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Covid-19 control measures and common paediatric infections

BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.n3093 (Published 12 January 2022) Cite this as: BMJ 2022;376:n3093

Linked Research

Indirect effects of the covid-19 pandemic on childhood infection in England

  1. Zachary Willis, assistant professor of pediatrics1,
  2. Annabelle de St Maurice, assistant professor of pediatric infectious diseases2
  1. 1Division of Pediatric Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
  2. 2University of California Los Angeles, Mattel Children’s Hospital, David Geffen School of Medicine, Los Angeles, CA, USA
  1. Correspondence to: Z Willis zwillis{at}med.unc.edu

Hospital admissions fell substantially, probably reflecting a real decrease in non-covid infections

Research, doi:10.1136/bmj-2021-067519

The covid-19 pandemic upended virtually all aspects of society, not least patterns of healthcare use. In a linked paper (doi:10.1136/bmj-2021-067519), Kadambari and colleagues report dramatic decreases in hospital admissions due to a range of 19 childhood infections in UK children in the 16 months after the start of the covid-19 pandemic.1 Almost all studied infections declined, including common respiratory viruses, vaccine preventable infections, and common bacterial infections. These findings support and expand data from the United States showing major decreases in childhood respiratory viruses.2

While some of the results might be expected, one surprising finding was the decrease in sporadic bacterial infections, osteomyelitis and septic arthritis, most commonly caused by Kingella kingae, Staphylococcus aureus, and Streptococcus pyogenes. Although progression from pathogen acquisition to symptomatic infection in bacterial musculoskeletal infections is not well understood, conditions such as acute haematogenous osteomyelitis probably begin with colonisation of mucosal sites with the causative pathogen.3 Encounters with such pathogens were probably less frequent during the study period. Furthermore, co-occurringviral respiratory infections appear to increase the colonisation density of pneumococci and other pathogenic bacteria in the upper …

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