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Clin Infect Dis. 2010 Jan 15;50(2):175-83. doi: 10.1086/649208.

Influenza circulation and the burden of invasive pneumococcal pneumonia during a non-pandemic period in the United States.

Author information

  • 1Epidemic Intelligence Service, Office of Workforce and Career Development Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Nicholas.Walter@ucdenver.edu

Abstract

BACKGROUND:

Animal models and data from influenza pandemics suggest that influenza infection predisposes individuals to pneumococcal pneumonia. Influenza may contribute to high winter rates of pneumococcal pneumonia during non-pandemic periods, but the magnitude of this effect is unknown. With use of United States surveillance data during 1995-2006, we estimated the association between influenza circulation and invasive pneumococcal pneumonia rates.

METHODS:

Weekly invasive pneumococcal pneumonia incidence, defined by isolation of pneumococci from normally sterile sites in persons with clinical or radiographic pneumonia, was estimated from active population-based surveillance in 3 regions of the United States. We used influenza virus data collected by World Health Organization collaborating laboratories in the same 3 regions in seasonally adjusted negative binomial regression models to estimate the influenza-associated fraction of pneumococcal pneumonia.

RESULTS:

During approximately 185 million person-years of surveillance, we observed 21,239 episodes of invasive pneumococcal pneumonia; 485,691 specimens were tested for influenza. Influenza circulation was associated with 11%-14% of pneumococcal pneumonia during periods of influenza circulation and 5%-6% overall. In 2 of 3 regions, the association was strongest when influenza circulation data were lagged by 1 week.

CONCLUSIONS:

During recent seasonal influenza epidemics in the United States, a modest but potentially preventable fraction of invasive pneumococcal pneumonia was associated with influenza circulation.

PMID:
20014948
[PubMed - indexed for MEDLINE]
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