No temporal association between influenza outbreaks and invasive pneumococcal infections

Andre M Toschke ¹, Stephan Arenz ¹, Rüdiger von Kries ¹, Wolfram Puppe ², Josef A Weigl ², Michael Höhle ³ and Ulrich Heininger ^4*

¹ Institute for Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-, Germany
² University Children's Hospital Kiel, Paediatric Infectious Diseases, Kiel, Germany
³ Ludwig-Maximilians University Munich, Department of Statistics, Munich, Germany, Germany
⁴ University Children's Hospital Basel, Division of Paediatric Infectious Diseases, Basel, Switzerland

^* To whom correspondence should be addressed. E-mail: ulrich.heininger{at}unibas.ch.

Accepted 19 March 2007

Abstract

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 analyzed.

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.

Keywords: influenza, invasive pneumococcal infections, seasonality, streptococcus pneumoniae

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