Open AccessAssociations between common respiratory viruses and invasive group A streptococcal infection: A time‐series analysis
Author(s) -
Gier Brechje,
Vlaminckx Bart J. M.,
Woudt Sjoukje H. S.,
Sorge Nina M.,
Asten Liselotte
Publication year - 2019
Publication title -
influenza and other respiratory viruses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.743
H-Index - 57
eISSN - 1750-2659
pISSN - 1750-2640
DOI - 10.1111/irv.12658
Subject(s) - rhinovirus , virus , streptococcus pyogenes , respiratory system , incidence (geometry) , biology , immunology , virology , influenza a virus , medicine , bacteria , genetics , physics , optics , staphylococcus aureus
Background Invasive infections by group A S treptococcus (iGAS, Streptococcus pyogenes ) have a winter seasonality which largely coincides with the season for influenza and other respiratory viruses. Influenza superinfections with GAS have been described to occur regularly and to show a severe clinical picture with high mortality. We aimed to study the extent to which influenza A and B viruses (IAV and IBV), respiratory syncytial virus (RSV) and rhinovirus circulation contribute to iGAS incidence and severity. Methods Time‐series regression models were built to explore the temporal associations between weekly laboratory counts of IAV, IBV, RSV and rhinovirus as independent variables and weekly counts of GAS disease notifications or laboratory GAS cultures as dependent variables. Results The weekly number of IAV detections showed a significant temporal association with the number of notifications of streptococcal toxic shock syndrome (STSS), a severe complication of iGAS. Depending on the season, up to 40% of all notified STSS cases was attributable to IAV circulation. Besides STSS, none of the other iGAS manifestations were associated with a respiratory virus. Conclusions Our study found an ecological temporal association between IAV and STSS, the most severe complication of iGAS. Future studies are needed to confirm this association and assess the possible preventability of STSS by influenza vaccination, especially in the age group 60 years and older.