Invasive Pneumococcal Disease Caused by Nonvaccine Serotypes Among Alaska Native Children With High Levels of 7-Valent Pneumococcal Conjugate Vaccine Coverage

Singleton, Rosalyn; Hennessy, Thomas W.; Bulkow, Lisa; Hammitt, Laura L.; Zulz, Tammy; Hurlburt, Debby; Butler, Jay C.; Rudolph, Karen; Parkinson, Alan J.

doi:10.1001/jama.297.16.1784

Cited by 563 publications

(466 citation statements)

References 34 publications

(63 reference statements)

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“…Although pneumococcal vaccine (PCV)-7 programs have significantly reduced pneumonia rates, its impact on some populations has been Page 10 of 27 A c c e p t e d M a n u s c r i p t 10 negligible. 35,40 Despite achieving high population PCV-7 vaccination coverage rates of ~90%, the incidence of WHO-defined radiological pneumonia in indigenous children living in the Northern Territory (Australia) was not significantly reduced. Among AN children, the serotypes of pneumococcus causing pneumonia transitioned to those uncovered by PCV-7 with no decrease in the frequency of pneumococcal pneumonia related hospitalizations.…”

Section: Pneumoniamentioning

confidence: 99%

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Lung disease in indigenous children

Chang

Brown

Toombs

et al. 2014

Paediatric Respiratory Reviews

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A c c e p t e d M a n u s c r i p t 2 EDUCATIONAL AIMSThe reader will be able to:• Discuss the common respiratory problems encountered by indigenous children.• Appreciate the similarities and differences in the aetiology, associations and management of these common respiratory problems.• Understand the many facets that impact on the clinical outcomes of common respiratory conditions affecting indigenous children.• Discuss potential intervention targets that can reduce the morbidity and mortality of respiratory diseases in indigenous children. Page 3 of 27A c c e p t e d M a n u s c r i p t 3 SUMMARY Children in indigenous populations have substantially higher respiratory morbidity than nonindigenous children. Indigenous children have more frequent respiratory infections that are, more severe and, associated with long-term sequelae. Post-infectious sequelae such as chronic suppurative lung disease and bronchiectasis are especially prevalent among indigenous groups and have lifelong impact on lung function. Also, although estimates of asthma prevalence among indigenous children are similar to non-indigenous groups the morbidity of asthma is higher in indigenous children. To reduce the morbidity of respiratory illness, best-practice medicine is essential in addition to improving socio-economic factors, (eg household crowding), tobacco smoke exposure, and access to health care and illness prevention programs that likely contribute to these issues. Although each indigenous group may have unique health beliefs and interfaces with modern health care, a culturally sensitive and community-based comprehensive care system of preventive and long term care can improve outcomes for all these conditions. This article focuses on common respiratory conditions encountered by indigenous children living in affluent countries where data is available.

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Section: Pneumoniamentioning

confidence: 99%

“…Among AN children, the serotypes of pneumococcus causing pneumonia transitioned to those uncovered by PCV-7 with no decrease in the frequency of pneumococcal pneumonia related hospitalizations. 35,40 The effect of PCV-13 remains unknown.…”

Section: Pneumoniamentioning

confidence: 99%

Lung disease in indigenous children

Chang

Brown

Toombs

et al. 2014

Paediatric Respiratory Reviews

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“…The conjugate vaccines have shown higher efficacy for invasive infections compared to polysaccharide vaccines; but have lower levels of protection against mucosal diseases, such as pneumonia. Furthermore, these vaccines do not protect against non-vaccine serotypes, which has led to the emergence of diseases caused by these serotypes (Hicks et al, 2007;Singleton et al, 2007). Moreover, conjugate vaccines are expensive, complicated and time consuming to manufacture thus limiting their usage especially in the low and middle income countries (LMICs) where a significant burden of the disease is reported (Walker et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary dry powder vaccine of pneumococcal antigen loaded nanoparticles

Kunda

Alfagih

Miyaji

et al. 2015

International Journal of Pharmaceutics

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Pneumonia, caused by Streptococcus pneumoniae, mainly affects the immune compromised, the very young and the old, and remains one of the leading causes of death.A steady rise in disease numbers from non-vaccine serotypes necessitates a new vaccine formulation that ideally has better antigen stability and integrity, does not require cold-chain and can be delivered non-invasively. In this study, a dry powder vaccine containing an important antigen of S. pneumoniae, pneumococcal surface protein A (PspA) that has shown cross-reactivity amongst serotypes to be delivered via the pulmonary route has been formulated. The formulation contains the antigen PspA adsorbed onto the surface of polymeric nanoparticles encapsulated in L-leucine microparticles that can be loaded into capsules and delivered via an inhaler. We have successfully synthesized particles of ~150 nm and achieved ~ 20 µg of PspA adsorption per mg of NPs. In addition, the spray-dried powders displayed a FPF of 74.31±1.32% and MMAD of 1.70±0.03 μm suggesting a broncho-alveolar lung deposition facilitating the uptake of the nanoparticles by dendritic cells. Also, the PspA released from the dry powders maintained antigen stability (SDS-PAGE), integrity (Circular dichroism) and activity (lactoferrin binding assay). Moreover, the released antigen also maintained its antigenicity as determined by ELISA.

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“…The 'Center for Disease Control' and several groups have documented that the number of pneumococcal infections caused by non PCV7 vaccine serotypes is increasing, primarily serotype 19A [3,9,13,15,16,18,19]. Moreover, multidrug antibiotic resistance among the 19A serotype isolates has become a major concern [13][14][15][16].…”

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confidence: 99%

Pneumococcal vaccination: time to move on?

Proesmans

2010

Eur J Pediatr

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Invasive Pneumococcal Disease Caused by Nonvaccine Serotypes Among Alaska Native Children With High Levels of 7-Valent Pneumococcal Conjugate Vaccine Coverage

Cited by 563 publications

References 34 publications

Lung disease in indigenous children

Lung disease in indigenous children

Pulmonary dry powder vaccine of pneumococcal antigen loaded nanoparticles

Pneumococcal vaccination: time to move on?

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