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No temporal association between influenza outbreaks and invasive pneumococcal infections

¹ Institute for Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians University Munich, Munich, Germany
² Division of Health and Social Care Research, King’s College London, London, UK
³ Pediatric Infectious Diseases, University Children’s Hospital Kiel, Kiel, Germany
⁴ Department of Statistics, Ludwig-Maximilians University Munich, Munich, Germany
⁵ Division of Pediatric Infectious Diseases, University Children’s Hospital Basel, Basel, Switzerland

Correspondence to:
Professor Ulrich Heininger, University Children’s Hospital Basel, PO Box 4005, Basel, Switzerland; Ulrich.Heininger{at}unibas.ch

Objective: To assess whether the influenza peak in populations precedes the annual peak for invasive pneumococcal infections (IPI) in winter.

Design: Ecological study. Active surveillance data on influenza A and IPI in children up to 16 years of age collected from 1997 to 2003 were analysed.

Setting: Paediatric hospitals in Germany.

Patients: Children under 16 years of age.

Results: In all years under study, the influenza A season did not appear to affect the IPI season (p = 0.49). Specifically, the influenza peak never preceded the IPI peak.

Conclusion: On a population level there was no indication that the annual influenza epidemic triggered the winter increase in the IPI rate or the peak of the IPI distribution in children.