Document Detail

Epidemiology of Invasive Pneumococcal Disease among High-Risk Adults since Introduction of Pneumococcal Conjugate Vaccine for Children.
MedLine Citation:
PMID:  23155149     Owner:  NLM     Status:  Publisher    
Background. Certain chronic diseases increase risk for invasive pneumococcal disease (IPD) and are indications for receipt of 23-valent pneumococcal polysaccharide vaccine (PPV23). Since the pediatric introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, incidence of IPD among adults has declined. The relative magnitude of these indirect effects among persons with and without PPV23 indications is unknown.Methods. We evaluated IPD incidence among adults with and without PPV23 indications using population- and laboratory-based data collected during 1998-2009 and estimates of the denominator populations with PPV23 indications from the National Health Interview Survey. We compared rates before and after PCV7 use by age, race, PPV23 indication and serotype.Results. The proportion of adult IPD cases with PPV23 indications increased from 51% before to 61% after PCV7 introduction (p<0.0001). PCV7-serotype IPD declined among all race, age and PPV23 indication strata, ranging from 82-97%. Overall IPD rates declined in most strata, by up to 65%. However, incidence remained highest among adults with PPV23 indications compared to those without (34.9 vs. 8.8 cases per 100,000 population, respectively). Apart from age ≥65 years, diabetes is now the most common indication for PPV23 (20% of all cases vs. 10% of cases in 1998-99).Conclusions. Although IPD rates have declined among adults, adults with underlying conditions remain at increased risk of IPD and comprise a larger proportion of adult IPD cases in 2009 compared to 2000. A continued increase in the prevalence of diabetes among U.S. adults could lead to increased burden of pneumococcal disease.
Riyadh D Muhammad; Reena Oza-Frank; Elizabeth Zell; Ruth Link-Gelles; K M Venkat Narayan; William Schaffner; Ann Thomas; Catherine Lexau; Nancy M Bennett; Monica M Farley; Lee H Harrison; Arthur Reingold; James Hadler; Bernard Beall; Keith P Klugman; Matthew R Moore
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-15
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Respiratory Diseases Branch, Centers for Disease Control and Prevention.
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