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Seasonal Patterns of Invasive Pneumococcal Disease

机译：侵袭性肺炎球菌疾病的季节性模式

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Pneumococcal infections increase each winter, a phe-nomenon that has not been well explained. We conductedpopulation-based active surveillance for all cases of inva-sive pneumococcal disease in seven states; plotted annu-alized weekly rates by geographic location, age, and lati-tude; and assessed correlations by time-series analysis. Inall geographic areas, invasive pneumococcal diseaseexhibited a distinct winter seasonality, including anincrease among children in the fall preceding that for adultsand a sharp spike in incidence among adults each yearbetween December 24 and January 7. Pneumococcal dis-ease correlated inversely with temperature (r –0.82 with a1-week lag; p<0.0001), but paradoxically the coldest stateshad the lowest rates, and no threshold temperature couldbe identified. The pattern of disease correlated directly withthe sinusoidal variations in photoperiod (r +0.85 with a 5-week lag; p<0.0001). Seemingly unrelated seasonal phe-nomena were also somewhat correlated. The reproducibleseasonal patterns in varied geographic locations are con-sistent with the hypothesis that nationwide seasonalchanges such as photoperiod-dependent variation in hostsusceptibility may underlie pneumococcal seasonality, butcaution is indicated in assigning causality as a result ofsuch correlations
机译：每年冬天，肺炎球菌感染都会增加，这种现象还没有得到很好的解释。我们对七个州的所有侵袭性肺炎球菌疾病病例进行了基于人群的主动监测;绘制按地理位置，年龄和纬度划分的年化每周费率;并通过时序分析评估相关性。在所有地理区域，侵袭性肺炎球菌疾病均表现出明显的冬季季节性变化，包括在成人发病之前的秋季秋季儿童发病率增加，以及每年12月24日至1月7日之间成年人发病率急剧上升。肺炎球菌疾病与温度呈负相关（r –0.82）。滞后时间为1周; p <0.0001），但自相矛盾的是，最冷的州的比率最低，无法确定阈值温度。疾病的模式与光周期的正弦变化直接相关（r +0.85，有5周的滞后; p <0.0001）。似乎无关的季节性phe-nomena也有些相关。在不同地理位置上可重现的季节模式与以下假设相一致：全国性季节性变化（例如寄主敏感性的光周期依赖性变化可能是肺炎球菌季节性的基础），但由于这种相关性，在分配因果关系时要谨慎

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