The Epidemiology of Invasive Pneumococcal Disease in Alaska, 1986-1990 Ethnic Differences and Opportunities for Prevention

Abstract

To assess prevention strategies for pneumococcal disease in Alaska, prospective surveillance during 1986-1990 identified 672 invasive pneumococcal infections, including 315 among Alaska Natives. Age-adjusted annual incidence was 74 per 100,000 for Alaska Natives and 16 per 100,000 for nonnatives. The annual incidence in Alaska Native children < 2 years old was 624 per 100,000; rates of 84 per 100,000 for meningitis and 290 per 100,000 for bacteremic pneumonia were 8-10 times higher than for other US groups. By age 75, cumulative incidence (7%) and mortality (1%) in Alaska Natives were almost 4 times higher than for nonnatives. Only 17% of Alaska Native adults with predisposing conditions and invasive infections previously received pneumococcal vaccine. For Alaska Natives, a proposed heptavalent conjugate pneumococcal vaccine will include serotypes responsible for 85% of invasive isolates from children < 2 years but only 32% of those from adults. The 23-valent polysaccharide pneumococcal vaccine, which contains > 94% of serotypes identified in Alaska Native toddlers and adults, should be used more widely.

Outbreak of Pneumococcal Pneumonia among Military Recruits

“…In certain populations and ethnic groups [4,5], the incidence may be increased 10 fold. It is a disease of continuing endemicity particularly in infancy and old age [6].…”

Establishing a laboratory for surveillance of invasive bacterial infections in a tertiary care government hospital in a rural province in the Philippines.

“…Streptococcus pneumoniae and H. influenzae were isolated from blood of 12 and 11 (1.3% and 1.2%) of the patients, respectively. Other unequivocal pathogens isolated were S. pyogenes (1), Salmonella typhi (2), and Salmonella Group B (2) (see Table 4 for other findings). Streptococcus pneumoniae and H. influenzae were isolated from the CSF of three and seven patients, respectively (Table 4).…”

“…The term invasive infection is practically defined as a bacterial infection, in which the causative agent has been isolated from blood, cerebrospinal fluid (CSF), or other normally sterile body fluid or site. [1][2][3] Etiologic diagnosis of invasive bacterial infections is important for epidemiologic and clinical reasons. Etiologic diagnosis gives an exact case definition for epidemiologic research and for planning and implementing preventive measures (improved water supply and sanitation, vaccination).…”

Population-based Survey of Invasive Bacterial Diseases, Greenland, 1995–2004

“…The clinical extent of invasive disease caused by S. pneumoniae is severe; sequelae and case-fatality rates are almost 4× higher in native than in nonnative populations (1,4). As living conditions in Arctic populations in many ways are comparable, an international, cooperative, population-based surveillance for invasive diseases was established in 1999 (5).…”