The impact of the COVID-19 pandemic on the epidemiology of common childhood infections in the federation of Bosnia and Herzegovina (2018–2024)

Background: While the global focus during the COVID-19 pandemic was directed at SARS-CoV-2 containment, collateral effects on other infectious diseases—particularly in children—have been underreported. In the pediatric population, lockdowns, school closures, and social distancing significantly altered exposure patterns to common childhood infections.

Objective: To analyze the epidemiological trends of selected viral infections in children (measles, influenza, varicella) before, during, and after the COVID-19 pandemic in the Federation of Bosnia and Herzegovina (FBiH) between 2018 and 2024.

Methods: A retrospective analysis was conducted using publicly available annual epidemiological bulletins from the Public Health Institute of the Federation of Bosnia and Herzegovina (www.zzjzfbih.ba). Reported cases of varicella, influenza, and measles from 2018 to 2024 were extracted and analyzed through descriptive and graphical methods to illustrate incidence trends.

Results: All three infections demonstrated a significant decline during the peak of the COVID-19 pandemic in 2020 and 2021, a period that coincided with widespread implementation of strict public health measures. Influenza incidence, for example, fell sharply from 9,295 reported cases in 2019 to just 248 in 2020 and 601 in 2021. A substantial resurgence was observed in 2023, with 11,122 reported cases. A similar pattern was seen with varicella (chickenpox), which decreased from 6,657 cases in 2019 to 2,073 in 2020, followed by a marked increase to 11,421 in 2023. Measles showed a complete absence of reported cases between 2020 and 2022; however, this was followed by a major outbreak in 2023, during which 4,520 cases were documented. These epidemiological patterns are consistent with the consequences of reduced viral exposure due to lockdowns and a concurrent drop in routine vaccination coverage. Early data from 2024 suggest a potential stabilization, though the reported incidence remains above pre-pandemic levels for all three infections.

Conclusion: The pandemic significantly disrupted the epidemiology of pediatric infectious diseases in FBiH. Non-pharmaceutical interventions suppressed routine transmission but created immunity gaps that contributed to post-pandemic surges. Targeted catch-up immunization and strengthened surveillance are critical to preventing future outbreaks in this vulnerable population.

Dr. Svjetlana Mikulić is a pediatrician and PhD candidate at the University Clinical Hospital Mostar. She has significant experience in neonatal intensive care and general neonatology. Currently, she works at the Department of Pulmonology and Allergology, managing both respiratory and allergic pediatric patients. Her research focuses on neonatal endocrinology, pediatric pulmonology, perinatal outcomes, and rare congenital disorders. Dr. Mikulić is actively involved in clinical research and regularly presents at national and international pediatric conferences.