No temporal association between influenza outbreaks and invasive pneumococcal infections

Objective: To assess whether the influenza peak in populations precedes the annual peak for invasive pneumococcal infections (IPI) in winter. Design: Ecological study. Active surveillance data on influenza A and IPI in children up to 16 years of age collected from 1997 to 2003 were analysed. Setting: Paediatric hospitals in Germany. Patients: Children under 16 years of age. Results: In all years under study, the influenza A season did not appear to affect the IPI season (p = 0.49). Specifically, the influenza peak never preceded the IPI peak. Conclusion: On a population level there was no indication that the annual influenza epidemic triggered the winter increase in the IPI rate or the peak of the IPI distribution in children.