Invasive pneumococcal disease and pandemic (H1N1) 2009, Denver, Colorado, USA

Emerg Infect Dis. 2012 Feb;18(2):208-16. doi: 10.3201/eid1802.110714.


Pneumococcal pneumonia was a complication during previous influenza pandemics but was not evident initially during pandemic (H1N1) 2009. During October 2009 in Denver, Colorado, USA, invasive pneumococcal disease (IPD) and pandemic (H1N1) 2009 peaked simultaneously, which suggests a link. We compared cases of IPD in October 2009 with cases in February 2009, the most recent peak month of seasonal influenza. During October 2009, we observed 58 IPD cases, which was 3× the average number of IPD cases that usually occur in October in Denver. Patients with IPD in October 2009 were younger and more likely to have chronic lung disease than patients who had IPD in February 2009; a total of 10/47 patients had influenza, and 33/53 patients had influenza-like illness. Thus, ≈17%-62% cases of IPD may have been associated with pandemic (H1N1) 2009. Pneumococcal disease prevention strategies should be emphasized during future influenza pandemics.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Colorado / epidemiology
  • Female
  • Humans
  • Infant
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human / complications*
  • Influenza, Human / epidemiology
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Pneumococcal / epidemiology
  • Pneumonia, Pneumococcal / etiology*
  • Pneumonia, Pneumococcal / microbiology
  • Streptococcus pneumoniae*
  • Young Adult