{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:31:57Z","timestamp":1790317917286,"version":"4.1.0"},"reference-count":43,"publisher":"National Academy of Sciences","issue":"5","license":[{"start":{"date-parts":[[2019,7,14]],"date-time":"2019-07-14T00:00:00Z","timestamp":1563062400000},"content-version":"vor","delay-in-days":181,"URL":"https:\/\/www.pnas.org\/site\/aboutpnas\/licenses.xhtml"}],"content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2019,1,29]]},"abstract":"<jats:p>\n                    Infections caused by\n                    <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                    \u2014including invasive pneumococcal diseases (IPDs)\u2014remain a significant public health concern worldwide. The marked winter seasonality of IPDs is a striking, but still enigmatic aspect of pneumococcal epidemiology in nontropical climates. Here we confronted age-structured dynamic models of carriage transmission and disease with detailed IPD incidence data to test a range of hypotheses about the components and the mechanisms of pneumococcal seasonality. We find that seasonal variations in climate, influenza-like illnesses, and interindividual contacts jointly explain IPD seasonality. We show that both the carriage acquisition rate and the invasion rate vary seasonally, acting in concert to generate the marked seasonality typical of IPDs. We also find evidence that influenza-like illnesses increase the invasion rate in an age-specific manner, with a more pronounced effect in the elderly than in other demographics. Finally, we quantify the potential impact of seasonally timed interventions, a type of control measures that exploit pneumococcal seasonality to help reduce IPDs. Our findings shed light on the epidemiology of pneumococcus and may have notable implications for the control of pneumococcal infections.\n                  <\/jats:p>","DOI":"10.1073\/pnas.1812388116","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T20:53:14Z","timestamp":1547499194000},"page":"1802-1807","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":58,"title":["Unraveling the seasonal epidemiology of pneumococcus"],"prefix":"10.1073","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9302-4858","authenticated-orcid":false,"given":"Matthieu","family":"Domenech de Cell\u00e8s","sequence":"first","affiliation":[{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, Universit\u00e9 de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Universit\u00e9 Paris-Saclay, F75724 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Arduin","sequence":"additional","affiliation":[{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, Universit\u00e9 de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Universit\u00e9 Paris-Saclay, F75724 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"L\u00e9vy-Bruhl","sequence":"additional","affiliation":[{"name":"Direction des Maladies Infectieuses, Sant\u00e9 Publique France, F94415 Saint-Maurice, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scarlett","family":"Georges","sequence":"additional","affiliation":[{"name":"Direction des Maladies Infectieuses, Sant\u00e9 Publique France, F94415 Saint-Maurice, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Souty","sequence":"additional","affiliation":[{"name":"Institut Pierre Louis d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique (UMR-S1136), Sorbonne Universit\u00e9, INSERM, F75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Guillemot","sequence":"additional","affiliation":[{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, Universit\u00e9 de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Universit\u00e9 Paris-Saclay, F75724 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Watier","sequence":"additional","affiliation":[{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, Universit\u00e9 de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Universit\u00e9 Paris-Saclay, F75724 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulla","family":"Opatowski","sequence":"additional","affiliation":[{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, Universit\u00e9 de Versailles Saint-Quentin-en-Yvelines, Institut Pasteur, Universit\u00e9 Paris-Saclay, F75724 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2019,1,14]]},"reference":[{"key":"e_1_3_4_1_2","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1586\/erv.12.53","article-title":"The fundamental link between pneumococcal carriage and disease","volume":"11","author":"Simell B","year":"2012","unstructured":"B Simell, , The fundamental link between pneumococcal carriage and disease. Expert Rev Vaccines; Pneumococcal Carriage Group 11, 841\u2013855 (2012).","journal-title":"Expert Rev Vaccines"},{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1016\/S0140-6736(10)62225-8","article-title":"Serotype replacement in disease after pneumococcal vaccination","volume":"378","author":"Weinberger DM","year":"2011","unstructured":"DM Weinberger, R Malley, M Lipsitch, Serotype replacement in disease after pneumococcal vaccination. Lancet 378, 1962\u20131973 (2011).","journal-title":"Lancet"},{"key":"e_1_3_4_3_2","doi-asserted-by":"crossref","first-page":"e744","DOI":"10.1016\/S2214-109X(18)30247-X","article-title":"Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: Global, regional, and national estimates for 2000-15","volume":"6","author":"Wahl B","year":"2018","unstructured":"B Wahl, , Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: Global, regional, and national estimates for 2000-15. Lancet Glob Health 6, e744\u2013e757 (2018).","journal-title":"Lancet Glob Health"},{"key":"e_1_3_4_4_2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1093\/cid\/cit726","article-title":"Editorial commentary: Seasonal changes in pneumococcal disease\u2014Still much of an enigma","volume":"58","author":"van Hoek AJ","year":"2014","unstructured":"AJ van Hoek, E Miller, Editorial commentary: Seasonal changes in pneumococcal disease\u2014Still much of an enigma. Clin Infect Dis 58, 195\u2013196 (2014).","journal-title":"Clin Infect Dis"},{"key":"e_1_3_4_5_2","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1093\/aje\/kwx336","article-title":"Characterizing and comparing the seasonality of influenza-like illnesses and invasive pneumococcal diseases using seasonal waveforms","volume":"187","author":"Domenech de Cell\u00e8s M","year":"2018","unstructured":"M Domenech de Cell\u00e8s, , Characterizing and comparing the seasonality of influenza-like illnesses and invasive pneumococcal diseases using seasonal waveforms. Am J Epidemiol 187, 1029\u20131039 (2018).","journal-title":"Am J Epidemiol"},{"key":"e_1_3_4_6_2","doi-asserted-by":"crossref","first-page":"e1001042","DOI":"10.1371\/journal.pmed.1001042","article-title":"Evaluation of coseasonality of influenza and invasive pneumococcal disease: Results from prospective surveillance","volume":"8","author":"Kuster SP","year":"2011","unstructured":"SP Kuster, AR Tuite, JC Kwong, A McGeer, DN Fisman, Evaluation of coseasonality of influenza and invasive pneumococcal disease: Results from prospective surveillance. 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