RT Journal Article
SR Electronic
T1 Identifying the Interaction Between Influenza and Pneumococcal Pneumonia Using Incidence Data
JF Science Translational Medicine
FD American Association for the Advancement of Science
SP 191ra84
OP 191ra84
DO 10.1126/scitranslmed.3005982
VO 5
IS 191
A1 Shrestha, Sourya
A1 Foxman, Betsy
A1 Weinberger, Daniel M.
A1 Steiner, Claudia
A1 Viboud, Cécile
A1 Rohani, Pejman
YR 2013
UL http://stm.sciencemag.org/content/5/191/191ra84.abstract
AB 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.