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Epidemiology of respiratory infections during the different levels of non-pharmaceutical interventions
Ting Shi1, Linlin Huang2, Jianmei Tian3
1Department of Infectious Diseases, Children's Hospital of Soochow University, 303 Jingde Road, Suzhou, Jiangsu, 215000, China.
Insights
Following the lifting of non-pharmaceutical interventions (NPIs), acute respiratory infections (ARIs) in children surged, driven by Mycoplasma pneumoniae (MP). Mixed infections also became more prevalent, indicating a significant increase in disease burden.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Public health interventions
Background:
- Non-pharmaceutical interventions (NPIs) significantly impacted the epidemiology of pediatric acute respiratory infections (ARIs).
- Understanding pathogen shifts post-NPIs is crucial for public health preparedness.
Purpose of the Study:
- To analyze changes in common respiratory pathogen prevalence in children with ARIs during varying levels of NPIs.
- To compare pathogen detection rates before and after the discontinuation of strict NPIs.
Main Methods:
- Retrospective analysis of 27,851 respiratory samples from pediatric ARI inpatients (September 2021-February 2024).
- Comparison of pathogen detection rates across different NPI levels.
- Identification of 12 common respiratory pathogens.
Main Results:
- Post-NPIs, the demographic shifted to older children (over 6 years).
- Mycoplasma pneumoniae (MP) became the dominant pathogen (35.9%), replacing Human Rhinovirus (HRV) (23.6%) which was prevalent during strict NPIs.
- Increased detection rates of MP and Adenovirus (ADV) were observed, alongside a shift in Human Respiratory Syncytial Virus (HRSV) seasonality and a rise in multiple pathogen infections.
Conclusions:
- The withdrawal of NPIs led to a sharp increase in ARI disease burden in children.
- Mycoplasma pneumoniae (MP) was the primary driver of this increase.
- Mixed respiratory pathogen infections became more frequent post-NPIs.
Objective:
This study aimed to describe epidemiological changes of common respiratory pathogens in children with acute respiratory infections (ARIs) during the different levels of non-pharmaceutical interventions(NPIs).
Methods:
In this retrospective study, we analyzed the prevalence of 12 respiratory pathogens from September 2021 through February 2024 in all inpatients with ARIs admitted to Children's Hospital of Soochow University(SCH). We compared the detection rates of these pathogens at different levels of public NPI measures.
Results:
In total, 27,851 respiratory samples were analyzed, including 15,231 boys and 12,620 girls. Under strict NPIs, inpatients with ARIs were more commonly boy and infants (p < 0.01). However, after the discontinuation of NPIs, they were more commonly children over 6 years of age (p < 0.01). Under the strict NPIs, the most detected respiratory pathogen was HRV(23.6%), followed by HRSV(16.0%), HMPV(10.8%) and HPIV(10.4%). But after the abolition strict NPIs, the most common respiratory pathogen was MP(35.9%), followed by HRV(19.7%), HRSV(17.5%) and HPIV (6.6%). Moreover, the number and detection rate of MP and ADV had significantly increased and remained at a high level (P<0.05). In addition, the number of HRSV detection increased and the epidemic season has changed(transitioning from winter to summer), and detection rate of multiple pathogens was more high after the abolition NPIs (P < 0.01).
Conclusions:
Withdrawal of major measures, the disease burden of ARIs in children in Suzhou has sharply increased, mainly attributed to MP, and mixed infections were more common.
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