Following the easing of pandemic restrictions in the US, cases of brain abscess in children under 18 reached unprecedented levels, as reported by the CDC earlier this year.
A peak of 102 cases was recorded in December 2022, and although the numbers have since declined, they have remained above the maximum baseline of 61 cases per month until March 2023.
The CDC emphasizes the importance of children staying up-to-date with their vaccinations, as these abscesses typically occur after a respiratory infection, including COVID-19, the flu, or sinusitis.
Brain abscesses, although relatively rare, pose significant danger as they are infections in the brain caused by bacteria or fungi. These infectious agents typically enter the brain through the bloodstream from another infection in the body or through an infection in the head, such as the ears, teeth, or sinuses.
These pockets of pus can exert pressure on the surrounding brain tissue and impede blood flow. They have the potential to cause brain damage and, in severe cases, can be fatal. Therefore, prompt treatment with antibiotics and potentially surgery is necessary.
According to a report from the CDC led by epidemiologist Emma Accorsi, the baseline median for brain abscess cases from 2016 to 2019 was 34 cases per month based on hospitalization data. The maximum baseline during this period was 61 cases per month.
With the onset of the global COVID-19 pandemic in March 2020, countries implemented measures to reduce infection spread, such as mask-wearing, respirator use, and lockdowns. Consequently, many illnesses, including influenza and respiratory syncytial virus (RSV), significantly declined.
However, after May 2021, cases of brain abscess began to rise significantly above pre-pandemic numbers.
Infectious disease expert Christopher Gill of Boston University attributes this rise to a rebound effect caused by low infection rates during the peak of pandemic restrictions.
He explains, “Due to the COVID-19 restrictions in recent years, we witnessed substantial declines in RSV and influenza incidence and impact. While this was beneficial, it also meant that the population did not develop as much herd immunity against these viruses.”
Gill further elaborates that infants continued to be born during this period, adding to the population of susceptible individuals. Consequently, the rebound effect resulted in a more severe resurgence of viral transmission compared to previous years.
After reaching a record high of 102 cases in December 2022, pediatric brain abscess cases began to decline but remained above the baseline maximum of 61 monthly cases until March 2023, with subsequent data not included in the report.
A second report published in June examined brain abscess cases in Nevada and tentatively correlated the rise in cases with the lifting of mask mandates in that state in February 2022.
It is crucial to note that brain abscess cases, including the peak in December 2022, are considered rare. However, the CDC will continue monitoring the situation and advises doctors to remain vigilant for signs of brain abscess in children presenting with respiratory symptoms.
As Accorsi and her team stated, “CDC continues to track pediatric intracranial infection trends and recommends that all individuals aged ≤18 years stay up-to-date with recommended vaccinations, including influenza and COVID-19.”
While there is currently no RSV vaccine available for individuals under 60, it is essential to be aware of the symptoms of brain abscess, which can be found on the Johns Hopkins Medicine website.
An earlier version of this article was published in June 2023.
