ABSTRACT
Background: Influenza has been shown to increase the risk for severe bacterial infection, in the tropics the seasonality of influenza epidemics is less marked and this may not be the case. Dengue is often followed by prolonged asthenia and some physicians hypothesized increased susceptibility to infections based on anecdotal observations.
Methods: Time series of influenza and dengue surveillance were confronted with bacterial sepsis admissions to test the hypotheses. Monthly surveillance data on influenza and dengue and aggregated sepsis data in Cayenne hospital were matched between 24/10/2007 and 27/09/2016. An ARIMA (1,0,1) model was used.
Results: The series of the number of monthly cases of sepsis was positively associated with the monthly number of cases of influenza at time t (β=0.001, p=0.0359). Forecasts were imperfectly correlated with sepsis since influenza is not the only risk factor for sepsis. None of the ARIMA models showed a significant link between the dengue series and the sepsis series.
Conclusions: There was thus no link between dengue epidemics and sepsis but it was estimated that for every 1,000 cases of flu there was one additional case of sepsis. In this tropical setting, influenza was highly seasonal, and improved vaccination coverage could have benefits on sepsis.
REFERENCES
Hament J-M, Kimpen JL, Fleer A, Wolfs TF. Respiratory viral infection predisposing for bacterial disease: a concise review. FEMS Immunol Med Microbiol 1999;26:189-95. DOI: https://doi.org/10.1111/j.1574-695X.1999.tb01389.x
de Vries RD, Mesman AW, Geijtenbeek TB, et al. The pathogenesis of measles. Curr Opin Virol 2012;2:248-55. DOI: https://doi.org/10.1016/j.coviro.2012.03.005
Halstead SB. Dengue. Lancet 2007;370:1644-52. DOI: https://doi.org/10.1016/S0140-6736(07)61687-0
Pagliari C, Quaresma JAS, Fernandes ER, et al. Immunopathogenesis of dengue hemorrhagic fever: contribution to the study of human liver lesions. J Med Virol 2014;86:1193-97. DOI: https://doi.org/10.1002/jmv.23758
Hirve S, Lambach P, Paget J, et al. Seasonal influenza vaccine policy, use and effectiveness in the tropics and subtropics–a systematic literature review. Influenza Other Respir Viruses 2016;10:254-67. DOI: https://doi.org/10.1111/irv.12374
Lowen AC, Mubareka S, Steel J, Palese P. Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog 2007;3:1470-6. DOI: https://doi.org/10.1371/journal.ppat.0030151
Lowen AC, Steel J. Roles of humidity and temperature in shaping influenza seasonality. J Virol 2014;88:7692-5. DOI: https://doi.org/10.1128/JVI.03544-13
Siegel SJ, Roche AM, Weiser JN. Influenza promotes pneumococcal growth during coinfection by providing host sialylated substrates as a nutrient source. Cell Host Microbe 2014;16:55-67. DOI: https://doi.org/10.1016/j.chom.2014.06.005
WHO. Influenza. World Health Organization. Available from: http://www.who.int/immunization/diseases/influenza/en/
Grijalva CG, Griffin MR, Edwards KM, et al. The role of influenza and parainfluenza infections in nasopharyngeal pneumococcal acquisition among young children. Clin Infect Dis 2014;58:1369-76. DOI: https://doi.org/10.1093/cid/ciu148
Finelli L, Fiore A, Dhara R, et al. Influenza-associated pediatric mortality in the United States: increase of Staphylococcus aureus coinfection. Pediatrics 2008;122:805-11. DOI: https://doi.org/10.1542/peds.2008-1336
Lee LN, Dias P, Han D, et al. A mouse model of lethal synergism between influenza virus and Haemophilus influenzae. Am J Pathol 2010;176:800-11. DOI: https://doi.org/10.2353/ajpath.2010.090596
Mulder JR. Haemophilus influenzae and influenza virus in relation to bronchitis. J Pathol Bacteriol 1940;50:317-22. DOI: https://doi.org/10.1002/path.1700500212
Robinson KM, Lee B, Scheller EV, et al. The role of IL-27 in susceptibility to post-influenza Staphylococcus aureus pneumonia. Respir Res 2015;16:1-12. DOI: https://doi.org/10.1186/s12931-015-0168-8
Rameix-Welti M-A, Zarantonelli ML, Giorgini D, et al. Influenza A virus neuraminidase enhances meningococcal adhesion to epithelial cells through interaction with sialic acid-containing meningococcal capsules. Infect Immun 2009;77:3588-95. DOI: https://doi.org/10.1128/IAI.00155-09
Jensen ES, Lundbye-Christensen S, Samuelsson S, et al. A 20-year ecological study of the temporal association between influenza and meningococcal disease. Eur J Epidemiol 2004;19:181-7. DOI: https://doi.org/10.1023/B:EJEP.0000017659.80903.5f
Jacobs JH, Viboud C, Tchetgen ET, et al. The association of meningococcal disease with influenza in the United States, 1989–2009. PloS One 2014;9:e107486. DOI: https://doi.org/10.1371/journal.pone.0107486
Cartwright KAV, Jones DM, Kaczmarski E, et al. Influenza A and meningococcal disease. Lancet 1991;338:554-7. DOI: https://doi.org/10.1016/0140-6736(91)91112-8
Hubert B, Watier L, Garnerin P, Richardson S. Meningococcal disease and influenza-like syndrome: a new approach to an old question. J Infect Dis 1992;166:542-5. DOI: https://doi.org/10.1093/infdis/166.3.542
Agence Regionale de la Santé de Guyane. Epidemiological and virological description of influenza epidemics in French Guiana: reflecting on the vaccination calendar. Agence Regionale de la Santé de Guyane.
Boivin G, Hardy I, Tellier G, Maziade J. Predicting influenza infections during epidemics with use of a clinical case definition. Clin Infect Dis 2000;31:1166‑9. DOI: https://doi.org/10.1086/317425