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Invasive pneumococcal and meningococcal disease: association with influenza virus and respiratory syncytial virus activity?

  • A. G. S. C. JANSEN (a1) (a2), E. A. M. SANDERS (a2), A. VAN DER ENDE (a3), A. M. VAN LOON (a4), A. W. HOES (a1) and E. HAK (a1) (a2)...

Few studies have examined the relationship between viral activity and bacterial invasive disease, considering both influenza virus and respiratory syncytial virus (RSV). This study aimed to assess the potential relationship between invasive pneumococcal disease (IPD), meningococcal disease (MD), and influenza virus and RSV activity in The Netherlands. Correlations were determined between population-based data on IPD and MD during 1997–2003 and influenza virus and RSV surveillance data. Incidence rate ratios of disease during periods of high influenza virus and RSV activity over the peri-seasonal and summer baseline periods were calculated. The analyses comprised 7266 and 3072 cases of IPD and MD. When data from all seasons were included, the occurrence of pneumococcal bacteraemia and MD correlated significantly with influenza virus and RSV activity both in children and adults. Periods of increased influenza virus and RSV activity showed higher rates of pneumococcal bacteraemia in older children and adults than the peri-season period. Rates of MD in children were also higher during periods of increased influenza virus activity; the same appeared true for MD in older children during periods of increased RSV activity. Although no causal relationship may be inferred from these data, they support a role for influenza virus and RSV in the pathogenesis of IPD and MD.

Corresponding author
*Author for correspondence: Dr A. G. S. C. Jansen, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. (Email:
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1. Kim PE, et al. Association of invasive pneumococcal disease with season, atmospheric conditions, air pollution, and the isolation of respiratory viruses. Clinical Infectious Diseases 1996; 22: 100106.
2. Dowell SF, et al. Seasonal patterns of invasive pneumococcal disease. Emerging Infectious Diseases 2003; 9: 573579.
3. Connolly M, Noah N. Is group C meningococcal disease increasing in Europe? A report of surveillance of meningococcal infection in Europe 1993–6. Epidemiology and Infection 1999; 122: 4149.
4. Shah AP, et al. Seasonality of primarily childhood and young adult infectious diseases in the United States. Chronobiology International 2006; 23: 10651082.
5. Hament JM, et al. Respiratory viral infection predisposing for bacterial disease: a concise review. FEMS Immunology and Medical Microbiology 1999; 26: 189195.
6. Young LS, et al. A simultaneous outbreak of meningococcal and influenza infections. New England Journal of Medicine 1972; 287: 59.
7. Cartwright KA, et al. Influenza A and meningococcal disease. Lancet 1991; 338: 554557.
8. Hubert B, et al. Meningococcal disease and influenza-like syndrome: a new approach to an old question. Journal of Infectious Diseases 1992; 166: 542545.
9. Stuart JM, Cartwright K, Andrews NJ. Respiratory syncytial virus infection and meningococcal disease. Epidemiology and Infection 1996; 117: 107111.
10. Talbot TR, et al. Seasonality of invasive pneumococcal disease: temporal relation to documented influenza and respiratory syncytial virus circulation. American Journal of Medicine 2005; 118: 285291.
11. Watson M, et al. The association of respiratory viruses, temperature, and other climatic parameters with the incidence of invasive pneumococcal disease in Sydney, Australia. Clinical Infectious Diseases 2006; 42: 211215.
12. Grabowska K, et al. Occurrence of invasive pneumococcal disease and number of excess cases due to influenza. BMC Infectious Diseases 2006; 6: 58.
13. Jensen ES, et al. A 20-year ecological study of the temporal association between influenza and meningococcal disease. European Journal of Epidemiology 2004; 19: 181187.
14. Kneyber MCJ, van Vught AJ. Respiratory syncytial virus infection and invasive meningococcal disease: is there an association? European Journal of Pediatrics 2003; 162: 352353.
15. Van den Brandhof WE, et al. Reporting virological diagnostics in The Netherlands. Representativity of data from the weekly viral reports [in Dutch]. Infectieziekten Bulletin 2002; 13: 110113.
16. De Greeff SC, et al. Two pneumococcal vaccines: the 7-valent conjugate vaccine (Prevenar) for children up to the age of 5 years of age and the 23-valent polysaccharide vaccine (Pneumo 23) for the elderly and specific groups at risk [in Dutch]. Nederlands Tijdschrift voor Geneeskunde 2007; 151: 14541457.
17. Tacken M, et al. Monitoring influenza vaccination campaign 2003 [in Dutch]. NIVEL 2004.
18. Izurieta HS, et al. Influenza and the rates of hospitalization for respiratory disease among infants and young children. New England Journal of Medicine 2000; 342: 232239.
19. O'Brien KL, et al. Severe pneumococcal pneumonia in previously healthy children: the role of preceding influenza infection. Clinical Infectious Diseases 2000; 30: 784789.
20. Madhi SA, Klugman KP. A role for Streptococcus pneumoniae in virus-associated pneumonia. Nature Medicine 2004; 10: 811813.
21. Dowell SF. Seasonal variation in host susceptibility and cycles of certain infectious diseases. Emerging Infectious Diseases 2001; 7: 369373.
22. Altizer S, et al. Seasonality and the dynamics of infectious diseases. Ecology Letters 2006; 9: 467484.
23. Lofgren E, et al. Influenza seasonality: underlying causes and modeling theories. Journal of Virology 2007; 81: 54295436.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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