title: Temporal association between rhinovirus circulation in the community and invasive pneumococcal disease in children.
abstract: 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.
authors.affiliation: Department of Pediatrics, Turku University Hospital, Turku, Finland. ville.peltola@utu.fi
authors.forename: Ville
authors.initials: V
authors.lastname: Peltola
authors.forename: Terho
authors.initials: T
authors.lastname: Heikkinen
authors.forename: Olli
authors.initials: O
authors.lastname: Ruuskanen
authors.forename: Tuomas
authors.initials: T
authors.lastname: Jartti
authors.forename: Tapani
authors.initials: T
authors.lastname: Hovi
authors.forename: Terhi
authors.initials: T
authors.lastname: Kilpi
authors.forename: Raija
authors.initials: R
authors.lastname: Vainionpää
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000150:complications* / Q000453:epidemiology* / Q000821:virology; D015897:Comorbidity; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D012229:Rhinovirus / Q000302:isolation & purification*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*