Evidence map›Paper›PMID 34045002›Full record

ArticleThe Lancet. Digital health2021

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.

Angela B Brueggemann, Melissa J Jansen van Rensburg, David Shaw, Noel D McCarthy, Keith A Jolley, Martin C J Maiden, Mark P G van der Linden, Zahin Amin-Chowdhury, Désirée E Bennett, Ray Borrow and 85 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Digital health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 325 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
325citing papers in PubMed, 5 pooled it
57.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

325 citing papers in PubMed, 5 syntheses or guidelines pooled it, 517 citations in OpenAlex.

  1. Pooled it
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  4. Pneumococcal Vaccine for Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices, United States, 2023.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2023
    Guideline
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265 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

95 authors at 20 institutions in 23 countries.

Angela B BrueggemannNuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK. Electronic address: angela.brueggemann@ndph.ox.ac.uk.
Melissa J Jansen van RensburgNuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
David ShawNuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
Noel D McCarthyTrinity College Dublin, Dublin, Ireland.
Keith A JolleyDepartment of Zoology, University of Oxford, Oxford, UK.
Martin C J MaidenDepartment of Zoology, University of Oxford, Oxford, UK.
Mark P G van der LindenDepartment of Medical Microbiology, German National Reference Center for Streptococci, University Hospital RWTH Aachen, Aachen, Germany.
Zahin Amin-ChowdhuryImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
Désirée E BennettDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.
Ray BorrowMeningococcal Reference Unit, National Infection Service, Public Health England, Manchester Royal Infirmary, Manchester, UK.
Maria-Cristina C BrandileoneNational Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil.
Karen BroughtonRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK.
Ruth CampbellPublic Health Agency, Belfast, Northern Ireland.
Bin CaoDepartment 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, China.
Carlo CasanovaSwiss National Reference Centre for invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Eun Hwa ChoiDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea.
Yiu Wai ChuDepartment of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China.
Stephen A ClarkMeningococcal Reference Unit, National Infection Service, Public Health England, Manchester Royal Infirmary, Manchester, UK.
Heike ClausGerman National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.
Juliana CoelhoRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK.
Mary CorcoranIrish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Simon CottrellPublic Health Wales, Cardiff, UK.
Robert J CunneyIrish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Tine DalbyDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Heather DaviesMeningococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand.
Linda de GouveiaCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.
Ala-Eddine DeghmaneInstitut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France.
Walter DemczukNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
Stefanie DesmetNational Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Richard J DrewIrish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland; Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Mignon du PlessisCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.
Helga ErlendsdottirDepartment of Clinical Microbiology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
Norman K FryImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
Kurt FuurstedDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Steve J GrayMeningococcal Reference Unit, National Infection Service, Public Health England, Manchester Royal Infirmary, Manchester, UK.
Birgitta Henriques-NormarkDepartment of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
Thomas HaleBlavatnik School of Government, University of Oxford, Oxford, UK.
Markus HiltySwiss National Reference Centre for invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
Steen HoffmannDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Hilary HumphreysDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.
Margaret IpDepartment of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Susanne JacobssonDepartment of Laboratory Medicine, National Reference Laboratory for Neisseria meningitidis, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Jillian JohnstonPublic Health Agency, Belfast, Northern Ireland.
Jana KozakovaNational Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
Karl G KristinssonDepartment of Clinical Microbiology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
Pavla KrizovaNational Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
Alicja KuchNational Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland.
Shamez N LadhaniImmunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
Thiên-Trí LâmGerman National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.
Vera LebedovaNational Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
Laura LindholmFinnish Institute for Health and Welfare, Helsinki, Finland.
David J LittRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK.
Irene MartinNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
Delphine MartinyNational 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, Belgium.
Wesley MattheusNational Reference Centre for Neisseria meningitidis, Sciensano, Brussels, Belgium.
Martha McElligottDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.
Mary MeehanDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.
Susan MeiringDivision of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.
Paula MöllingDepartment of Laboratory Medicine, National Reference Laboratory for Neisseria meningitidis, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Eva MorfeldtPublic Health Agency of Sweden, Solna, Sweden.
Julie MorganStreptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand.
Robert M MulhallDepartment of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.
Carmen Muñoz-AlmagroInstituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, Spain.
David R MurdochDepartment of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
Joy MurphyPublic Health Agency, Belfast, Northern Ireland.
Martin MusilekNational Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
Alexandre MzabiLaboratoire National de Sante, Dudelange, Luxembourg.
Amaresh Perez-ArgüelloInstituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, Spain.
Monique PerrinLaboratoire National de Sante, Dudelange, Luxembourg.
Malorie PerryPublic Health Wales, Cardiff, UK.
Alba RedinInstituto de Recerca Pediatrica, Hospital Sant Joan de Deu, Barcelona, Spain.
Richard RobertsPublic Health Wales, Cardiff, UK.
Maria RobertsPublic Health Wales, Cardiff, UK.
Assaf RokneyGovernment Central Laboratories, Ministry of Health, Jerusalem, Israel.
Merav RonGovernment Central Laboratories, Ministry of Health, Jerusalem, Israel.
Kevin J ScottBacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow, UK.
Carmen L SheppardRespiratory and Vaccine Preventable Bacteria Reference Unit, National Infection Service, Public Health England, London, UK.
Lotta SiiraFinnish Institute for Health and Welfare, Helsinki, Finland.
Anna SkoczyńskaNational Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland.
Monica SloanPublic Health Agency, Belfast, Northern Ireland.
Hans-Christian SlotvedDepartment of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Andrew J SmithBacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow, UK.
Joon Young SongDepartment of Internal Medicine, Division of Infectious Diseases, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
Muhamed-Kheir TahaInstitut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France.
Maija ToropainenFinnish Institute for Health and Welfare, Helsinki, Finland.
Dominic TsangDepartment of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China.
Anni VainioFinnish Institute for Health and Welfare, Helsinki, Finland.
Nina M van SorgeDepartment 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, Netherlands.
Emmanuelle VaronLaboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France.
Jiri VlachNational Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
Ulrich VogelGerman National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany.
Sandra VohrnovaNational Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
Anne von GottbergCentre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.
Rosemeire C ZanellaNational Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil.
Fei ZhouDepartment 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, China.
Public Health England · GBBeaumont Hospital · IENational Institute of Public Health · CZUniversity of Oxford · GBFinnish Institute for Health and Welfare · FINational Health Laboratory Service · ZAPublic Health Wales · GBStatens Serum Institut · DKHospital Sant Joan de Déu Barcelona · ESUniversity of Würzburg · DEDepartment of Health · CNInstituto Adolfo Lutz · BRInstitut Pasteur · FRIsrael Ministry of Health · ILLaboratoire National de Santé · LUNarodowy Instytut Leków · PLNational University Hospital of Iceland · ISNew Zealand Institute for Public Health and Forensic Science · NZÖrebro University · SEPublic Health Agency of Canada · CA

Funding

Wellcome Trust 206394Wellcome Trust 206394/Z/17/ZWellcome Trust 218205Wellcome Trust 218205/Z/19/Z)
6 · The paper itself

Abstract

backgroundStreptococcus 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.

methodsIn 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.

findings27 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.

interpretationThe 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.

fundingWellcome 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).

Indexed as

COVID-19Bacterial InfectionsHaemophilus influenzaeHumansIncidenceInterrupted Time Series AnalysisNeisseria meningitidisPopulation SurveillanceProspective StudiesPublic Health PracticeRespiratory Tract InfectionsStreptococcus agalactiaeStreptococcus pneumoniae

Identifiers

PMID34045002
PMCPMC8166576
OpenAlexW3164937600

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.