Research ArticleEpidemiology

Identifying the Interaction Between Influenza and Pneumococcal Pneumonia Using Incidence Data

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Science Translational Medicine  26 Jun 2013:
Vol. 5, Issue 191, pp. 191ra84
DOI: 10.1126/scitranslmed.3005982

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Tipping the Scales for Pathogen Interaction

As if it weren’t bad enough to be infected by one pathogen, sometimes a primary infection can pave the way for a secondary infection as well. This has been thought to be the case with influenza virus and Streptococcus pneumoniae. Indeed, there are a lot of data in both humans and animal models that this does happen at the individual level. However, epidemiological studies measuring population-level effects do not reflect this observation. Now, Shrestha et al. use mathematical modeling of weekly incidence reports to reconcile these two seemingly disparate observations.

The authors constructed a mechanistic transmission model within a likelihood-based inference framework and characterized the timing, nature, and magnitude of the interaction between influenza virus and pneumococcal pneumonia. In individuals, they see that flu increases the susceptibility to subsequent pneumococcal pneumonia more than 100 times. However, at the population level, there is only a modest effect. These data suggest that influenza virus may contribute to pneumococcal pneumonia pathogenesis, but that these effects may be masked in the total population.

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