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[Fatal pneumococcal meningitis due to serotype 19 A: A preventable case?]

M Carolina Rivacoba, José Cofré, M Elena Santolaya

    Revista Chilena De Infectologia : Organo Oficial De La Sociedad Chilena De Infectologia
    |March 12, 2016
    PubMed

    Insights

    Invasive pneumococcal disease (IPD) decreased in Chile after infant vaccination. However, a fatal case of meningitis caused by a non-vaccine serotype (19A) highlights the need for ongoing surveillance.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Vaccinology

    Background:

    • Invasive pneumococcal disease (IPD) is a significant global health concern.
    • Chile incorporated the 10-valent pneumococcal conjugate vaccine (PCV10) into its routine infant immunization program (EPI).
    • PCV10 introduction led to a decrease in IPD incidence in Chile.

    Observation:

    • A fatal case of pneumococcal meningitis occurred in a child.
    • The causative agent was identified as Streptococcus pneumoniae serotype 19A.
    • Serotype 19A is not included in the 10-valent pneumococcal vaccine.

    Findings:

    • This case represents a potential serotype replacement phenomenon, where non-vaccine serotypes may emerge after widespread vaccination.
    • The occurrence of IPD due to serotype 19A highlights the limitations of current vaccine formulations in covering all circulating serotypes.

    Implications:

    • Active surveillance for IPD is crucial to monitor the impact of vaccination programs.
    • Understanding the distribution of circulating serotypes and their clinical correlation is essential for public health strategies.
    • This case underscores the need for continued research into broader-spectrum pneumococcal vaccines.

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