As the U.S. eases pandemic restrictions, cases of brain abscesses in children under 18 have risen to new highs, according to two reports released by the Centers for Disease Control and Prevention earlier this year.
In December 2022, the peak of cases nationwide reached 102. Since then, cases have failed again, but as of and including March 2023, they are still above the baseline cap of 61 cases per month.
The CDC says these abscesses often develop after a respiratory infection, including COVID-19, influenza, or sinusitis, highlighting the importance of children getting their vaccinations up to date.
Brain abscesses—even in such high numbers—are relatively rare, but can be quite dangerous. They are brain infections caused by bacteria or fungi that enter the brain, usually through the bloodstream from an infection elsewhere in the body (such as pneumonia), or through an infection in the head (such as ears, teeth), or sinuses.
These pus-filled pockets can put pressure on surrounding brain tissue and even cut off blood flow. Abscesses can cause brain damage and, in severe cases, be fatal, so they need to be treated as quickly as possible with antibiotics and, in some cases, surgery.
A report released in June by CDC epidemiologist Emma Accorsi showed that there were 34 cases of brain abscess per month between 2016 and 2019 as a baseline, based on hospitalization data. number of digits. During this period, the baseline maximum in one month was 61 cases.
Then, in March 2020, the COVID-19 pandemic swept the world, and countries around the world began taking measures to try to reduce the spread of the infection, including wearing masks, using respirators to reduce aerosol transmission, and implementing lockdowns. They are confined to their homes to reduce human contact.
Over the next few months, many illnesses abated. For example, both influenza cases and respiratory syncytial virus (RSV) cases have dropped significantly.It appears that cases of brain abscess are caused by Streptococcus It’s another one. This bacteria is commonly seen in people with RSV or influenza.
The CDC reports that starting in May 2020, monthly case numbers were well below baseline and remained that way until May 2021. Since then, however, case numbers have begun to climb, significantly higher than pre-pandemic numbers.
“Although some differences were observed among U.S. Census Bureau regions, the overall pattern was generally similar: persistently low case numbers following the pandemic outbreak, followed by a period of increases beginning in mid-to-late 2021, followed by winter 2022 Large spike – 2023,” explained Accorsi and her team.
Cases of brain abscess in children are considered a serious complication of viral respiratory infections in children. Respiratory viruses are on the rise globally as pandemic restrictions ease in 2022. In particular, influenza and RSV cases have reached new heights, along with COVID-19, in what has come to be known as the “triple epidemic.”
Christopher Gill, an infectious disease expert at Boston University, said the reason for this is the rebound effect of low infection rates during pandemic restrictions.
“We’ve seen a huge drop in the incidence and impact of RSV and influenza over the past few years due to COVID-19 restrictions. That’s great, but it also means people don’t gain as much herd immunity against other viruses,” he said in December 2022.
“At the same time, babies are still being born and increasing the number of susceptible people. The result is a bit like winding up the clock because now the rebound is much worse than usual. Although it is a very complicated process Simplifying a little bit, our best guess is that we are now in the midst of a rebound in the spread of the virus globally.”
Pediatric brain abscess cases have begun to decline after a record peak of 102 cases in December – more than three times the baseline median. However, they remained above the baseline maximum of 61 cases per month until March 2023. Data after that date are not included in the report.
While the report did not speculate on the cause of the increase in cases, a second report, also released in June, looked specifically at cases in Nevada and did make a tentative link. Researchers, led by the CDC’s Jessica Penney, said there may be a link between the rise in brain abscess cases and the state’s lifting of the mask mandate in February 2022.
Even at the peak in December 2022, cases will remain rare, but the CDC will continue to monitor this phenomenon and recommends that doctors remain vigilant for signs of brain abscess in children with respiratory symptoms.
“CDC continues to track trends in intracranial infections in children and recommends that all persons under 18 years of age continue to receive recommended vaccines, including influenza vaccine and COVID-19 vaccine,” Accorsi and her team said.
There is currently no RSV vaccine available for people under 60 years of age. But you can familiarize yourself with the symptoms of a brain abscess on the Johns Hopkins Medicine website.
An earlier version of this article was published in June 2023.