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Infant Pneumococcal Carriage During Influenza, RSV, and hMPV Respiratory Illness Within a Maternal Influenza

Alastair F Murray1, Janet A Englund2,3, Jane Kuypers4

  • 1School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia.

The Journal of Infectious Diseases
|May 7, 2019
PubMed

Insights

Maternal influenza vaccination reduced pneumococcal carriage in infants with influenza. This suggests prenatal flu shots may help prevent co-infections in infants during respiratory illness seasons.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Vaccinology

Background:

  • Pneumococcal carriage is a precursor to invasive pneumococcal disease.
  • Influenza and other respiratory viruses can increase the risk of secondary bacterial infections, including pneumococcal disease.
  • Prenatal influenza vaccination is recommended to protect mothers and infants.

Purpose of the Study:

  • To analyze the impact of maternal influenza vaccination on infant pneumococcal carriage during respiratory viral infections.
  • To determine if pneumococcal carriage affects the severity of lower respiratory tract disease caused by influenza, RSV, or hMPV in infants.

Main Methods:

  • Post-hoc analysis of a randomized prenatal influenza vaccination trial in Nepal.
  • Infant respiratory illness surveillance and midnasal pneumococcal carriage detection.
  • Comparison of pneumococcal carriage rates between infants born to vaccinated and placebo-group mothers.

Main Results:

  • Pneumococcus was detected in 75.5% of infants with influenza, RSV, or hMPV illness.
  • Pneumococcal carriage did not influence lower respiratory tract disease rates for these viruses.
  • Influenza-infected infants born to vaccinated mothers had significantly lower pneumococcal carriage (58.1%) than those born to placebo mothers (71.6%).

Conclusions:

  • Maternal influenza immunization may reduce pneumococcal acquisition in infants during influenza infections.
  • Prenatal influenza vaccination could be a strategy to mitigate co-infections in infants.
  • Further research is warranted to explore the mechanisms and broader implications of this finding.

Keywords:
RSVhMPVinfluenzamaternal immunizationpneumococcusvaccine

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