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. 2021 Mar 16;18(6):3070.
doi: 10.3390/ijerph18063070.

A Significant Decrease in the Incidence of Shigellosis in Israel during COVID-19 Pandemic

Ravit Bassal  1   2 , Lital Keinan-Boker  1   3 , Dani Cohen  2
Affiliations

A Significant Decrease in the Incidence of Shigellosis in Israel during COVID-19 Pandemic

Ravit Bassal et al. Int J Environ Res Public Health. .

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes COVID-19 and is mostly person-to-person transmitted through respiratory droplets. The implications of the strategies implemented to prevent COVID-19 transmission on other infectious diseases are unclear. We aimed to appraise trends in the incidence of salmonellosis, shigellosis and campylobacteriosis in Israel during COVID-19 pandemic. Positive stool samples for Salmonella, Shigella and Campylobacter are reported on a monthly basis to the Israel Center for Disease Control from sentinel laboratories, within the framework of a surveillance network of bacterial culture-proven enteric diseases. Age-adjusted incidence rates per 100,000 of shigellosis, salmonellosis and campylobacteriosis were calculated. Mean rates before and after the local onset of COVID-19 pandemic in Israel were compared and Relative Risk Reduction (RRR) was calculated. Joinpoint was used to evaluate secular trends. The mean age-adjusted incidence rate of shigellosis in March-July 2020 was lower than the rate observed in March-July 2018-2019 (RRR = 86.6%), but also decreased for salmonellosis (RRR = 33.0%) and campylobacteriosis (RRR = 30.0%). Using Joinpoint we have shown that the decrease observed for shigellosis was significantly sharper (Annual Percent Change (APC) = -77.7) between February 2020 and May 2020 than for salmonellosis (APC = -14.0) between July 2019 and April 2020 and for campylobacteriosis (APC = -1.1) between January 2018 and July 2020. The preventive measures applied to reduce transmission of COVID-19, including social distancing and hand washing, were ecologically associated with a decreased risk of bacterial enteric diseases in Israel. The association was strongest for shigellosis, a disease that is mostly person-to-person transmitted, as compared to salmonellosis and campylobacteriosis which are mostly foodborne transmitted.

Keywords: COVID-19; enteric diseases; incidence; outbreak; trend.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Salmonellosis, shigellosis and campylobacteriosis age-adjusted incidence rate per 100,000 in sentinel laboratories, Israel, January 1999–July 2020, and a focus on January 2018–July 2020.
Figure 2
Figure 2
Modeled age-adjusted incidence rates of shigellosis, salmonellosis and campylobacteriosis per 100,000, January 2018–July 2020. * p-value < 0.05.
See this image and copyright information in PMC

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