Abstract：
BACKGROUND: In the conjugate vaccine era, viruses are the most common cause of meningitis. Here, we evaluated epidemiological trends in laboratory-confirmed viral meningitis across all age-groups over an 11-year period in England.
METHODS: In England, hospital laboratories routinely report laboratory-confirmed infections electronically to the UK Health Security Agency. Records of positive viral detections in cerebrospinal fluid during 2013-2023 were extracted. Incidence rates with confidence intervals were calculated using mid-year resident population estimates.
RESULTS: There were 22,114 laboratory-confirmed viral meningitis cases, including 15,299 cases during 2013-19 (pre COVID-19), with a gradual increase in incidence from 3.5/100,00 (95%CI: 3.3-3.6) to 3.9/100,000 (95%CI: 3.6-4.1). During 2020-21 when pandemic restrictions were in place, there were 2061 cases (1.8/100,000; 1.7-1.9), which increased to 4754 (4.2/100,000; 4.0-4.3) during 2022-23 (post pandemic restrictions). Infants aged <3 months accounted for 39.4% (8702/22,048) of all cases, with a stable incidence 2013-19 (504/100,000, 95%CI: 491-517), followed by a significant decline during 2020-21 (204/100,000; 188-221) and then an increase during 2022-23 (780/100,000; 749-812), with enteroviruses being the commonest cause (84.9%, 7387/8702; 424.74/100,000; 95%CI: 415.12-434.51), followed by parechoviruses (9.1%, 792/8702; 45.54/100,000; 95%CI: 42.42-48.82) and herpes simplex virus (4.4%, 380/8702; 21.85/100,000; 95%CI: 19.71-24.16). Pandemic restrictions were associated with significant declines in the incidence of enterovirus (77.7%) and parechoviruses (64% lower), with rebounds after societal restrictions were lifted.
CONCLUSIONS: Rates of viral meningitis have returned to pre-pandemic levels since societal restrictions were lifted. The highest incidence of viral meningitis remains in infants aged <3 months and most commonly due to enteroviral infection.
METHODS: In England, hospital laboratories routinely report laboratory-confirmed infections electronically to the UK Health Security Agency. Records of positive viral detections in cerebrospinal fluid during 2013-2023 were extracted. Incidence rates with confidence intervals were calculated using mid-year resident population estimates.
RESULTS: There were 22,114 laboratory-confirmed viral meningitis cases, including 15,299 cases during 2013-19 (pre COVID-19), with a gradual increase in incidence from 3.5/100,00 (95%CI: 3.3-3.6) to 3.9/100,000 (95%CI: 3.6-4.1). During 2020-21 when pandemic restrictions were in place, there were 2061 cases (1.8/100,000; 1.7-1.9), which increased to 4754 (4.2/100,000; 4.0-4.3) during 2022-23 (post pandemic restrictions). Infants aged <3 months accounted for 39.4% (8702/22,048) of all cases, with a stable incidence 2013-19 (504/100,000, 95%CI: 491-517), followed by a significant decline during 2020-21 (204/100,000; 188-221) and then an increase during 2022-23 (780/100,000; 749-812), with enteroviruses being the commonest cause (84.9%, 7387/8702; 424.74/100,000; 95%CI: 415.12-434.51), followed by parechoviruses (9.1%, 792/8702; 45.54/100,000; 95%CI: 42.42-48.82) and herpes simplex virus (4.4%, 380/8702; 21.85/100,000; 95%CI: 19.71-24.16). Pandemic restrictions were associated with significant declines in the incidence of enterovirus (77.7%) and parechoviruses (64% lower), with rebounds after societal restrictions were lifted.
CONCLUSIONS: Rates of viral meningitis have returned to pre-pandemic levels since societal restrictions were lifted. The highest incidence of viral meningitis remains in infants aged <3 months and most commonly due to enteroviral infection.
摘要：
背景：在结合疫苗时代，病毒是脑膜炎的最常见原因。这里,我们评估了英格兰所有年龄组11年期间实验室确诊的病毒性脑膜炎的流行病学趋势.
方法：在英国，医院实验室定期以电子方式向英国卫生安全局报告实验室确认的感染。提取了2013-2023年期间脑脊液中病毒检测阳性的记录。使用年中常住人口估计值计算具有置信区间的发病率。
结果：有22,114例实验室确诊的病毒性脑膜炎病例，包括2013-19年期间的15299例（新冠肺炎之前），发病率从3.5/100,00（95CI，3.3-3.6）逐渐增加到3.9/100,000（95CI，3.6-4.1）。在2020-21年期间，当大流行限制到位时，有2061例（1.8/100,000；1.7-1.9），在2022-23年间（大流行后限制）增加到4754（4.2/100,000；4.0-4.3）。年龄<3个月的婴儿占所有病例的39.4%(8,702/22,048),2013-19年发病率稳定(504/100,000，95CI:491-517)，随后在2020-21年期间大幅下降（204/100,000；188-221），然后在2022-23年期间上升（780/100,000；749-812），肠道病毒是最常见的原因(84.9%，7387/8,702；424.74/100,000；95CI，415.12-434.51），其次是副病毒(9.1%，792/8702；45.54/100,000；95CI，42.42-48.82）和单纯疱疹病毒（4.4％，380/8702；21.85/100,000；95CI，19.71-24.16）。大流行限制与肠道病毒（77.7％）和部分病毒（低64％）的发病率显着下降有关，社会限制解除后反弹。
结论：自社会限制解除以来，病毒性脑膜炎的发病率已恢复到大流行前的水平。病毒性脑膜炎的发病率最高的仍然是3个月以下的婴儿，最常见的原因是肠病毒感染。
方法：在英国，医院实验室定期以电子方式向英国卫生安全局报告实验室确认的感染。提取了2013-2023年期间脑脊液中病毒检测阳性的记录。使用年中常住人口估计值计算具有置信区间的发病率。
结果：有22,114例实验室确诊的病毒性脑膜炎病例，包括2013-19年期间的15299例（新冠肺炎之前），发病率从3.5/100,00（95CI，3.3-3.6）逐渐增加到3.9/100,000（95CI，3.6-4.1）。在2020-21年期间，当大流行限制到位时，有2061例（1.8/100,000；1.7-1.9），在2022-23年间（大流行后限制）增加到4754（4.2/100,000；4.0-4.3）。年龄<3个月的婴儿占所有病例的39.4%(8,702/22,048),2013-19年发病率稳定(504/100,000，95CI:491-517)，随后在2020-21年期间大幅下降（204/100,000；188-221），然后在2022-23年期间上升（780/100,000；749-812），肠道病毒是最常见的原因(84.9%，7387/8,702；424.74/100,000；95CI，415.12-434.51），其次是副病毒(9.1%，792/8702；45.54/100,000；95CI，42.42-48.82）和单纯疱疹病毒（4.4％，380/8702；21.85/100,000；95CI，19.71-24.16）。大流行限制与肠道病毒（77.7％）和部分病毒（低64％）的发病率显着下降有关，社会限制解除后反弹。
结论：自社会限制解除以来，病毒性脑膜炎的发病率已恢复到大流行前的水平。病毒性脑膜炎的发病率最高的仍然是3个月以下的婴儿，最常见的原因是肠病毒感染。
