INFECTIOUS DISEASES
The Impact of COVID-19 on Other Respiratory Diseases
By Alisa Bochnowski , ScM , senior specialist , Respiratory Diseases
For the better part of 2020 , the infectious disease community has been working to address the COVID-19 pandemic . Public health officials , epidemiologists and clinicians have been closely monitoring the evolution of this disease and scientists have been hard at work trying to learn more about SARS-CoV-2 . However , there are many other respiratory pathogens in circulation . In some cases , public health interventions implemented in response to COVID-19 may suppress the transmission of these diseases , and in other cases , such as Legionellosis , they could exacerbate the problem . So what is the current status of some other respiratory diseases ?
Influenza
Recent
US Centers for Disease Control and Prevention ( CDC ) and
World Health Organization ( WHO ) data indicate community mitigation efforts for COVID-19 also slow the spread of influenza . But the overlap of influenza with COVID-19 could significantly strain both clinical and public health resources , even at low levels . Newly developed diagnostic assays will distinguish the two viruses and improve laboratory throughput . Understanding influenza prevalence and circulation patterns will help clinicians and public health officials make informed decisions as they work to tease apart these diseases with similar clinical presentations . Furthermore , national and international influenza surveillance remains critical to informing vaccine decisions for the 2021-2022 influenza season and monitoring for novel and antiviral resistant viruses . To facilitate the maintenance of influenza surveillance ,
CDC ’ s 2020-2021 influenza specimen submission guidance offers public health laboratories increased flexibility with influenza typing and subtyping / lineage testing workflows .
Measles
Legionellosis
Since its identification in 1976 , cases of pneumonia caused by
Legionella bacteria have been on the rise . Since Legionellae grow in stagnant water , the closure of office buildings and schools could create a prime environment for Legionella growth . The best way to prevent a Legionellosis outbreak is by closely monitoring and cleaning these water systems , which may not be occurring during the pandemic . Water testing and consideration of Legionella as a potential etiology in pneumonia cases will be important as people reoccupy buildings that were closed for long periods .
Measles
Outbreaks of measles have occurred over the past several years domestically and abroad . Among poorly nourished children and those with underlying health conditions , measles continues to be a leading cause of death . Under the
Global Vaccine Action Plan , measles and rubella were targeted for elimination in five WHO Regions by 2020 , but with the emergence of COVID-19 , this deadline may be in jeopardy .
COVID-19 has disrupted supply chain and vaccination efforts in several countries . Additionally , many families have delayed or missed milestone vaccinations due to COVID-19 exposure concerns . Prior to the halt in global travel , Brazil , the Philippines and the Democratic Republic of Congo were all in the midst of sustained measles outbreaks . These countries continue to have cases of measles alongside COVID- 19 , and there is concern of importation of cases into the United States once travel resumes .
APHL Vaccine Preventable Disease Reference Centers continue to operate during the pandemic and provide critical testing capacity for US public health laboratories .
Acute Flaccid Myelitis
Acute Flaccid Myelitis ( AFM ) is a rare neurological condition that causes muscle weakness in young children . Since surveillance efforts began in 2014 , scientists have observed cases peaking biennially , generally between the months of August and November . Public health officials expected to see a peak of cases again in 2020 , but with COVID-19 shuttering many schools and daycares , it remains to be seen if this pattern will continue .
While scientists have not identified a definitive cause of recent AFM outbreaks , enteroviruses ,
particularly EV-D68 and EV-A71 are suspected to be responsible for these biennial outbreaks . Public health laboratories and CDC remain on alert for AFM and still seek specimens from patients under investigation for this illness . n
22 LAB MATTERS Fall 2020