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Updated: Feb 7, 2026
Capsular Serotyping of Streptococcus pneumoniae by Latex Agglutination
Published on: September 25, 2014
Local outbreak of Streptococcus pneumoniae serotype 12F caused high morbidity and mortality among children and adults
T Ikuse1, R Habuka2, Y Wakamatsu3
1Department of Paediatrics,Tsuruoka Municipal Shonai Hospital,4-20, Izumimachi,Tsuruoka City,Yamagata 997-8515,Japan.
Insights
A 2016 outbreak of Streptococcus pneumoniae serotype 12F invasive pneumococcal disease (IPD) occurred in Japan following 13-valent pneumococcal conjugate vaccine (PCV) introduction. Close contact with children suggested a transmission source, highlighting the need for ongoing IPD surveillance.
Area of Science:
- Microbiology
- Epidemiology
- Public Health
Background:
- Pneumococcal serotype replacement is a recognized issue following pneumococcal conjugate vaccine (PCV) implementation.
- Increased incidence of Streptococcus pneumoniae serotype 12F (Sp12F) invasive pneumococcal disease (IPD) has been observed post-13-valent PCV in some regions.
- No Sp12F outbreaks had been reported in the post-13-valent PCV era prior to this study.
Purpose of the Study:
- To report a local outbreak of Sp12F IPD in Tsuruoka city, Japan, after the introduction of 13-valent PCV.
- To investigate potential transmission routes and risk factors associated with the Sp12F outbreak.
- To emphasize the importance of continuous surveillance for IPD in the post-PCV era.
Main Methods:
- Retrospective case review of Sp12F IPD patients during March-May 2016.
- Analysis of patient demographics, clinical progression, and potential exposure history.
- Epidemiological investigation of the outbreak's characteristics.
Main Results:
- Nine cases of Sp12F IPD were identified, including two children and seven adults.
- Three adult patients died due to rapid disease progression.
- Close contact with children was reported in 89% of patients, suggesting children as a potential reservoir for transmission.
Conclusions:
- This study documents the first reported Sp12F IPD outbreak in the post-13-valent PCV era.
- Childhood colonization may serve as a crucial source for Sp12F transmission to adults.
- Continuous monitoring of IPDs and serotypes is essential, and new control strategies may be required if such fatal outbreaks persist.
Abstract:
Pneumococcal serotype replacement is an important issue after the introduction of pneumococcal conjugate vaccine (PCV) in children. After the introduction of 13-valent PCV, the incidence of invasive pneumococcal diseases (IPD) caused by Streptococcus pneumoniae serotype 12F (Sp12F) have increased in some countries; however, an outbreak of Sp12F has not reported in the post-13-valent PCV era. We experienced a local outbreak of Sp12F during March through May 2016 in Tsuruoka city, Japan after the introduction of 13-valent PCV in 2013. The IPD patients were two children and seven adults, three of whom died with a rapid disease progress. Although the clear transmission route was not determined, eight of the nine patients (89%) had close contact with children, which suggests that transmitted colonisation of Sp12F among children and adults might be the source of transmission. Continuous monitoring of IPDs, along with the determination of pneumococcal serotypes, is warranted in the post-13-valent PCV era. New IPD control strategies may be needed if this fatal outbreak continues to occur.
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