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Background During the initial phase of the Coronavirus Disease 2019 (COVID-19) pandemic, reduced numbers of acutely ill or injured children presented to emergency departments (EDs). Concerns were raised about the potential for delayed and more severe presentations and an increase in diagnoses such as diabetic ketoacidosis and mental health issues. This multinational observational study aimed to study the number of children presenting to EDs across Europe during the early COVID-19 pandemic and factors influencing this and to investigate changes in severity of illness and diagnoses. Methods and findings Routine health data were extracted retrospectively from electronic patient records of children aged 18 years and under, presenting to 38 EDs in 16 European countries for the period January 2018 to May 2020, using predefined and standardized data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRRs), using predicted counts for each site as offset to adjust for case-mix differences, were used to compare age groups, diagnoses, and outcomes. Reductions in pediatric ED attendances, hospital admissions, and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (IRR 2·26, 95% CI 1·90 to 2·70, p < 0.001) and in children aged Conclusions Reductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell. Trial registration ISRCTN91495258 https://www.isrctn.com/ISRCTN91495258., Author(s): Ruud G. Nijman 1,2,3,*, Kate Honeyford 4, Ruth Farrugia 5, Katy Rose 1,6, Zsolt Bognar 7, Danilo Buonsenso 8,9, Liviana Da Dalt 10, Tisham De 2, Ian K. Maconochie [...]

Using multiple national surveillance systems, we found an increase in the incidence of invasive pneumococcal disease during after the relaxation of non-pharmaceutical interventions against COVID-19, which strongly varied by age. Age groups with higher incidence of respiratory syncytial virus and influenza also experienced higher increase in invasive pneumococcal disease incidence, with no change in pneumococcal carriage. [ABSTRACT FROM AUTHOR]

A time series analysis of 871 543 pediatric emergency visits revealed that the coronavirus disease 2019 (COVID-19) lockdown and school closures were associated with a significant decrease in infectious diseases disseminated through airborne or fecal–oral transmission: common cold, gastroenteritis, bronchiolitis, and acute otitis. No change was found for urinary tract infections. [ABSTRACT FROM AUTHOR]

The article explores the coronavirus disease 2019 (COVID-19) pandemic, health, education, and the economy represent major priorities, and a fine-tuning has to be found [1–3]. While vaccine development has opened the door to more optimism, to date, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate is at its highest.

Objectives: We aimed to describe cases of acute bacterial meningitis (ABM) without cerebrospinal fluid (CSF) pleocytosis and clinical and biological characteristics of children., Methods: We analyzed results of a nation-wide population-based prospective surveillance study of acute ABM in children aged 3 months to 15 years in France. Absence of CSF pleocytosis was defined as CSF leukocyte count ≤5/mm., Results We Included: 4,754 cases of acute ABM from 2001 to 2022: 173 patients (3.6%) did not have CSF pleocytosis. ABM cases without CSF pleocytosis were mainly related to meningococcus (70% vs 44% with CSF pleocytosis, p<0.001). When performed in CSF with normal leukocyte count, Gram staining was positive for 33%, culture for 80%, PCR results for 41%, and antigen detection for 20% of cases. Case fatality rate was higher for cases without than with CSF pleocytosis (18% vs 6%, p<0.001). On multivariate analysis, absence of CSF pleocytosis was only associated with seizures before hospital arrival (adjusted odds ratio 2.3, 95% confidence interval 1.2-4.6, p<0.01)., Conclusions: ABM without CSF pleocytosis is infrequent but not exceptional, particularly in children with seizures before hospital arrival. Extended vaccination against meningococcus could prevent this clinical form with a high case fatality rate., Competing Interests: Conflict of interest Corinne Levy reported receiving grants from Pfizer during the conduct of the study, personal fees from Pfizer and MSD, and nonfinancial support from Pfizer outside the submitted work. Emmanuelle Varon reports grants from French public health agency, during the conduct of the study; grants from Pfizer and from MSD, outside the submitted work. M.K. Taha performs contract work for the Institut Pasteur funded by GSK, Pfizer and Sanofi Pasteur. M.K. Taha has a patent NZ630133A Patent with GSK "Vaccines for serogroup X meningococcus" issued. Naïm Ouldali reported receiving grants from Pfizer to his institution during the conduct of the study and travel grants from Pfizer, Sanofi, and GlaxoSmithKline outside the submitted work. François Angoulvant reports receiving personal fees from MSD, Sanofi, and AstraZeneca outside the submitted work. Robert Cohen reported receiving personal fees from Sanofi, Pfizer, MSD, Viatris and GSK; travel grants from Sanofi, Pfizer and MSD, and grants from Sanofi, Pfizer, MSD, and GSK outside the submitted work. Alexis Rybak reports personal fees from MSD and Pfizer outside the submitted work and non-financial support from Pfizer and AstraZeneca. Other authors have no conflict of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Bronchiolitis is a major source of morbimortality among young children worldwide. Non-pharmaceutical interventions (NPIs) implemented to reduce the spread of severe acute respiratory syndrome coronavirus 2 may have had an important impact on bronchiolitis outbreaks, as well as major societal consequences. Discriminating between their respective impacts would help define optimal public health strategies against bronchiolitis. We aimed to assess the respective impact of each NPI on bronchiolitis outbreaks in 14 European countries., Methods: We conducted a quasi-experimental interrupted time-series analysis based on a multicentre international study. All children diagnosed with bronchiolitis presenting to the paediatric emergency department of one of 27 centres from January 2018 to March 2021 were included. We assessed the association between each NPI and change in the bronchiolitis trend over time by seasonally adjusted multivariable quasi-Poisson regression modelling., Results: In total, 42 916 children were included. We observed an overall cumulative 78% (95% CI -100- -54%; p<0.0001) reduction in bronchiolitis cases following NPI implementation. The decrease varied between countries from -97% (95% CI -100- -47%; p=0.0005) to -36% (95% CI -79-7%; p=0.105). Full lockdown (incidence rate ratio (IRR) 0.21 (95% CI 0.14-0.30); p<0.001), secondary school closure (IRR 0.33 (95% CI 0.20-0.52); p<0.0001), wearing a mask indoors (IRR 0.49 (95% CI 0.25-0.94); p=0.034) and teleworking (IRR 0.55 (95% CI 0.31-0.97); p=0.038) were independently associated with reducing bronchiolitis., Conclusions: Several NPIs were associated with a reduction of bronchiolitis outbreaks, including full lockdown, school closure, teleworking and facial masking. Some of these public health interventions may be considered to further reduce the global burden of bronchiolitis., Competing Interests: Conflict of interest: N. Ouldali reports travel grants from Pfizer, GSK and Sanofi. No other authors have conflicts of interest to disclose., (Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.)

Background: Covid-19 pandemic control has imposed several non-pharmaceutical interventions (NPIs). Strict application of these measures has had a dramatic reduction on the epidemiology of several infectious diseases. As the pandemic is ongoing for more than 2 years, some of these measures have been removed, mitigated, or less well applied. The aim of this study is to investigate the trends of pediatric ambulatory infectious diseases before and up to two years after the onset of the pandemic., Methods: We conducted a prospective surveillance study in France with 107 pediatricians specifically trained in pediatric infectious diseases. From January 2018 to April 2022, the electronic medical records of children with an infectious disease were automatically extracted. The annual number of infectious diseases in 2020 and 2021 was compared to 2018-2019 and their frequency was compared by logistic regression., Findings: From 2018 to 2021, 185,368 infectious diseases were recorded. Compared to 2018 ( n= 47,116) and 2019 ( n= 51,667), the annual number of cases decreased in 2020 ( n= 35,432) by about a third. Frequency of scarlet fever, tonsillopharyngitis, enteroviral infections, bronchiolitis, and gastroenteritis decreased with OR varying from 0·6 (CI95% [0·5;0·7]) to 0·9 (CI95% [0·8;0·9]), p< 0·001. In 2021, among the 52,153 infectious diagnoses, an off-season rebound was observed with increased frequency of enteroviral infections, bronchiolitis, gastroenteritis and otitis with OR varying from 1·1 (CI95% [1·0;1·1]) to 1·5 (CI95% [1·4;1·5]), p< 0·001., Interpretation: While during NPIs strict application, the overall frequency of community-acquired infections was reduced, after relaxation of these measures, a rebound of some of them (enteroviral infections, bronchiolitis, gastroenteritis, otitis) occurred beyond the pre-pandemic level. These findings highlight the need for continuous surveillance of infectious diseases, especially insofar as future epidemics are largely unpredictable., Funding: ACTIV, AFPA, GSK, MSD, Pfizer and Sanofi., Competing Interests: RC reports grants to the institution ACTIV, personal fees, and nonfinancial support from GSK, Sanofi, Pfizer, and Merck, outside the submitted work. AR reports travel grants from Pfizer and AstraZeneca. FA reports receiving personal fees from MSD, AstraZeneca, Sanofi and Pfizer.NO reports travel grants from Pfizer, Sanofi, and GSK, outside the submitted work. BF is employed by CompuGroup Medical. CL reports grants to the institution ACTIV from GSK, Sanofi, Pfizer, and Merck, and personal fees and nonfinancial support from Pfizer and Merck, outside the conduct of the study. All other authors report no potential conflicts., (© 2022 The Author(s).)

Competing Interests: N. Ouladlai déclare n’avoir aucun lien d’intérêts. A. Rybak déclare avoir été pris en charge lors de congrès par Edimark et ACTIV. R. Cohen déclare intervenir ponctuellement pour GSK, Pfizer, Sanofi-Pasteur, Merck et AstraZeneca et avoir été pris en charge lors de congrès par Pfizer.

Competing Interests: A. Rybak déclare avoir été pris en charge lors de congrès par Edimark et ACTIV. E. Grimprel déclare n’avoir aucun lien d’intérêts. R. Cohen déclare intervenir ponctuellement pour GSK, Pfizer, Sanofi-Pasteur, Merck et Astra Zeneca et avoir été pris en charge lors de congrès par Pfizer.

Competing Interests: R. Cohen déclare intervenir ponctuellement pour GSK, Pfizer, Sanofi Pasteur, Merck et AstraZeneca et avoir été pris en charge lors de congrès par Pfizer. A. Rybak déclare avoir été pris en charge lors de congrès par Edimark et ACTIV. M. Tauzin déclare avoir été prise en charge lors de congrès par Edimark. C. Levy déclare intervenir ponctuellement pour GSK, Pfizer, Sanofi et Merck, et avoir été prise en charge lors de congrès par Pfizer.