Welcome to the ISPPD 2022 Meeting Calendar

Background

Endemic respiratory diseases decreased worldwide in the fall and winter of 2020, concurrent with nonpharmaceutical interventions (NPIs) implemented to slow transmission of SARS-CoV-2. Different levels and durations of NPIs were implemented in the United States, with varying levels of adherence, throughout 2020 and 2021.

Methods

The CDC compiles weekly reported invasive pneumococcal disease (IPD) cases from state health departments. A baseline of IPD cases from 2016-2019 was compared to weekly IPD cases in 2020 and in 2021. These reports were compared to mobility data from cellular phone location reports, to a composite measurement of stringency to NPIs, and to respiratory syncytial virus (RSV) levels. Bivariate comparisons were done with Spearman correlations.

Results

In 2020, all states and regional groupings showed decreases in IPD from baseline levels. By the end of 2021, almost all states showed a consistent return to baseline IPD levels, though the timing of the return to normalcy varied geographically. Returns to baseline levels of IPD might be correlated with NPI stringency, changes in mobility patterns, and local RSV levels. The surveillance system for IPD experienced more reporting irregularities in 2020, as measured by an increase in discrepancies between initial and final case count values.

Conclusions

The decreases in IPD during the first year of the SARS-CoV-2 pandemic in the US were temporary, returning to baseline levels in 2021. The rate of return to baseline levels of IPD is likely multifactorial.

Background

The COVID-19 pandemic, starting in Israel in March-2020, was associated with a marked reduction of both IPD and community-acquired alveolar pneumonia (CAAP; considered mostly pneumococcal), in young children. This coincided with a complete disappearance of specific pneumonia-associated viruses (RSV, hMPV, influenza) (CID, https://doi.org/10.1093/cid/ciab1014). Social distancing was assumed to interrupt pneumococcal transmission. Starting in March-2021, an off-season CAAP resurgence occurred in young children, coinciding with a major off-season surge of hMPV and RSV (Danino, Abstract/ISPPD/2021; Figure-1A). We investigated PNC-CAR rates among children <3y, during 2020-2021, as an indicator of pneumococcal circulation in our community, vs. pre-Covid rates (2016-2019).

Methods

In this prospective study, nasopharyngeal swabs were obtained from children <3y without respiratory symptoms and cultured for pneumoccous. Cultures were obtained daily, January-2016 through December-2021. Serotyping was done using Quellung. Semi-quantitative density was measured (Danino, CID/2021). Monthly rates during 2020-2021 were compared to mean monthly rates in 2016-2019. The study was interrupted March-May 2020, during lockdown.

Results

4,471/10,298 cultures (43.4%) were positive. No clear seasonality during 2016-2019 was observed, except for a small, but significant nadir, July-September. The mean PNC-CAR in 2016-2019 was 45 % (27% to 57%). During 2020-2021, overall PNC-CAR and density resembled those of 2016-2019 (Figure-1-B-C). No correlation of carriage with CAAP rates was observed. Serotype distributions during 2020-2021 and 2016-2019 were similar.

Conclusions

The results demonstrate that PNC-CAR rates did not decline during the COVID-19 pandemic in young children, ruling out disruption of pneumococcal transmission as a driver of the declines in pneumococcal-related diseases observed during the pandemic.

Background

Non-pharmaceutical interventions (NPIs) associated with the COVID-19 pandemic have resulted in decreases in invasive pneumococcal disease. Previous studies propose the decline is due to reduced pneumococcal transmission and/or suppression of respiratory viruses. Nasopharyngeal colonization is required for transmission and disease, yet few studies have evaluated the impact of NPIs on pneumococcal carriage. Here we report pneumococcal carriage and density during the COVID-19 pandemic in Ho Chi Minh City, Vietnam.

Methods

Nasopharyngeal samples from children aged 24 months enrolled in a trial investigating reduced-dose schedules of pneumococcal conjugate vaccines were assessed in three periods: pre-COVID (n=1393), NPI period 1 (school closures and bans on public gatherings, n=307), NPI period 2 (post-national lockdown with mask-wearing mandate, n=262). Pneumococci were quantified by lytA qPCR and serotyped by microarray. Carriage prevalence and density were assessed in each NPI period compared with the pre-COVID period using logistic and linear regression adjusted for age, district, respiratory symptoms, antibiotic use, and season.

Results

No changes in carriage prevalence were observed in either NPI period compared with pre-COVID. Overall density decreased by 0.41log₁₀genome equivalents (GE)/ml (95%CI: 0.09-0.73) and 0.75log₁₀GE/ml (0.40-1.11) in NPI periods 1 and 2 compared with pre-COVID. Greater reductions were found for density of capsular (0.47log₁₀GE/ml decrease (0.09-0.85) and 1.07log₁₀GE/ml decrease (0.66-1.47)) than non-encapsulated pneumococci (0.49log₁₀GE/ml decrease (0.02-0.95) and 0.24log₁₀GE/ml decrease (-0.30-0.77; p>0.05) in periods 1 and 2 compared with pre-COVID.

Conclusions

Pneumococcal carriage did not vary during the COVID-19 pandemic. The observed reduction in pneumococcal density may provide a plausible mechanism for the decline in invasive pneumococcal disease.

Background

The COVID-19 preventive measures such as social distancing, cough etiquette and lockdown strategies were associated with a significant decrease in pediatric infectious diseases including non-COVID CAP in children following the COVID-19 outbreaks, notably during high COVID transmission period. This study aimed to assess the impact of the COVID-19 pandemic on non-COVID-19 CAP in children.

Methods

We conducted a retrospective analysis of all patients (age ≤18 years) presenting with CAP from April 2019 to March 2021 in Bangladesh Shishu Hospital & Institute. We compared the patients admitted with non-COVID CAP between April 2020 to March 2021 and April 2019 to March 2020.

Results

The number of hospitalized patients with non-COVID CAP was significantly lower in 2020-2021 (2240 cases) than that in 2019-2020 (3604 cases), a decline of cases by -43.9% in 2020-2021. During 2019-2020 more non-COVID CAP cases were hospitalized, April-June 29.3% and July-September 22.65% in contrast to decreasing cases during, April-June 9.78% and July-September 10.54% in 2020-2021. Whereas hospitalization of child with non-COVID CAP cases increased during October-December 24.6% and January-March 55.63% in 2020-2021 during the low transmission status of COVID 19 in the country. On the other hand, lower number of cases were detected during October-December 18.3% and January-March 29.31% of 2019-2020.

Conclusions

The number of children with non-COVID CAP during 2020-2021 was lower than the same period in 2019-2020. The role of SARS-COV-2 and preventive measures for COVID-19 helped in reducing child CAP cases.

Background

The COVID-19 control measures have led to declines in several respiratory diseases including invasive pneumococcal disease (IPD). Since pneumococci comprise many serotypes with different transmissibility and virulence, we evaluated serotype-specific changes in IPD epidemiology in the Netherlands during the SARS-CoV-2 pandemic.

Methods

IPD cases were based on nationwide invasive bacteriological surveillance. Cases and serotype-distribution were compared between the pre-COVID period (April 2015-March 2020) and the COVID-19 period (presented now: April 2020-March 2021; will be updated until March 2022 for ISPPD). Patients aged 73-79 years were excluded because of recent PPV23 introduction in this age-group.

Results

We included 2,655 cases pre-COVID and 175 cases of the COVID-19 period. Overall, IPD cases decreased by 67% in the first COVID-19 year compared to the pre-COVID period. The decrease was larger (69%) for ages 65+ years compared to those aged under 5 years (53%). Neonatal invasive disease cases caused by Streptococcus agalactiae and Escherichia coli, which were used as controls, did not decrease, indicating stable isolate submission. Changes in IPD epidemiology varied among pneumococcal serotypes. Of the serotypes with on average ≥10 cases yearly pre-COVID, 6C (16% decrease) and 19A (50%) showed the smallest reductions and serotypes 8 (76%), 12F (82%), 15A (86%), 33F (87%) and 7F (100%) showed the largest declines.

Conclusions

Our results indicate serotype-specific effects, coinciding with implementation of COVID-19 control measures. This likely reflects intrinsic differences in transmissibility and possible differences by age in (adherence to) control measures. Continued surveillance is critical to monitor potential rebound effects once restriction measures are lifted.

Background

The COVID-19 epidemic has been a great challenge to the health system. S. pneumoniae coinfection with SARS-CoV-2 can result in synergistic lethality resulting in greater mortality and morbidity. In the study, we have analyzed SARS-CoV-2 impact on pneumococcal carriage in Indian population

Methods

lytA PCR was performed on 1501 COVID19 positive samples, collected between April–May, 2021 at CRL,KIMS. LytA positive samples were subjected to Real-time Multiplex PCR for detection of pneumococcal serotypes

Results

Of 1501 samples,12.5%(n=188) were positive for S.pneumoniae. Ct value representing viral load in these S.pneumoniae positive samples ranged from 11.5-34.5 for orf1ab and 12.2–34.5 for N-gene. Age group of the LytA positive samples ranged from 3-84 yrs. Around 42.5% of LytA positive samples were from 25-44yrs age group (80/188).

Among 188Spn positive samples, 66 samples had one serotype, 59–two serotypes, 22-three serotypes, 12-four serotypes, 3-five serotypes and 26-non-typable. Predominant serotypes in total population were 4,24F,11BC,9LN and 9VA. Among 3-5 yrs children, serotype 1,4 and 11BC were predominant. Serotypes 4,9VA,24F,9LN,19F,23A and 2 were predominant among patients with >65yrs of age. Prevailing serotypes among median age group population (25-44yrs) were 11BC, 24F and 4.

Among the 162 typable samples, vaccine coverage with PCV10, PCV13 and PPV23 was 34.1%, 36.8% and 57.1%; 65.9%, 63.2% and 42.9% were non-vaccine serotypes respectively

Conclusions

No significant differences in pneumococcal-colonization and serotype-distribution found in terms of age, gender and COVID19 viral load. Interestingly,NVTs were higher in comparison to carriage in general population. Awareness on the possible SARS-CoV-2-pneumococcus association is necessary to avoid misdiagnosis and delayed antibiotic therapy.

Background

The 13-valent pneumococcal conjugate vaccine (PCV13) introduction into Cameroon’s expanded immunization programme in July 2011followed an accelerated primary dose series given at 6, 10 and 14 weeks of age. We reviewed the evaluation of the PCV13 programme, and the potential challenges in conducting future nasopharyngeal pneumococcal colonization (NPC) studies amidst the COVID-19 pandemic

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Methods

We used findings from previous cross-sectional studies which assessed the prevalence of NPC, pneumococcal meningitis (PM) and otitis media (OM) among Cameroonian children under-five years old in the PCV13 era.

Results

Declines in the proportion of PM due to vaccine serotypes (VT) have been shown, mainly due to reductions of serotypes 6A/6B, 1, 19A, and 23F; as eleven of the PCV13 VTs remain in circulation. Furthermore, OM prevalence was unexpectedly higher among the PCV13-vaccinated group compared to those not vaccinated, due to the predominance of other pathogens and non-PCV13-type pneumococci as disease causing microbes or waning vaccine immunity among the vaccinated children or the absence of any indirect effects.

Conclusions

Ten years after PCV13 implementation in Cameroon, its impact evaluation remains incomplete. Remaining knowledge gaps include its evaluation on the incidence of all-cause paediatric pneumonia hospitalization among vaccinated and unvaccinated age-groups, as well as colonization rates on infant-adult pairs. But, our recent experience in conducting COVID-19 seroprevalence studies proves this may be challenging. Besides the challenges, we discuss how pneumococcal research could be re-contextualized in the era of COVID-19 operational research and beyond. Lessons learned on community engagement, improved laboratory network, understanding vaccine hesitancy to decision-making are vital.