Gastrointestinal infection halved in early pandemic phases
Tuesday March 22nd 2022
The number of gastrointestinal infection outbreaks more than halved during the first six months of the COVID-19 pandemic in the UK - while laboratory confirmed cases fell by a third, new analysis reports.
A research team, led by the UK Health Security Agency, say while it is likely that several factors are behind the fall in outbreaks, public health measures to reduce the spread of COVID-19 infection, such as improved hand hygiene, will have a played key role.
Writing in BMJ Open, Dr Nicola Love, senior epidemiology scientist at UK Health Security Agency, and colleagues say if this level of hygiene practice were to be maintained once the pandemic is over, there could be a permanent change in the number of gastrointestinal infections reported.
The researchers drew on routinely collected health data from seven English surveillance systems co-ordinated by the UK Health Security Agency (UKHSA), previously Public Health England, and Google Trend data, from 1 January to 2 August 2020.
The team was interested in a range of infectious microbes, including Campylobacter spp, Cryptosporidium spp, Shiga-toxin producing E coli (STEC), Giardia sp, Listeria spp, norovirus, non-typhoidal Salmonella spp, and Shigella spp.
The data were split into seven phases: pre-outbreak (phase one); early outbreak (phase two); pre-lockdown (phase three); early lockdown (phase four); late lockdown (phase five); lockdown easing (phase six) and further easing (phase seven).
These were compared with data collected from week one to week 31 from 2015-19 to find the five-year average.
Analysis showed that in the first six months of 2020, there were 1,544 suspected and lab-confirmed gastrointestinal infection outbreaks reported in England – a 52% drop on the five-year average for the period.
Notified outbreaks were comparable to previous years’ figures in the pre-outbreak phase of weeks one to four, but from week seven – the early outbreak phase – there were 22% fewer reported outbreaks that the previous five-year average at 510 compared to 651.
By weeks 19-22, the late lockdown phase, notified infection outbreaks were 87% lower at 46 compared to 350.
About 95% of suspected or confirmed outbreaks of gastrointestinal infections reported in England are attributed to viruses, and mostly occur in hospitals and care homes, and the researchers found that between phases two to seven, reported suspected and confirmed viral outbreaks fell by 62% at 862 compared to 2239).
They found a 94% fall in parasitic infection outbreaks at two compared to 32, while bacterial infection outbreaks decreased by 47% at 51 compared to 97.
Emergency care attendances, GP consultations, and calls to the NHS 111 helpline for gastroenteritis and diarrhoea/vomiting were all lower than in 2019. Although NHS 111 calls gradually increased, they remained substantially lower than in 2019.
Although this is an observational study, Dr Love and colleagues say: “There has been a marked change in trends of [gastrointestinal] infections in the context of the COVID-19 pandemic.
“The drivers of this change are likely to be multifactorial: while changes in health seeking behaviour, pressure on diagnostic services, and surveillance system ascertainment have undoubtedly played a role, there has likely been a true decrease in the incidence for some pathogens resulting from the control measures and restrictions implemented.
“This suggests that if some of these changes in behaviour, such as improved hand hygiene were maintained, then we could potentially see sustained reductions in the burden of [gastrointestinal] illness.”
Love NK, Elliot AJ, Chalmers RM et al. Impact of the COVID-19 pandemic on gastrointestinal infection trends in England, February–July 2020 BMJ Open 22 March 2022
Tags: Flu & Viruses | Gastroenterology | UK News
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