Proportion of Invasive Pneumococcal Infections in German Children Preventable by Pneumococcal Conjugate Vaccines

Abstract

The incidence and serotype distribution of Streptococcus pneumoniae as a cause of invasive diseases are unknown with regard to most European countries. From January 1997 through December 1998, population-based nationwide prospective surveillance was undertaken for invasive pneumococcal disease (IPD) in children in Germany, based on monthly independent reports from all pediatric hospitals and from clinical microbiology laboratories. On the basis of 896 reported IPD cases (including 404 with meningitis), the incidences per 10(5) children in different age groups were as follows: children aged <1 year, 18.9 (9.7 for meningitis); children aged <2 years, 16. 0 (7.2 for meningitis); for children aged <5 years, 8.9 (3.9 for meningitis); and for children aged <16 years, 3.2 (1.4 for meningitis). The proportions of cases involving strains (304 serotyped) included in conjugate vaccines were as follows: for the 7-valent vaccine, 52%; for the 9-valent, 62%; and for the 11-valent, 71%. None of the isolates were resistant to penicillin or cefotaxime. Although the rate for meningitis is similar, other manifestations of IPD are less commonly diagnosed in Germany than in other countries. The serotype distribution only partially matched that used in the recent development of pneumococcal conjugate vaccines.

Molecular Epidemiology of Pneumococcal Carriage among Children with Upper Respiratory Tract Infections in Hanoi, Vietnam

“…Since several studies have demonstrated a cross-reactive effect against serotype 6A, we assume a cumulative rate of coverage of the conjugate vaccine of 83% (7,32). These data are comparable to those found in studies conducted in Europe and the United States, where rates of coverage of 60 to 80% are expected (17,19,21,31,33,39).…”

Impact of 10- and 13-valent pneumococcal conjugate vaccines on incidence of invasive pneumococcal disease in children aged under 16 years in Germany, 2009 to 2012

“…For countries with high blood culturing rates, and therefore a high proportion of non-meningitis IPD, aggregate estimates of PCV impact on IPD may mask a differential effect on meningitis IPD. Meningitis IPD, however, has a higher clinical relevance and public health impact because case fatality and sequelae rates are about fourfold higher than for non-meningitis IPD [6].…”

“…Although chance might be another explanation, given the wide 95% CIs of the IRRs, biological explanations related to the tropism of different pneumococcal serotypes appear more likely: German data collected in 1997-98 (during the pre-vaccination period) showed an about equal incidence of meningitis and non-meningitis IPD for serotypes 6A, 7F and 19A, whereas the incidence of serotypes 1, 3 and 5 was significantly higher in non-meningitis than in meningitis IPD [6]. A similar pattern was observed after the introduction of PCV in 2007 (data not shown).…”

“…It is managed by the German paediatric surveillance unit, Erhebungseinheit für seltene pädia-trische Erkrankungen (ESPED). In the laboratory sentinel surveillance, cases are reported through a web interface (PneumoWeb) hosted by the Robert Koch Institute [2,[6][7][8].…”

Rotavirus Disease in Germany—A Prospective Survey of Very Severe Cases

“…the true incidence might be twice as high because eSPed does not capture all cases as shown by capture-recapture analyses. 17,18 Comparing this incidence with the overall reported incidence of rV disease in the same age group in germany (115/10,000), 1 a vsrVd occurs in about 1% of all reported rV cases in children under 5 years of age. 19 the median duration of hospitalization (6 days) is considerably longer than the median duration of all reported hospitalized rV cases (2-3 days).…”