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Temporal Association Between Rhinovirus Circulation in the Community and Invasive Pneumococcal Disease in Children

Peltola, Ville MD, PhD*†; Heikkinen, Terho MD, PhD*; Ruuskanen, Olli MD, PhD*; Jartti, Tuomas MD, PhD*; Hovi, Tapani MD, PhD; Kilpi, Terhi MD, PhD; Vainionpää, Raija PhD§

The Pediatric Infectious Disease Journal: June 2011 - Volume 30 - Issue 6 - p 456-461
doi: 10.1097/INF.0b013e318208ee82
Original Studies

Background: Mucosal coinfections with respiratory viruses and Streptococcus pneumoniae are common, but the role of rhinovirus infections in the development of invasive pneumococcal disease (IPD) in children has not been studied.

Methods: During 1995 and 2007, we analyzed the association of IPD in children less than 5 years of age with respiratory virus epidemics by combining data from the National Infectious Disease Register, 3 prospective epidemiologic studies, and the database of the Department of Virology, University of Turku, Finland.

Results: The mean IPD rate in children younger than 5 years of age in Finland was 2.9 cases per week (95% confidence interval [CI], 2.5–3.3) during periods of high rhinovirus activity, and 1.4 (95% CI, 1.2–1.6) during periods of low rhinovirus activity (P < 0.001). The IPD rate correlated with the rhinovirus activity recorded at the Department of Virology (correlation coefficient, 0.23; P = 0.001) and in the epidemiologic studies (correlation coefficients, 0.28, 0.25, and 0.31). The IPD rate was moderately increased during periods of high respiratory syncytial virus activity (mean, 2.1 cases per week; 95% CI, 1.8–2.3) compared with periods of low respiratory syncytial virus activity (mean, 1.7; 95% CI, 1.6–1.9; P = 0.008). There were no differences in the IPD rate between the periods of high and low influenza activity.

Conclusions: Rhinovirus circulation in the community had an association with IPD in children younger than 5 years of age. This study suggests that rhinovirus infection may be a contributor in the development of IPD in the population of young children.


From the *Department of Pediatrics, Turku University Hospital, Turku, Finland; †Turku Institute for Child and Youth Research, University of Turku, Turku, Finland; ‡Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland; and §Department of Virology, University of Turku, Turku, Finland.

Accepted for publication November 19, 2010.

Supported by the Academy of Finland (grant no. 109148), the Foundation for Pediatric Research, and the Finnish Medical Foundation.

Address for correspondence: Ville Peltola, MD, PhD, Department of Pediatrics, Turku University Hospital, 20521 Turku, Finland. E-mail:

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© 2011 Lippincott Williams & Wilkins, Inc.