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The changing pattern of enteric pathogen infections in China during the COVID-19 pandemic: a nation-wide observational study.
Wang, Li-Ping; Han, Jia-Yi; Zhou, Shi-Xia; Yu, Lin-Jie; Lu, Qing-Bin; Zhang, Xiao-Ai; Zhang, Hai-Yang; Ren, Xiang; Zhang, Cui-Hong; Wang, Yi-Fei; Lin, Sheng-Hong; Xu, Qiang; Jiang, Bao-Gui; Lv, Chen-Long; Chen, Jin-Jin; Li, Chang-Jun; Li, Zhong-Jie; Yang, Yang; Liu, Wei; Fang, Li-Qun; Hay, Simon I; Gao, George F; Yang, Wei-Zhong.
  • Wang LP; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Han JY; School of Mathematical Sciences, Ocean University of China, Qingdao, China.
  • Zhou SX; Anhui Medical University, Hefei, China.
  • Yu LJ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Lu QB; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Zhang XA; Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, P. R. China.
  • Zhang HY; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Ren X; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Zhang CH; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Wang YF; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Lin SH; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Xu Q; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Jiang BG; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Lv CL; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Chen JJ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Li CJ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Li ZJ; School of Mathematical Sciences, Ocean University of China, Qingdao, China.
  • Yang Y; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
  • Liu W; Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, U. S. A.
  • Fang LQ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
  • Hay SI; Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, P. R. China.
  • Gao GF; Anhui Medical University, Hefei, China.
  • Yang WZ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
Lancet Reg Health West Pac ; 16: 100268, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1415636
ABSTRACT

BACKGROUND:

Non pharmaceutical interventions (NPI) including hand washing directives were implemented in China and worldwide to combat the COVID-19 pandemic, which are likely to have had impacted a broad spectrum of enteric pathogen infections.

METHODS:

Etiologically diagnostic data from 45 937 and 67 395 patients with acute diarrhea between 2012 and 2020, who were tested for seven viral pathogens and 13 bacteria respectively, were analyzed to assess the changes of enteric pathogen infections in China during the first COVID-19 pandemic year compared to pre-pandemic years.

FINDINGS:

Test positive rates of all enteric viruses decreased during 2020, compared to the average levels during 2012-2019, with a relative decrease of 71•75% for adenovirus, 58•76% for norovirus, 53•50% for rotavirus A, and 72•07% for the combination of other four uncommon viruses. In general, a larger reduction of positive rate in viruses was seen among adults than pediatric patients. A rebound of rotavirus A was seen after September 2020 in North China rather than South China. Test positive rates of bacteria decreased during 2020, compared to the average levels during 2012-2019, excepting for nontyphoidal Salmonella and Campylobacter coli with 66•53% and 90•48% increase respectively. This increase was larger for pediatric patients than for adult patients.

INTERPRETATION:

The activity of enteric pathogens changed profoundly alongside the NPIs implemented during the COVID-19 pandemic in China. Greater reductions of the test positive rates were found for almost all enteric viruses than for bacteria among acute diarrhea patients, with further large differences by age and geography. Lifting of NPIs will lead to resurgence of enteric pathogen infections, particularly in children whose immunity may not have been developed and/or waned.

FUNDING:

China Mega-Project on Infectious Disease Prevention; National Natural Science Funds.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prognostic study Language: English Journal: Lancet Reg Health West Pac Year: 2021 Document Type: Article Affiliation country: J.lanwpc.2021.100268

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prognostic study Language: English Journal: Lancet Reg Health West Pac Year: 2021 Document Type: Article Affiliation country: J.lanwpc.2021.100268