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Identifying the interaction between influenza and pneumococcal pneumonia using incidence data.
Open accessAbstract
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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“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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Metadata
- 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
- Venue
- Science Translational Medicine
- Published
- 2013-06-26
- Volume
- 5
- Issue
- 191
- Pages
- 191ra84-191ra84
- ISSN
- 1946-6234 (ISSN-L)
- 1946-6242
- 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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