Pneumococcal Infections

Baltimore, Robert S.; Shapiro, Eugene D.

doi:10.1007/978-1-4615-5327-4_29

Cited by 2 publications

(2 citation statements)

References 145 publications

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“…The bacterium has been subclassified into 94 different serotypes on the basis of the structure of its capsular polysaccharide. Each capsular polysaccharide induces type-specific antibodies [1]. …”

Section: Introductionmentioning

confidence: 99%

A mathematical model of serotype replacement in pneumococcal carriage following vaccination

Bottomley

Roca

Hill³

et al. 2013

J. R. Soc. Interface.

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A number of childhood vaccination programmes have recently introduced vaccination against Streptococcus pneumoniae, the pneumococcus, a major cause of pneumonia and meningitis. The pneumococcal conjugate vaccines (PCVs) that are currently in use only protect against some serotypes of the bacterium, and there is now strong evidence that those serotypes not included in the vaccine increase in prevalence among most vaccinated populations. We present a mathematical model for the dynamics of nasopharyngeal carriage of S. pneumoniae that allows for carriage with multiple serotypes. The model is used to predict the prevalence of vaccine type (VT) and non-VT (NVT) serotypes following the introduction of PCV. Parameter estimates for the model are obtained by maximum likelihood using pre-vaccination data from The Gambia. The model predicts that low (1, 6A and 9V) and medium (4, 5, 7F, 14, 18C, 19A and 19F) prevalence serotypes can be eliminated through vaccination, but that the overall prevalence of carriage will be reduced only slightly because of an increase in the prevalence of NVT serotypes. Serotype replacement will be sequential, with high and medium prevalence NVT serotypes dominating initially, followed by an increase of serotypes of low prevalence. We examine the impact of a hypothetical vaccine that provides partial protection against all serotypes, and find that this reduces overall carriage, but is unable to eliminate low or medium prevalence serotypes.

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Section: Introductionmentioning

confidence: 99%

A mathematical model of serotype replacement in pneumococcal carriage following vaccination

Bottomley

Roca

Hill³

et al. 2013

J. R. Soc. Interface.

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show abstract

“…In unimmunized populations, the incidence of invasive disease follows a well-known age distribution, peaking in the first 2 y of life, declining by more than an order of magnitude by the second and third decades of life, and then rising at an accelerating pace, with incidence in persons over 70 y approaching that in infants [5]. The reason for the decline in incidence has not been conclusively determined, yet it is often suggested that the acquisition of anticapsular antibodies plays a critical role in this decline [6,7]. Indeed, it has been proposed that the human immune system sees each serotype of Streptococcus pneumoniae as a distinct, independent pathogen [8].…”

Section: Introductionmentioning

confidence: 99%

Are Anticapsular Antibodies the Primary Mechanism of Protection against Invasive Pneumococcal Disease?

et al. 2005

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BackgroundAntibody to capsular polysaccharide has been the basis of several vaccines that offer protection against invasive disease from Streptococcus pneumoniae. The success of such vaccines has led to the inference that natural protection against invasive pneumococcal disease is largely conferred by anticapsular antibody. If this is so, one would expect that the decline in disease from different serotypes would vary significantly, and that the appearance of substantial concentrations of anticapsular antibodies would coincide temporally with the decline in age-specific incidence.Methods and FindingsUsing incidence data from the United States, we show that, on the contrary, the decline in incidence with age is quite similar for the seven most important serogroups, despite large differences in exposure in the population. Moreover, only modest increases in antibody concentration occur over the second and third years of life, a period in which serotype-specific incidence declines to less than 25% of its peak. We also present detailed data on the distribution of antibody concentrations in Israeli toddlers, which are consistent with the United States findings. The same conclusion is supported by new data on age-specific incidence in Finland, which is compared with published data on antibody acquisition in Finnish toddlers.ConclusionWe suggest some additional studies of the mechanisms of protection that could distinguish among potential alternative mechanisms, including acquired immunity to noncapsular antigens, maturation of nonspecific immune responses, or changes in anatomy or exposure.

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Pneumococcal Infections

Cited by 2 publications

References 145 publications

A mathematical model of serotype replacement in pneumococcal carriage following vaccination

A mathematical model of serotype replacement in pneumococcal carriage following vaccination

Are Anticapsular Antibodies the Primary Mechanism of Protection against Invasive Pneumococcal Disease?

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