Pneumococcal population structure influences the effects of air pollution on invasive disease risk in South Africa

Short summary

Invasive pneumococcal disease (IPD) risk increased by 5% with moderate humidity (33–49%) and 4% with cold minimum temperatures (4–10 °C) over 8 weeks, while warm maximum temperatures (27–38 °C) increased risk by up to 10% within a week. Air pollution (PM 2.5) also positively associated with IPD, with specific serotypes (4, 8, 23F) and the GPSC21 lineage showing immediate risk following exposure.

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