Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.

Shrestha, Sourya; Foxman, Betsy; Weinberger, Daniel M.; Steiner, Claudia; Viboud, Cécile; Rohani, Pejman

doi:10.1126/scitranslmed.3005982

Cited by 148Pneumonia and Respiratory InfectionsInfluenza Virus Research StudiesRespiratory viral infections research

Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.

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Shrestha, Sourya, Foxman, Betsy, Weinberger, Daniel M., Steiner, Claudia, Viboud, Cécile, Rohani, Pejman·2013·Science Translational Medicine

DOI 10.1126/scitranslmed.3005982PMC PMC4178309

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Abstract

The association between influenza virus and the bacterium Streptococcus pneumoniae (pneumococcus) has been proposed as a polymicrobial system, whereby transmission and pathogenicity of one pathogen (the bacterium) are affected by interactions with the other (the virus). However, studies focusing on different scales of resolution have painted an inconsistent picture: Individual-scale animal experiments have unequivocally demonstrated an association, whereas epidemiological support in human populations is, at best, inconclusive. We integrate weekly incidence reports and a mechanistic transmission model within a likelihood-based inference framework to characterize the nature, timing, and magnitude of this interaction. We find support for a strong but short-lived interaction, with influenza infection increasing susceptibility to pneumococcal pneumonia ~100-fold. We infer modest population-level impacts arising from strong processes at the level of an individual, thereby resolving the dichotomy in seemingly inconsistent observations across scales. An accurate characterization of the influenza-pneumococcal interaction can form a basis for more effective clinical care and public health measures for pneumococcal pneumonia.

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Influenza infection facilitates the acquisition, colonization, and development of disease from S. pneumoniae in people of all ages.
“Many studies have shown that influenza infection facilitates the acquisition, colonization and development of disease from S. pneumoniae in people of all ages (Shrestha et al., 2013; Grijalva et al., 2014; Siegel et al., 2014).”
From Secondary bacterial infections associated with influenza pandemics (2017) · cites this paper as Shrestha et al., 2013

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The role of influenza in the epidemiology of pneumonia
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Authors: Shrestha, S., Foxman, B., Weinberger, D. M., Steiner, C., Viboud, C., & Rohani, P.
Affiliations: University of Michigan (US)
National Institutes of Health (US)
Agency for Healthcare Research and Quality (US)
Division of International Epidemiology and Population Studies, National Institutes of Health, Bethesda, MD 20892, USA.
Corresponding author: Shrestha, Sourya
ORCID: Shrestha, Sourya
Foxman, Betsy
Weinberger, Daniel M.
Rohani, Pejman
Venue: Science Translational Medicine
Publisher: American Association for the Advancement of Science (AAAS)
Published: 2013-06-26
Volume: 5
Issue: 191
Pages: 191ra84-191ra84
ISSN: 1946-6234 (ISSN-L)
1946-6242
DOI: 10.1126/scitranslmed.3005982
PMC: PMC4178309
OpenAlex: W2126106976
Cited by: 148
References: 64
Citations by year: 2026: 9 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 10 · 2021: 9 · 2020: 15 · 2019: 17 · 2018: 13 · 2017: 10 · 2016: 12 · 2015: 13 · 2014: 15 · 2013: 2
FWCI: 10.10
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Science Translational Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (Z99 TW999999)
Topics: Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
Keywords: influenza, pneumococcal pneumonia, Streptococcus pneumoniae, polymicrobial interactions, host susceptibility, incidence data, mechanistic transmission model, likelihood-based inference, scale resolution
MeSH terms: Humans, Influenza, Human, Pneumonia, Pneumococcal, Streptococcus pneumoniae, Incidence, Coinfection

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Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.

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