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Increased incidence of adult pneumococcal pneumonia during school holiday periods

Daniel, Priya; Rodrigo, Chamira; Bewick, Thomas; Sheppard, Carmen; Greenwood, Sonia; McKeever, Tricia M.; Slack, Mary; Lim, Wei Shen


Priya Daniel

Chamira Rodrigo

Thomas Bewick

Carmen Sheppard

Sonia Greenwood

Professor of Epidemiology and Medical Statistics

Mary Slack

Wei Shen Lim


Child contact is a recognised risk factor for adult pneumococcal disease. Peaks in invasive pneumococcal disease incidence observed during winter holidays may be related to changes in social dynamics. This analysis was conducted to examine adult pneumococcal community-acquired pneumonia (CAP) incidence during school holiday periods.Between September 2008 and 2013, consecutive adults admitted to hospitals covering the Greater Nottingham area with a diagnosis of CAP were studied. Pneumococcal pneumonia was detected using culture and antigen detection methods.Of 2221 adults studied, 575 (25.9%) were admitted during school holidays and 643 (29.0%) had pneumococcal CAP. CAP of pneumococcal aetiology was significantly more likely in adults admitted during school holidays compared to term time (35.3% versus 26.7%; adjusted OR 1.38, 95% CI 1.11–1.72, p=0.004). Over the 5-year period, the age-adjusted incidence of hospitalised pneumococcal CAP was higher during school holidays compared to term time (incident rate ratio 1.35, 95% CI 1.14–1.60, p<0.001); there was no difference in rates of all-cause CAP or non-pneumococcal CAP. Reported child contact was higher in individuals with pneumococcal CAP admitted during school holidays compared to term time (42.0% versus 33.7%, OR 1.43, 95% CI 1.00–2.03, p=0.046).Further study of transmission dynamics in relation to these findings and to identify appropriate intervention strategies is warranted.School holiday periods are associated with an increased incidence of adult pneumococcal community-acquired pneumonia


Daniel, P., Rodrigo, C., Bewick, T., Sheppard, C., Greenwood, S., McKeever, T. M., …Lim, W. S. (2017). Increased incidence of adult pneumococcal pneumonia during school holiday periods. ERJ Open Research, 3(1),

Journal Article Type Article
Acceptance Date Dec 31, 2016
Publication Date Jan 1, 2017
Deposit Date Mar 15, 2017
Publicly Available Date Mar 15, 2017
Journal ERJ Open Research
Electronic ISSN 2312-0541
Publisher European Respiratory Society
Peer Reviewed Peer Reviewed
Volume 3
Issue 1
Public URL
Publisher URL


Daniel 2017 ERJ Open Rearch.pdf (418 Kb)

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