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Impact of the 7-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in infants younger than 90 days in England and Wales.
MedLine Citation:
PMID:  23175560     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. Streptococcus pneumoniae is an uncommon but well-recognized cause of invasive bacterial disease in young infants. This study aimed to determine the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) on invasive pneumococcal disease (IPD) in infants <90 days in England and Wales and describe their clinical characteristics following PCV7 introduction.Methods. Trends in IPD among infants aged <90 days during 1998/99-2009/10 were analysed using enhanced national surveillance data. Following PCV7 introduction, clinical information was also obtained for IPD cases in the birth cohorts eligible for vaccination.Results. Prior to PCV7 introduction, IPD incidence in infants aged <90 days was 13.0 (95% CI, 12.0-14.0) per 100,000 live births and PCV7 serotypes accounted for 44% (154/349) of serotyped isolates. PCV7 introduction resulted in 83% (95% CI, 66-91%; P<0.001) reduction in PCV7-IPD and a declining trend in overall IPD by 2009/10. Of the 256 cases diagnosed after PCV7 introduction, 23% (n=60) had been born before 37 weeks gestation. A third of cases (84/256, 33%) developed IPD in the first 48 hours of life, where 42% (35/84) were premature. Meningitis was diagnosed in 94 infants (37%) and its prevalence increased with age. Pneumococcal-attributable case fatality was 7% (18/256) and was higher for meningitis than non-meningitis cases (adjusted OR 3.8, 95% CI, 1.2-12.0, P=0.024)Conclusions. Young infants have benefited from PCV7 through indirect (herd) protection. Given that a third of cases occurred within 48 hours of birth, further studies should focus on risk factors for IPD in pregnancy and strategies to prevent mother-to-child transmission.
Authors:
Shamez N Ladhani; Nick J Andrews; Pauline Waight; Ray Borrow; Mary P E Slack; Elizabeth Miller
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-21
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:  2012-11-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Health Protection Services Colindale, London NW9 5EQ, United Kingdom.
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