Temporal Association Between Rhinovirus Circulation in the Community and Invasive Pneumococcal Disease in Children


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Abstract

Background:Mucosal coinfections with respiratory viruses and Streptococcus pneumoniae are common, but the role of rhinovirus infections in the development of invasive pneumococcal disease (IPD) in children has not been studied.Methods:During 1995 and 2007, we analyzed the association of IPD in children less than 5 years of age with respiratory virus epidemics by combining data from the National Infectious Disease Register, 3 prospective epidemiologic studies, and the database of the Department of Virology, University of Turku, Finland.Results:The mean IPD rate in children younger than 5 years of age in Finland was 2.9 cases per week (95% confidence interval [CI], 2.5–3.3) during periods of high rhinovirus activity, and 1.4 (95% CI, 1.2–1.6) during periods of low rhinovirus activity (P < 0.001). The IPD rate correlated with the rhinovirus activity recorded at the Department of Virology (correlation coefficient, 0.23; P = 0.001) and in the epidemiologic studies (correlation coefficients, 0.28, 0.25, and 0.31). The IPD rate was moderately increased during periods of high respiratory syncytial virus activity (mean, 2.1 cases per week; 95% CI, 1.8–2.3) compared with periods of low respiratory syncytial virus activity (mean, 1.7; 95% CI, 1.6–1.9; P = 0.008). There were no differences in the IPD rate between the periods of high and low influenza activity.Conclusions:Rhinovirus circulation in the community had an association with IPD in children younger than 5 years of age. This study suggests that rhinovirus infection may be a contributor in the development of IPD in the population of young children.

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