Retreat of the pneumococcus?

Abstract

This Supplement includes the most comprehensive data available on pneumococcal disease in Australia, demonstrating a considerable disease burden that could be reduced by vaccination

Laboratory surveillance of invasive pneumococcal disease in New South Wales, Australia, before and after introduction of 7-valent conjugate vaccine: reduced disease, but not antibiotic resistance rates

“…3/100 000 in children aged <5 years). Of 2271 cases notified, 44% presented with pneumonia, 5% with meningitis and 35 % with unlocalized bacteraemia [2,3].…”

Invasive pneumococcal disease in the Kimberley, 1995–2001

“…1,2 The 13% fatality rate observed in the Kimberley is comparable with that reported elsewhere. 7,10 IPD incidence in Kimberley Aboriginal adults decreased from 98/100 000 py in 1997 to 38/100 000 py in 2001. This was slightly smaller than the decrease, from 110/ 100 000 py to 28/100 000 py, observed in far north Queensland 7 years after a vaccination program was introduced.…”

Invasive pneumococcal disease in the Australian Capital Territory and Queanbeyan region: Do high infant rates reflect more disease or better detection?

“…Substantial differences in IPD rates between Europe and the USA have been attributed to differences in blood culture collection practices, as European and North American rates of pneumococcal meningitis are comparable 35 . Pneumococcal meningitis is a useful marker of IPD prevalence because rates of diagnosis are likely to be less dependent on diagnostic effort than other forms of IPD 4 . In developed countries nearly all cases are likely to be detected by hospital‐based or laboratory‐based surveillance.…”

“…Comparable rates for NSW were 1.8% (3.75% of children under 5 years), and for the whole of Australia 2.0% (4.3% of children under 5 years) 36−38 . Chronic illness is a major risk factor for IPD, but underlies only a small minority of cases in infants 4 .…”

“…As a result, regional surveillance studies often report rates of invasive pneumococcal disease (IPD), defined as isolation of S. pneumoniae from a normally sterile site such as blood, cerebrospinal fluid (CSF) or synovial fluid. This is an easily measured and objective marker of the ‘severe end’ of the spectrum of pneumococcal disease in the community 4 .…”