Unexplained Increase in Pediatric Intracranial Infections in Nevada

In October 2022, the Southern Nevada Health District learned of an unusually large number of pediatric intracranial infections. A total of 14 children had been admitted with such dangerous infections that year in just 1 hospital in Clark County, which includes Las Vegas. These are the findings of a report published in Morbidity and Mortality Weekly Report.

Subsequent medical chart review and telephone interviews yielded reports of a total 18 cases in Clark County, between February and October of 2022, for a quarterly median of 5 cases. This was a considerable increase in incidence, as there were a median 1.5 cases per quarter in 2020 and 2021, and a median .5 cases per quarter before the COVID-19 pandemic.

Most of the patients were boys. The most common prehospitalization complaint was cold symptoms; most of the children had been brought by a caregiver to an emergency room. Hospital stays lasted a median 15 days. Out of 18 patients, 15 required craniotomies to drain an abscess. None of these patients died from these infections.

Authors of the report noted that the incidence of intracranial infections among children had already begun to rise in Clark County in the middle of 2021; but, the months after February 2022 marked a greater spike in the incidence rate. No specific pathogen or community exposure was tied to these infections. On February 10, 2022, the face mask mandate in Nevada was lifted, which has prompted the question whether cessation of masking contributed to this infection cluster. None of the Clark County patients in 2022 was diagnosed with SARS-CoV-2 infection.

For now, officials have speculated that “although this investigation did not identify unexpected risk factors for intracranial abscesses, the substantial increase in cases after the mask mandate in Nevada was lifted might be partially attributable to changes in respiratory pathogen transmission.”

The Southern Nevada Health District continues to monitor the incidence rate of pediatric intracranial infection through 2023.