Infant Pneumococcal Carriage in Belgium Not Affected by COVID-19 Containment Measures

Abstract

Streptococcus pneumoniae is an important and frequently carried respiratory pathogen that has the potential to cause serious invasive diseases, such as pneumonia, meningitis, and sepsis. Young children and older adults are among the most vulnerable to developing serious disease. With the arrival of the COVID-19 pandemic and the concomitant restrictive measures, invasive disease cases caused by respiratory bacterial species, including pneumococci, decreased substantially. Notably, the stringency of the containment measures as well as the visible reduction in the movement of people appeared to coincide with the drop in invasive disease cases. One could argue that wearing protective masks and adhering to social distancing guidelines to halt the spread of the SARS-CoV-2 virus, also led to a reduction in the person-to-person transmission of respiratory bacterial species. Although plausible, this conjecture is challenged by novel data obtained from our nasopharyngeal carriage study which is performed yearly in healthy daycare center attending children. A sustained and high pneumococcal carriage rate was observed amid periods of stringent restrictive measures. This finding prompts us to revisit the connection between nasopharyngeal colonization and invasion and invites us to look closer at the nasopharyngeal microbiome as a whole.

Impact of COVID-19 non-pharmaceutical interventions on pneumococcal carriage prevalence and density in Vietnam

“…Studies in Belgium and Israel found no substantive reductions in prevalence pre- and post-NPIs, although in both our study and the Israel study pneumococcal prevalence was lower in one of the two time periods assessed. [4,5] Importantly, we observed a substantial decline in overall and capsular pneumococcal carriage density after the implementation of NPIs. In contrast, the Israel study found no difference in pneumococcal density pre- and post-NPI implementation.…”

“…[2–4] Only two studies have examined the impact of NPIs on pneumococcal carriage prevalence. [4,5] No substantive differences in carriage prevalence were observed in children pre- and post-implementation of NPIs in Belgium and Israel, but a decline in the prevalence of respiratory viruses was temporally associated with a decline in IPD in the Israel study. [4] Respiratory viruses increase pneumococcal carriage density, which contributes to transmission and disease.…”

Pneumococcal nasopharyngeal carriage in children under 5 years of age at an outpatient healthcare facility in Novi Sad, Serbia during the COVID-19 pandemic

“…However, data from the few studies that have addressed this issue to date suggest that this does not seem to be the case. In Belgium and Israel, the prevalence of pneumococcal carriage in children aged <3 years was either unchanged during the pandemic or was only reduced slightly, although the IPD rates decreased markedly in the same age group ( Danino et al., 2021 ; Willen et al., 2022 ), Moreover, in Israel, colonization density and pneumococcal serotype distributions were similar to previous years ( Danino et al., 2021 ). The present study did not find a decline in pneumococcal carriage rates among children aged 24–60 months during the COVID-19 pandemic, but instead found a significant increase in rates in 2020 that remained high to June 2021.…”

Persistence of pneumococcal carriage among older adults in the community despite COVID-19 mitigation measures

“…It was initially assumed that the reduction in the incidence of IPD was due to reduced transmission of the bacteria resulting from the implementation of non-pharmaceutical interventions. Pneumococcus is commonly carried in the upper respiratory tract of young children, however, the prevalence of pneumococcal carriage in children was near normal levels during 2020-2021 [3,8]. This demonstrates that children were still being exposed to and acquiring pneumococcus but not getting sick.…”