Temporary Increase in Incidence of Invasive Infection Due to Streptococcus pneumoniae in the Netherlands

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Abstract
In 1996 and 1997, the Netherlands Reference Laboratory for Bacterial Meningitis (Amsterdam) noted an increase in Streptococcus pneumoniae isolates from blood but not from CSF [1]. To find an explanation for this increase, we determined the incidence of invasive pneumococcal disease detected in the period 1991–1998 by 6 regional public health laboratories covering 18% of the Dutch population (15.4 million inhabitants in 1994). Subsequently, we related this incidence to the inci-dence of influenza and the severity of the winters in the study period [2].