Epidemiological trends in viral meningitis in England: prospective national surveillance, 2013-2023

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES Journal of Infection Pub Date : 2024-07-08 DOI:10.1016/j.jinf.2024.106223

Seilesh Kadambari , Fariyo Abdullahi , Cristina Celma , Shamez Ladhani

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Abstract

Background

In the conjugate vaccine era, viruses are the most common cause of meningitis. Here, we evaluated epidemiological trends in laboratory-confirmed viral meningitis across all age-groups over an 11-year period in England.

Methods

In England, hospital laboratories routinely report laboratory-confirmed infections electronically to the UK Health Security Agency. Records of positive viral detections in cerebrospinal fluid during 2013-2023 were extracted. Incidence rates with confidence intervals were calculated using mid-year resident population estimates.

Results

There were 22,114 laboratory-confirmed viral meningitis cases, including 15,299 cases during 2013-19 (pre COVID-19), with a gradual increase in incidence from 3.5/100,00 (95%CI, 3.3-3.6) to 3.9/100,000 (95%CI, 3.6-4.1). During 2020-21 when pandemic restrictions were in place, there were 2,061 cases (1.8/100,000; 1.7 - 1.9), which increased to 4,754 (4.2/100,000; 4.0-4.3) during 2022-23 (post pandemic restrictions).

Infants aged <3 months accounted for 39.4% (8,702/22,048) of all cases, with a stable incidence 2013-19 (504/100,000, 95%CI: 491-517), followed by a significant decline during 2020-21 (204/100,000; 188-221) and then an increase during 2022-23 (780/100,000; 749-812), with enteroviruses being the commonest cause (84.9%, 7387/8,702; 424.74/100,000; 95%CI, 415.12-434.51), followed by parechoviruses (9.1%, 792/8702; 45.54/100,000; 95%CI, 42.42-48.82) and herpes simplex virus (4.4%, 380/8702; 21.85/100,000; 95%CI, 19.71-24.16). Pandemic restrictions were associated with significant declines in the incidence of enterovirus (77.7%) and parechoviruses (64% lower), with rebounds after societal restrictions lifted.

Conclusions

Rates of viral meningitis have returned to pre-pandemic levels since societal restrictions were lifted. The highest incidence of viral meningitis remains in infants aged <3 months and most commonly due to enteroviral infection.

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英格兰病毒性脑膜炎的流行趋势：2013-2023 年前瞻性全国监测。

背景：在联合疫苗时代，病毒是脑膜炎最常见的病因。在此，我们评估了英国 11 年间各年龄组实验室确诊的病毒性脑膜炎的流行趋势：在英格兰，医院实验室通过电子方式向英国卫生安全局例行报告实验室确诊的感染病例。我们提取了 2013-2023 年间脑脊液中病毒检测呈阳性的记录。使用年中常住人口估计数计算发病率和置信区间：结果：实验室确诊的病毒性脑膜炎病例为 22,114 例，其中 2013-19 年（COVID-19 之前）为 15,299 例，发病率从 3.5/100,00（95%CI，3.3-3.6）逐渐上升至 3.9/100,000（95%CI，3.6-4.1）。在 2020-21 年大流行限制期间，有 2,061 例（1.8/100,000；1.7-1.9），在 2022-23 年（大流行限制后）增加到 4,754 例（4.2/100,000；4.0-4.3）。婴儿年龄结论社会限制解除后，病毒性脑膜炎的发病率已恢复到大流行前的水平。病毒性脑膜炎发病率最高的年龄段仍然是

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.