc Stefanie Desmet, PharmD Richard J Drew, MD Mignon du Plessis, PhD Helga Erlendsdottir, ProfMSc Norman K Fry, PhD Kurt Fuursted, MD Steve J Gray, PhD Birgitta Henriques-Normark, ProfMD Thomas Hale, PhD Markus Hilty, PhD Steen Hoffmann, MD Hilary Humphreys, ProfMD Margaret Ip, MD Susanne Jacobsson, PhD Jillian Johnston, MBBS Jana Kozakova, MD Karl G Kristinsson, ProfMD Pavla Krizova, MD Alicja Kuch, PhD Shamez N Ladhani, MD Thiên-Trí Lâm, MD Vera Lebedova, MD Laura Lindholm, MSc David J Litt, PhD Irene Martin, BSc Delphine Martiny, ProfPhD Wesley Mattheus, PhD Martha McElligott, PhD Mary Meehan, PhD Susan Meiring, MBChB Paula Mölling, PhD Eva Morfeldt, PhD Julie Morgan, HND Robert M Mulhall, PhD Carmen Muñoz-Almagro, ProfMD David R Murdoch, ProfMD Joy Murphy, BA Hons Martin Musilek, PhD Alexandre Mzabi, MD Amaresh Perez-Argüello, MLT Monique Perrin, MD Malorie Perry, MSc Alba Redin, BSc Richard Roberts, MPH Maria Roberts, BSc Assaf Rokney, PhD Merav Ron, PhD Kevin J Scott, PhD Carmen L Sheppard, PhD Lotta Siira, PhD Anna Skoczyńska, ProfPhD Monica Sloan Hans-Christian Slotved, PhD Andrew J Smith, ProfPhD Joon Young Song, MD Muhamed-Kheir Taha, MD Maija Toropainen, PhD Dominic Tsang, MD Anni Vainio, PhD Nina M van Sorge, PhD Emmanuelle Varon, MD Jiri Vlach, PhD Ulrich Vogel, ProfMD Sandra Vohrnova, MD Anne von Gottberg, PhD Rosemeire C Zanella, PhD Fei Zhou, PhD
spellingShingle	Angela B Brueggemann, ProfDPhil Melissa J Jansen van Rensburg, ProfDPhil David Shaw, MD Noel D McCarthy, ProfDPhil Keith A Jolley, PhD Martin C J Maiden, ProfPhD Mark P G van der Linden, PhD Zahin Amin-Chowdhury, BSc Désirée E Bennett, PhD Ray Borrow, PhD Maria-Cristina C Brandileone, PhD Karen Broughton, MSc Ruth Campbell Bin Cao, ProfMD Carlo Casanova, PhD Eun Hwa Choi, ProfMD Yiu Wai Chu, PhD Stephen A Clark, PhD Heike Claus, PhD Juliana Coelho, PhD Mary Corcoran, PhD Simon Cottrell, PhD Robert J Cunney, MD Tine Dalby, PhD Heather Davies, NZCS Linda de Gouveia, NatDipMicro Ala-Eddine Deghmane, PhD Walter Demczuk, BSc Stefanie Desmet, PharmD Richard J Drew, MD Mignon du Plessis, PhD Helga Erlendsdottir, ProfMSc Norman K Fry, PhD Kurt Fuursted, MD Steve J Gray, PhD Birgitta Henriques-Normark, ProfMD Thomas Hale, PhD Markus Hilty, PhD Steen Hoffmann, MD Hilary Humphreys, ProfMD Margaret Ip, MD Susanne Jacobsson, PhD Jillian Johnston, MBBS Jana Kozakova, MD Karl G Kristinsson, ProfMD Pavla Krizova, MD Alicja Kuch, PhD Shamez N Ladhani, MD Thiên-Trí Lâm, MD Vera Lebedova, MD Laura Lindholm, MSc David J Litt, PhD Irene Martin, BSc Delphine Martiny, ProfPhD Wesley Mattheus, PhD Martha McElligott, PhD Mary Meehan, PhD Susan Meiring, MBChB Paula Mölling, PhD Eva Morfeldt, PhD Julie Morgan, HND Robert M Mulhall, PhD Carmen Muñoz-Almagro, ProfMD David R Murdoch, ProfMD Joy Murphy, BA Hons Martin Musilek, PhD Alexandre Mzabi, MD Amaresh Perez-Argüello, MLT Monique Perrin, MD Malorie Perry, MSc Alba Redin, BSc Richard Roberts, MPH Maria Roberts, BSc Assaf Rokney, PhD Merav Ron, PhD Kevin J Scott, PhD Carmen L Sheppard, PhD Lotta Siira, PhD Anna Skoczyńska, ProfPhD Monica Sloan Hans-Christian Slotved, PhD Andrew J Smith, ProfPhD Joon Young Song, MD Muhamed-Kheir Taha, MD Maija Toropainen, PhD Dominic Tsang, MD Anni Vainio, PhD Nina M van Sorge, PhD Emmanuelle Varon, MD Jiri Vlach, PhD Ulrich Vogel, ProfMD Sandra Vohrnova, MD Anne von Gottberg, PhD Rosemeire C Zanella, PhD Fei Zhou, PhD 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 The Lancet: Digital Health
author_facet	Angela B Brueggemann, ProfDPhil Melissa J Jansen van Rensburg, ProfDPhil David Shaw, MD Noel D McCarthy, ProfDPhil Keith A Jolley, PhD Martin C J Maiden, ProfPhD Mark P G van der Linden, PhD Zahin Amin-Chowdhury, BSc Désirée E Bennett, PhD Ray Borrow, PhD Maria-Cristina C Brandileone, PhD Karen Broughton, MSc Ruth Campbell Bin Cao, ProfMD Carlo Casanova, PhD Eun Hwa Choi, ProfMD Yiu Wai Chu, PhD Stephen A Clark, PhD Heike Claus, PhD Juliana Coelho, PhD Mary Corcoran, PhD Simon Cottrell, PhD Robert J Cunney, MD Tine Dalby, PhD Heather Davies, NZCS Linda de Gouveia, NatDipMicro Ala-Eddine Deghmane, PhD Walter Demczuk, BSc Stefanie Desmet, PharmD Richard J Drew, MD Mignon du Plessis, PhD Helga Erlendsdottir, ProfMSc Norman K Fry, PhD Kurt Fuursted, MD Steve J Gray, PhD Birgitta Henriques-Normark, ProfMD Thomas Hale, PhD Markus Hilty, PhD Steen Hoffmann, MD Hilary Humphreys, ProfMD Margaret Ip, MD Susanne Jacobsson, PhD Jillian Johnston, MBBS Jana Kozakova, MD Karl G Kristinsson, ProfMD Pavla Krizova, MD Alicja Kuch, PhD Shamez N Ladhani, MD Thiên-Trí Lâm, MD Vera Lebedova, MD Laura Lindholm, MSc David J Litt, PhD Irene Martin, BSc Delphine Martiny, ProfPhD Wesley Mattheus, PhD Martha McElligott, PhD Mary Meehan, PhD Susan Meiring, MBChB Paula Mölling, PhD Eva Morfeldt, PhD Julie Morgan, HND Robert M Mulhall, PhD Carmen Muñoz-Almagro, ProfMD David R Murdoch, ProfMD Joy Murphy, BA Hons Martin Musilek, PhD Alexandre Mzabi, MD Amaresh Perez-Argüello, MLT Monique Perrin, MD Malorie Perry, MSc Alba Redin, BSc Richard Roberts, MPH Maria Roberts, BSc Assaf Rokney, PhD Merav Ron, PhD Kevin J Scott, PhD Carmen L Sheppard, PhD Lotta Siira, PhD Anna Skoczyńska, ProfPhD Monica Sloan Hans-Christian Slotved, PhD Andrew J Smith, ProfPhD Joon Young Song, MD Muhamed-Kheir Taha, MD Maija Toropainen, PhD Dominic Tsang, MD Anni Vainio, PhD Nina M van Sorge, PhD Emmanuelle Varon, MD Jiri Vlach, PhD Ulrich Vogel, ProfMD Sandra Vohrnova, MD Anne von Gottberg, PhD Rosemeire C Zanella, PhD Fei Zhou, PhD
author_sort	Angela B Brueggemann, ProfDPhil
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Elsevier
series	The Lancet: Digital Health
issn	2589-7500
publishDate	2021-06-01
description	Summary: Background: 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. Methods: 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. Findings: 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. Interpretation: 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. Funding: 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).
url	http://www.sciencedirect.com/science/article/pii/S2589750021000777
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changesintheincidenceofinvasivediseaseduetostreptococcuspneumoniaehaemophilusinfluenzaeandneisseriameningitidisduringthecovid19pandemicin26countriesandterritoriesintheinvasiverespiratoryinfectionsurveillanceinitiativeaprospectiveanalysisofsurveillancedata AT sandravohrnovamd changesintheincidenceofinvasivediseaseduetostreptococcuspneumoniaehaemophilusinfluenzaeandneisseriameningitidisduringthecovid19pandemicin26countriesandterritoriesintheinvasiverespiratoryinfectionsurveillanceinitiativeaprospectiveanalysisofsurveillancedata AT annevongottbergphd changesintheincidenceofinvasivediseaseduetostreptococcuspneumoniaehaemophilusinfluenzaeandneisseriameningitidisduringthecovid19pandemicin26countriesandterritoriesintheinvasiverespiratoryinfectionsurveillanceinitiativeaprospectiveanalysisofsurveillancedata AT rosemeireczanellaphd 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spelling	doaj-f6fe24685f384a75a4df9fa5518751582021-05-26T04:28:27ZengElsevierThe Lancet: Digital Health2589-75002021-06-0136e360e370Changes 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 dataAngela B Brueggemann, ProfDPhil0Melissa J Jansen van Rensburg, ProfDPhil1David Shaw, MD2Noel D McCarthy, ProfDPhil3Keith A Jolley, PhD4Martin C J Maiden, ProfPhD5Mark P G van der Linden, PhD6Zahin Amin-Chowdhury, BSc7Désirée E Bennett, PhD8Ray Borrow, PhD9Maria-Cristina C Brandileone, PhD10Karen Broughton, MSc11Ruth Campbell12Bin Cao, ProfMD13Carlo Casanova, PhD14Eun Hwa Choi, ProfMD15Yiu Wai Chu, PhD16Stephen A Clark, PhD17Heike Claus, PhD18Juliana Coelho, PhD19Mary Corcoran, PhD20Simon Cottrell, PhD21Robert J Cunney, MD22Tine Dalby, PhD23Heather Davies, NZCS24Linda de Gouveia, NatDipMicro25Ala-Eddine Deghmane, PhD26Walter Demczuk, BSc27Stefanie Desmet, PharmD28Richard J Drew, MD29Mignon du Plessis, PhD30Helga Erlendsdottir, ProfMSc31Norman K Fry, PhD32Kurt Fuursted, MD33Steve J Gray, PhD34Birgitta Henriques-Normark, ProfMD35Thomas Hale, PhD36Markus Hilty, PhD37Steen Hoffmann, MD38Hilary Humphreys, ProfMD39Margaret Ip, MD40Susanne Jacobsson, PhD41Jillian Johnston, MBBS42Jana Kozakova, MD43Karl G Kristinsson, ProfMD44Pavla Krizova, MD45Alicja Kuch, PhD46Shamez N Ladhani, MD47Thiên-Trí Lâm, MD48Vera Lebedova, MD49Laura Lindholm, MSc50David J Litt, PhD51Irene Martin, BSc52Delphine Martiny, ProfPhD53Wesley Mattheus, PhD54Martha McElligott, PhD55Mary Meehan, PhD56Susan Meiring, MBChB57Paula Mölling, PhD58Eva Morfeldt, PhD59Julie Morgan, HND60Robert M Mulhall, PhD61Carmen Muñoz-Almagro, ProfMD62David R Murdoch, ProfMD63Joy Murphy, BA Hons64Martin Musilek, PhD65Alexandre Mzabi, MD66Amaresh Perez-Argüello, MLT67Monique Perrin, MD68Malorie Perry, MSc69Alba Redin, BSc70Richard Roberts, MPH71Maria Roberts, BSc72Assaf Rokney, PhD73Merav Ron, PhD74Kevin J Scott, PhD75Carmen L Sheppard, PhD76Lotta Siira, PhD77Anna Skoczyńska, ProfPhD78Monica Sloan79Hans-Christian Slotved, PhD80Andrew J Smith, ProfPhD81Joon Young Song, MD82Muhamed-Kheir Taha, MD83Maija Toropainen, PhD84Dominic Tsang, MD85Anni Vainio, PhD86Nina M van Sorge, PhD87Emmanuelle Varon, MD88Jiri Vlach, PhD89Ulrich Vogel, ProfMD90Sandra Vohrnova, MD91Anne von Gottberg, PhD92Rosemeire C Zanella, PhD93Fei Zhou, PhD94Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK; Correspondence to: Prof Angela B Brueggemann, Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford OX37LF, UKNuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UKNuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UKTrinity College Dublin, Dublin, IrelandDepartment of Zoology, University of Oxford, Oxford, UKDepartment of Zoology, University of Oxford, Oxford, UKDepartment of Medical Microbiology, German National Reference Center for Streptococci, University Hospital RWTH Aachen, Aachen, GermanyImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UKDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, IrelandMeningococcal Reference Unit, National Infection Service, Public Health England, Manchester Royal Infirmary, Manchester, UKNational Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, BrazilRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UKPublic Health Agency, Belfast, Northern IrelandDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, ChinaSwiss National Reference Centre for invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, SwitzerlandDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, ChinaMeningococcal Reference Unit, National Infection Service, Public Health England, Manchester Royal Infirmary, Manchester, UKGerman National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, GermanyRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UKIrish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, IrelandPublic Health Wales, Cardiff, UKIrish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, IrelandDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, DenmarkMeningococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New ZealandCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South AfricaInstitut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, FranceNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, CanadaNational Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumIrish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, IrelandCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Clinical Microbiology, Landspitali-The National University Hospital of Iceland, Reykjavik, IcelandImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UKDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, DenmarkMeningococcal Reference Unit, National Infection Service, Public Health England, Manchester Royal Infirmary, Manchester, UKDepartment of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SwedenBlavatnik School of Government, University of Oxford, Oxford, UKSwiss National Reference Centre for invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, SwitzerlandDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, DenmarkDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, IrelandDepartment of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, ChinaDepartment of Laboratory Medicine, National Reference Laboratory for Neisseria meningitidis, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, SwedenPublic Health Agency, Belfast, Northern IrelandNational Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech RepublicDepartment of Clinical Microbiology, Landspitali-The National University Hospital of Iceland, Reykjavik, IcelandNational Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech RepublicNational Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, PolandImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UKGerman National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, GermanyNational Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech RepublicFinnish Institute for Health and Welfare, Helsinki, FinlandRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UKNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, CanadaNational Reference Centre for Haemophilus influenzae, Laboratoires des Hôpitaux Universitaires de Bruxelles, Universitaire Laboratorium Brussel, Brussels, Belgium; Faculté de Médecine et Pharmacie, Université de Mons, Mons, BelgiumNational Reference Centre for Neisseria meningitidis, Sciensano, Brussels, BelgiumDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, IrelandDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, IrelandDivision of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South AfricaDepartment of Laboratory Medicine, National Reference Laboratory for Neisseria meningitidis, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, SwedenPublic Health Agency of Sweden, Solna, SwedenStreptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New ZealandDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, IrelandInstituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, SpainDepartment of Pathology and Biomedical Science, University of Otago, Christchurch, New ZealandPublic Health Agency, Belfast, Northern IrelandNational Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech RepublicLaboratoire National de Sante, Dudelange, LuxembourgInstituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, SpainLaboratoire National de Sante, Dudelange, LuxembourgPublic Health Wales, Cardiff, UKInstituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, SpainPublic Health Wales, Cardiff, UKPublic Health Wales, Cardiff, UKGovernment Central Laboratories, Ministry of Health, Jerusalem, IsraelGovernment Central Laboratories, Ministry of Health, Jerusalem, IsraelBacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow, UKRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UKFinnish Institute for Health and Welfare, Helsinki, FinlandNational Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, PolandPublic Health Agency, Belfast, Northern IrelandDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, DenmarkBacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow, UKDepartment of Internal Medicine, Division of Infectious Diseases, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South KoreaInstitut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, FranceFinnish Institute for Health and Welfare, Helsinki, FinlandDepartment of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, ChinaFinnish Institute for Health and Welfare, Helsinki, FinlandDepartment of Medical Microbiology and Infection Prevention, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands; Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, NetherlandsLaboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, FranceNational Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech RepublicGerman National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, GermanyNational Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech RepublicCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South AfricaNational Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, BrazilDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, ChinaSummary: Background: 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. Methods: 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. Findings: 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. Interpretation: 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. Funding: 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).http://www.sciencedirect.com/science/article/pii/S2589750021000777

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

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