Incidence of Invasive Pneumococcal Disease among Individuals with Sickle Cell Disease before and after the Introduction of the Pneumococcal Conjugate Vaccine

Halasa, Natasha; Shankar, Sadhna; Talbot, Thomas R.; Arbogast, Patrick G.; Mitchel, Edward F.; Wang, Winfred C.; Schaffner, William; Craig, Allen S.; Griffin, Marie R.

doi:10.1086/516781

Cited by 215 publications

(186 citation statements)

References 35 publications

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“…The small percentage of children with invasive infections is likely attributable to the introduction of penicillin prophylaxis and pneumococcal and meningococcal vaccines. 19,20 Unfortunately, risk of infection still exists because of the emergence of nontypeable and nonvaccine strains of pneumococcus. 21,22 In the BABY HUG trial, all 3 S pneumoniae infections occurred in children not taking hydroxyurea.…”

Section: Discussionmentioning

confidence: 99%

Impact of hydroxyurea on clinical events in the BABY HUG trial

Thornburg

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Luo

et al. 2012

Blood

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The Pediatric Hydroxyurea Phase 3 Clinical Trial (BABY HUG) was a phase 3 multicenter, randomized, double-blind, placebocontrolled clinical trial of hydroxyurea in infants (beginning at 9-18 months of age) with sickle cell anemia. An important secondary objective of this study was to compare clinical events between the hydroxyurea and placebo groups. One hundred and ninetythree subjects were randomized to hy- Continuing Medical Education onlineThis activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and the American Society of Hematology. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™ . Physicians should claim only the credit commensurate with the extent of their participationin the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at http://www.medscape.org/journal/blood; and (4) view/print certificate. For CME questions, see page 4448. Disclosures The authors, the Associate Editor Narla Mohandas, and CME questions author Laurie Barclay, freelance writer and reviewer, Medscape, LLC, declare no competing financial interests. Learning objectivesUpon completion of this activity, participants will be able to:1. Describe the effect of hydroxyurea on rates of sickle cell complications for infants with sickle cell anemia (SCA) on the basis of a phase 3, multicenter, randomized trial.2. Describe the effect of hydroxyurea on rates of hospitalizations and transfusions for infants with SCA on the basis of a phase 3, multicenter, randomized trial.3. Describe the safety of hydroxyurea for infants with SCA on the basis of a phase 3, multicenter, randomized trial.

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Section: Discussionmentioning

confidence: 99%

Impact of hydroxyurea on clinical events in the BABY HUG trial

Thornburg

Files

Luo

et al. 2012

Blood

229

185

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“…Before the use of conjugated pneumococcal vaccine (PCV7; 1995-1999), the rate of pneumococcal bacteremia was 2,004 per 100,000 person years in children with SCD <5 years of age. After the use of PCV7 (2001)(2002)(2003)(2004), the rate of pneumococcal bacteremia decreased by 93.4% in children aged <5 years to 134 cases per 100,000 person-years; P < 0.001 [44].…”

Section: Advances In Vaccination Against Streptococcus Pneumoniae Andmentioning

confidence: 99%

Evolution of sickle cell disease from a life‐threatening disease of children to a chronic disease of adults: The last 40 years

2015

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Over the past 40 years, public health measures such as universal newborn screening, penicillin prophylaxis, vaccinations, and hydroxyurea therapy have led to an impressive decline in sickle cell disease (SCD)-related childhood mortality and SCD-related morbidity in high-income countries. We remain cautiously optimistic that the next 40 years will be focused on meeting current challenges in SCD by addressing chronic complications of SCD to reduce mortality and improve quality of life in a growing population of adults with SCD in high-income countries, while simultaneously decreasing the disparity of medical care between high and low-income countries.

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“…Overwhelming blood infections may be largely prevented by pneumococcal prophylaxis, which includes the conjugate pneumococcal vaccine at 2, 4, and 6 mo (Halasa et al 2007), and regular penicillin (Gaston et al 1986) although there are concerns that the conjugate vaccine may select nonvaccine serotypes (McCavit et al 2011). Acute splenic sequestration may commence as early as 3 mo of age but is most common in the second 6 mo of life; two-thirds of attacks occur before 2 yr of age, and events become rare after 6 yr of age.…”

Section: Clinical Features the First Yearmentioning

confidence: 99%