Invasive pneumococcal disease among children in Victoria
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Published on: February 23, 2014
Min Liu1, Ross Andrews, Joanne Stylianopoulos
1Public Heath Training Scheme, Department of Human Services, Victoria. min.liu@dhs.vic.gov.au
Insights
Invasive pneumococcal disease (IPD) surveillance in Victoria found high rates in children under two. Most cases involved vaccine-preventable serotypes, yet few children were vaccinated, suggesting expanded public funding is needed.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Enhanced surveillance of invasive pneumococcal disease (IPD) was implemented in Victoria.
- Focus on children under five years of age to understand infection risks and vaccination status.
Purpose of the Study:
- Analyze IPD notification data from the first year of enhanced surveillance.
- Identify risk factors and vaccination status in children under five.
- Evaluate the impact of the 7-valent conjugate pneumococcal vaccine (7vPCV) program.
Main Methods:
- Analysis of IPD notification data from July 1, 2001, to June 30, 2002.
- Calculation of notification rates by age group.
- Assessment of clinical presentations, hospitalization, and mortality.
- Serotype analysis and comparison with 7vPCV vaccine components.
Main Results:
- 397 IPD notifications, with 131 in children under five.
- Highest rates in children under two years (72.6 per 100,000).
- Bacteraemia was the most common presentation (64%); 89% hospitalized; 3% died.
- 92% of known serotypes were vaccine-related, but 98% of cases were ineligible for funded vaccination.
Conclusions:
- IPD poses a significant burden on young children in Victoria.
- The majority of IPD cases were caused by serotypes covered by 7vPCV.
- Current publicly funded vaccination program in Victoria has limited reach; expansion to all children under two should be considered.
Abstract:
This study analysed notification data from the first year of enhanced surveillance of invasive pneumococcal disease (IPD) in Victoria (1 July 2001 - 30 June 2002), with a focus on risk factors for infection and vaccination status among children under five years of age. Overall, there were 397 notifications (8.2 per 100,000 population), 131 (33%) were children under five years of age. The highest notification rates were among those aged less than two years (72.6 per 100,000 population). Among children aged less than five years: bacteraemia without a primary focus of infection was the most common clinical presentation (64%); 89 per cent were hospitalised with the median length of stay being three days; four children (3%) died. There were 107 cases of a known serotype, 92% (n = 98) were either in or closely related to those included in the 7-valent conjugate pneumococcal vaccine (7vPCV). Most cases (98%) were not eligible for free 7vPCV under the currently funded program in Victoria. Only one child had been vaccinated. The results from the first year of enhanced IPD surveillance in Victoria suggest consideration should be given to extending the publicly funded program to include all children under two years of age.
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