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Updated: Mar 26, 2026

Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43
Published on: September 11, 2020
Epidemiology of Serotype 1 Invasive Pneumococcal Disease, South Africa, 2003-2013
Insights
Pneumococcal conjugate vaccine (PCV) introduction in South Africa impacted Streptococcus pneumoniae serotype 1 disease. Serotype 1 invasive pneumococcal disease (IPD) showed distinct features and decreased incidence post-PCV13 introduction.
Area of Science:
- Epidemiology
- Infectious Diseases
- Vaccinology
Background:
- South Africa introduced 7-valent pneumococcal conjugate vaccine (PCV) in 2009, replaced by 13-valent PCV (PCV13) in 2011.
- Understanding the epidemiology of Streptococcus pneumoniae serotype 1 invasive pneumococcal disease (IPD) is crucial for public health interventions.
Observation:
- A decade of laboratory-based IPD surveillance (2003-2013) in South Africa monitored serotype 1 disease.
- Two distinct clusters of serotype 1 IPD were identified during 2003-2004 and 2008-2012.
Findings:
- Serotype 1 accounted for 10% (4,544/46,483) of all IPD cases.
- Incidence of serotype 1 IPD decreased notably after the introduction of PCV13 in 2011.
- Serotype 1 IPD cases exhibited distinct clinical features, including longer hospital stays, higher rates of penicillin-nonsusceptible disease, HIV prevalence, and in-hospital mortality compared to non-serotype 1 IPD.
Implications:
- PCV13 vaccination has demonstrated effectiveness in reducing serotype 1 Streptococcus pneumoniae infections in South Africa.
- The distinct clinical profile of serotype 1 IPD highlights its significant public health burden.
- Continued surveillance is essential to monitor vaccine effectiveness and emerging serotype trends.
Abstract:
In South Africa, 7-valent pneumococcal conjugate vaccine (PCV) was introduced in April 2009 and replaced with 13-valent PCV in April 2011. We describe the epidemiology of serotype 1 Streptococcus pneumoniae disease during the pre- and post-PCV eras (2003-2013). Using laboratory-based invasive pneumococcal disease (IPD) surveillance, we calculated annual incidences, identified IPD clusters, and determined serotype 1-associated factors. Of 46,483 IPD cases, 4,544 (10%) were caused by serotype 1. Two clusters of serotype 1 infection were detected during 2003-2004 and 2008-2012, but incidence decreased after 2011. Among children <5 years of age, those who had non-serotype 1 IPD had shorter hospital stays, fewer cases of penicillin-nonsusceptible disease, and lower HIV prevalence and in-hospital death rates than did those with serotype 1 IPD; similar factors were noted for older patients. Serotype 1 IPD had distinctive clinical features in South Africa, and annual incidences fluctuated, with decreases noted after the introduction of PCV13.
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