International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Temporal association and seasonal variation of respiratory viruses and invasive group A streptococcal infections in western Sweden: A 15-year analysis across pre- and post-pandemic periods.
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Nygren Maria, Dahlgren Henrik Mellström, Gustavsson Lars, Snygg-Martin Ulrika, Sundell Nicklas, Pettersson Magnus, Westin Johan
Аннотация
OBJECTIVES: To examine the seasonal variation of invasive group A streptococcal infections (iGAS) in relation to respiratory viral circulation, with special reference to pandemic restrictions, and to assess whether increases in viral activity may explain recent increases in iGAS.
METHODS: We performed a time-series analysis using a multivariate negative binomial regression model, with weekly counts of respiratory virus detections as the independent variable and weekly counts of iGAS cases as the dependent variable, covering the period from January 2010 to December 2024.
RESULTS: We found a significant association between influenza and iGAS, with increases in influenza activity followed by an increase in iGAS cases. The association was strongest at a 2-week time lag. Influenza A (incidence rate ratio 1.0050, P <0.001) and influenza B (incidence rate ratio 1.0133, P <0.001) were both independent predictors of the number of iGAS reported 2 weeks later. The proportion of iGAS cases related to influenza activity was 21.7% before and 23.4% after the pandemic. The iGAS incidence declined by 76% during the period of COVID-19 restrictions.
CONCLUSION: Annual influenza epidemics appear to contribute to seasonal increases in iGAS cases. Preventive measures aimed at reducing influenza spread may have a potential to reduce iGAS incidence.
METHODS: We performed a time-series analysis using a multivariate negative binomial regression model, with weekly counts of respiratory virus detections as the independent variable and weekly counts of iGAS cases as the dependent variable, covering the period from January 2010 to December 2024.
RESULTS: We found a significant association between influenza and iGAS, with increases in influenza activity followed by an increase in iGAS cases. The association was strongest at a 2-week time lag. Influenza A (incidence rate ratio 1.0050, P <0.001) and influenza B (incidence rate ratio 1.0133, P <0.001) were both independent predictors of the number of iGAS reported 2 weeks later. The proportion of iGAS cases related to influenza activity was 21.7% before and 23.4% after the pandemic. The iGAS incidence declined by 76% during the period of COVID-19 restrictions.
CONCLUSION: Annual influenza epidemics appear to contribute to seasonal increases in iGAS cases. Preventive measures aimed at reducing influenza spread may have a potential to reduce iGAS incidence.