Incidence Rates for Invasive Streptococcus pneumoniae and Haemophilus influenzae Infections in US Military Pediatric
Matthew D Penfold1, Sarah Prabhakar1,2, Michael Rajnik1
1Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Insights
COVID-19 pandemic mitigation strategies reduced invasive bacterial infections like invasive pneumococcal disease (IPD) and invasive *Haemophilus influenzae* (IHI) in children. Rates fluctuated with policy changes, showing IPD and IHI resurgence post-relaxation.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Invasive *Streptococcus pneumoniae* disease (IPD) and invasive *Haemophilus influenzae* (IHI) are significant pediatric infections.
- The COVID-19 pandemic altered the incidence of viral illnesses, potentially impacting bacterial infections.
Purpose of the Study:
- To analyze trends in IPD and IHI hospitalizations in children under 5 before and during the COVID-19 pandemic.
- To assess the impact of pandemic-related mitigation strategies on these invasive bacterial infections.
Main Methods:
- A retrospective, monthly cross-sectional study using Military Health System Data Repository (MDR) inpatient data.
- Analysis of hospitalization rates from March 2018 to February 2023 for children under 5.
- Inclusion of 1.27 million children in the study cohort.
Main Results:
- A total of 200 IPD and 171 IHI cases were identified.
- Hospitalization rates for both IPD and IHI decreased in Year 1 of the pandemic.
- IPD returned to baseline in Year 2, then increased above baseline in Year 3, while IHI remained below baseline in Year 2 and returned to baseline in Year 3.
Conclusions:
- Pandemic mitigation measures (hand hygiene, social distancing) likely reduced invasive bacterial disease incidence.
- Relaxation of these measures correlated with a resurgence of IHI and an increase in IPD among pediatric populations.
Abstract:
Background/Objectives: Invasive Streptococcus pneumoniae disease (IPD) and invasive Haemophilus influenzae (IHI) infections cause disease in pediatric patients. The COVID-19 pandemic brought about a change in the rates of common viral illnesses that can lead to superimposed bacterial infections. Methods: A repeated monthly cross-sectional study was performed using inpatient data from the Military Health System Data Repository (MDR) to observe differences in IPD and IHI hospitalization rates before and during the COVID-19 pandemic starting in March 2018 and continuing to February 2023. Our study included a cohort of 1.27 million children under the age of 5 years old. Results: A total of 200 unique cases of IPD and 171 unique cases of IHI were identified. In Year 1 of the pandemic, the hospitalization rates for IHI and IPD decreased. In Year 2, IPD returned to the pre-pandemic baseline, and IHI remained below the baseline. In Year 3, IPD increased above the baseline, and IHI returned to the baseline. Conclusions: These data support the notion that the interventions implemented to reduce the spread of COVID-19, such as hand hygiene and social distancing, likely led to a reduction in the incidence of invasive disease. The subsequent relaxation of these mitigation strategies likely led to a resurgence of IHI and an increase in IPD in our population.
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