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The Epidemiology and Biostatistics of Pneumococcus

  • Godwin OligbuEmail author
  • Norman K. Fry
  • Shamez N. Ladhani
Protocol
Part of the Methods in Molecular Biology book series (MIMB, volume 1968)

Abstract

Invasive infections caused by Streptococcus pneumoniae, such as pneumonia, meningitis, and bacteremia, are a major cause of morbidity and mortality in young children and older adults worldwide. The introduction of pneumococcal conjugate vaccines into national childhood immunization programs has led to large and sustained reductions in the incidence of invasive pneumococcal disease across all age groups. Here we describe the epidemiology and biostatistics of pneumococcal disease as well as the impact of vaccination on the burden of pneumococcal disease globally.

Key words

Streptococcus pneumoniae Invasive pneumococcal disease Pneumococcal conjugate vaccine Public health Surveillance 

References

  1. 1.
    Russel F, Sanderson C, Temple B, Mulholand K (2011) Global review of the distribution of pneumococcal disease by age and region. World Health Organization, Geneva, Switzerland. http://www.who.int/immunization/sage/6_Russel_review_age_specific_epidemiology_PCV_schedules_session_novl 1.pdf. 2011.Nov
  2. 2.
    Drijkoningen JJ, Rhode GG (2014) Pneumococcal infection in adults: burden of disease. Clin Microbiol Infect 20:45–51CrossRefGoogle Scholar
  3. 3.
    Advisory Committee on Immunization Practices (2000) Preventing pneumococcal disease among infants and young children. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 49(RR-9):1–35Google Scholar
  4. 4.
    Butler JC, Schuchat A (1999) Epidemiology of pneumococcal infections in the elderly. Drugs Aging 15(Suppl 1):11–19CrossRefGoogle Scholar
  5. 5.
    Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA et al (2013) Global burden of childhood pneumonia and diarrhoea. Lancet 381(9875):1405–1416CrossRefGoogle Scholar
  6. 6.
    World Health Organization (2008) Estimated Hib and pneumococcal deaths for children under 5 years of age. http://www.who.int/immunization/monitoring_surveillance/burden/estimates/Pneumo_hib/en/. Accessed 12 May
  7. 7.
    O’Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N et al (2009) Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet 374(9693):893–902CrossRefGoogle Scholar
  8. 8.
    Mackenzie GA, Hill PC, Jeffries DJ, Hossain I, Uchendu U, Ameh D et al (2016) Effect of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease in The Gambia: a population-based surveillance study. Lancet Infect Dis 16(6):703–711CrossRefGoogle Scholar
  9. 9.
    Izurieta P, Bahety P, Adegbola R, Clarke C, Hoet B (2018) Public health impact of pneumococcal conjugate vaccine infant immunization programs: assessment of invasive pneumococcal disease burden and serotype distribution. Expert Rev Vaccines 17(6):479–493CrossRefGoogle Scholar
  10. 10.
    Kyaw MH, Christie P, Clarke SC, Mooney JD, Ahmed S, Jones IG et al (2003) Invasive pneumococcal disease in Scotland, 1999–2001: use of record linkage to explore associations between patients and disease in relation to future vaccination policy. Clin Infect Dis 37:1283–1291CrossRefGoogle Scholar
  11. 11.
    Reinert RR, Haupts S, van der LM HC, Cil MY, Al-Lahham A et al (2005) Invasive pneumococcal disease in adults in North-Rhine Westphalia, Germany, 2001–2003. Clin Microbiol Infect 11:985–991CrossRefGoogle Scholar
  12. 12.
    Lynch JP, Zhanel GG (2009) Streptococcus pneumoniae: epidemiology, risk factors, and strategies for prevention. Semin Respir Crit Care Med 30:189–209CrossRefGoogle Scholar
  13. 13.
    Jackson ML, Neuzil KM, Thomson WW et al (2004) The burden of community-acquired pneumonia in seniors: results of a population-based study. Clin Infect Dis 39:1642–1650CrossRefGoogle Scholar
  14. 14.
    Vila-Corcoles A, Ochoa-Gondar O, Llor C, Rodríguez T, Gómez A (2005) Protective effect of pneumococcal vaccine against death by pneumonia in elderly subjects. Eur Respir J 26(6):1086–1091CrossRefGoogle Scholar
  15. 15.
    El-Solh AA, Sikka P, Ramadan F, Davies J (2001) Etiology of severe pneumonia in the very elderly. Am J Respir Crit Care Med 163(3 Pt 1):645–651CrossRefGoogle Scholar
  16. 16.
    Maimaiti N, Ahmed Z, Isa ZM, Ghazi HF, Aljunid S (2013) Clinical burden of invasive pneumococcal disease in selected developing countries. Value Health Reg Issues 2(2):259–263CrossRefGoogle Scholar
  17. 17.
    Weycker D, Strutton D, Edelsberg J, Sato R, Jackson LA (2010) Clinical and economic burden of pneumococcal disease in older US adults. Vaccine 28:4955–4960CrossRefGoogle Scholar
  18. 18.
    Huang SS, Johnson KM, Ray GT et al (2011) Healthcare utilization and cost of pneumococcal disease in the United States. Vaccine 29:3398–3412CrossRefGoogle Scholar
  19. 19.
    Gibson GJ, Loddenkemper R, Sibille Y, European Respiratory Society/European Lung Foundation (2003) Lung Health in Europe Facts and Figures. ERSJ, SheffieldGoogle Scholar
  20. 20.
    Davis SM, Deloria-Knoll M, Kassa HT, O’Brien KL (2013) Impact of pneumococcal conjugate vaccines on nasopharyngeal carriage and invasive disease among unvaccinated people: review of evidence on indirect effects. Vaccine 32:133–145CrossRefGoogle Scholar
  21. 21.
    Hennessy TW, Singleton RJ, Bulkow LR et al (2005) Impact of heptavalent pneumococcal conjugate vaccine on invasive disease, antimicrobial resistance and colonization in Alaska Natives: progress towards elimination of a health disparity. Vaccine 23:5464–5473CrossRefGoogle Scholar
  22. 22.
    Cohen R, Levy C, Bingen E, Bonnet E, Koskas M, Attal S, et al (2011) Impact of 13-valent pneumococcal conjugate vaccine (PCV13) on nasopharyngeal (NP) flora in children with acute otitis media (AOM). In: Presented at the 51st ICAAC, September 17–20, 2011, Chicago, USAGoogle Scholar
  23. 23.
    Conklin L, Loo JD, Kirk J, Fleming-Dutra KE, Deloria Knoll M, Park DE et al (2014) Systematic review of the effect of pneumococcal conjugate vaccine dosing schedules on vaccine-type invasive pneumococcal disease among young children. Pediatr Infect Dis J 33(Suppl 2 Optimum Dosing of Pneumococcal Conjugate Vaccine For Infants 0 A Landscape Analysis of Evidence Supporting Different Schedules):S109–S118CrossRefGoogle Scholar
  24. 24.
    Kaplan SL, Barson WJ, Lin PL, Romero JR, Bradley JS, Tan TQ et al (2013) Early trends for invasive pneumococcal infections in children after the introduction of the 13-valent pneumococcal conjugate vaccine. Pediatr Infect Dis J 32:203–207CrossRefGoogle Scholar
  25. 25.
    Waight PA, Andrews NJ, Ladhani SN, Sheppard CL, Slack MPE, Miller E (2015) Effect of the 13-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in England and Wales 4 years after its introduction: an observational cohort study. Lancet Infect Dis 15(5):535–543CrossRefGoogle Scholar
  26. 26.
    Gilmour R, Holland R, Kampen R, Brown M, Gilbert L, Hogg G et al (2008) Invasive pneumococcal disease in Australia, 2006. Commun Dis Intell 32(1):18–30Google Scholar
  27. 27.
    Kellner JD, Church DL, MacDonald J, Tyrrell GJ, Scheifele D (2005) Progress in the prevention of pneumococcal infection. Can Med Assoc J 173(10):1149–1151CrossRefGoogle Scholar
  28. 28.
    Zangeneh TT, Baracco G, Al-Tawfiq JA (2011) Impact of conjugate pneumococcal vaccines on the changing epidemiology of pneumococcal infections. Expert Rev Vaccines 10(3):345–353CrossRefGoogle Scholar
  29. 29.
    World Health Organization position paper - Pneumococcal conjugate vaccine for childhood immunization (2007) WHO position paper. Wkly Epidemiol Rec 82(12):93–104Google Scholar
  30. 30.
    Myint TT, Madhava H, Balmer P, Christopoulou D, Attal S, Menegas D et al (2013) The impact of 7-valent pneumococcal conjugate vaccine on invasive pneumococcal disease: a literature review. Adv Ther 30(2):127–151CrossRefGoogle Scholar
  31. 31.
    Miller E, Andrews NJ, Waight PA, Slack MPE, George RC (2011) Herd immunity and serotype replacement 4 years after seven-valent pneumococcal conjugate vaccination in England and Wales: an observational cohort study. Lancet Infect Dis 11(10):760–768CrossRefGoogle Scholar
  32. 32.
    Weinberger DM, Malley RLM (2011) Serotype replacement in disease after pneumococcal vaccination. Lancet 378(9807):1962–1973CrossRefGoogle Scholar
  33. 33.
    Singleton RJ, Hennessy TW, Bulkow LR, Hammitt LL, Zulz T, Hurlburt DA et al (2007) Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. JAMA 297(16):1784–1792CrossRefGoogle Scholar
  34. 34.
    Park SY, Van Beneden CA, Pilishvili T, Martin M, Facklam RR, Whitney CG (2010) Invasive pneumococcal infections among vaccinated children in the United States active bacterial core surveillance team. J Pediatr 158(3):478–483.e2CrossRefGoogle Scholar
  35. 35.
    Ben-Shimol S, Givon-Lavi N, Grisaru-Soen G, Megged O, Greenberg D, Dagan R (2017) Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies. Vaccine 36(36):5477–5484CrossRefGoogle Scholar
  36. 36.
    Alari A, Chaussade H, Domenech De Cellès M, Le Fouler L, Varon E, Opatowski L et al (2016) Impact of pneumococcal conjugate vaccines on pneumococcal meningitis cases in France between 2001 and 2014: a time series analysis. BMC Med 14(1):211CrossRefGoogle Scholar
  37. 37.
    Hsu HE, Shutt KA, Moore MR, Beall BW, Bennett NM, Craig AS et al (2009) Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. N Engl J Med 360(3):244–256CrossRefGoogle Scholar
  38. 38.
    Ruiz-Contreras J, Picazo J, Casado-Flores J, Baquero-Artigao F, Hernández-Sampelayo T, HERACLES STUDY GROUP et al (2017) Impact of 13-valent pneumococcal conjugate vaccine on pneumococcal meningitis in children. Vaccine 35(35 Pt B):4646–4651CrossRefGoogle Scholar
  39. 39.
    Tsai CJ, Griffin MR, Nuorti JP, Grijalva GC (2008) Changing epidemiology of pneumococcal meningitis after introduction of pneumococcal conjugate vaccine in the United States. Clin Infect Dis 46(11):1664–1672CrossRefGoogle Scholar
  40. 40.
    Olarte L, Barson WJ, Barson RM, Lin PL, Romero JR, Tan TQ et al (2015) Impact of the 13-valent pneumococcal conjugate vaccine on pneumococcal meningitis in US children. Clin Infect Dis 61(5):767–775CrossRefGoogle Scholar
  41. 41.
    Jacobs M (2008) Antimicrobial-resistant streptococcus pneumoniae: trends and management. Expert Rev Anti-Infect Ther 6(5):619–635CrossRefGoogle Scholar
  42. 42.
    Park IH, Moore MR, Treanor JJ, Pelton SI, Pilishvili T, Beall B et al (2008) Active bacteria core surveillance team. Differential effects of pneumococcal vaccines against serotypes 6A and 6C. J Infect Dis 198(12):1818–1822CrossRefGoogle Scholar
  43. 43.
    Pelton SI, Huot H, Finkelstein JA, Bishop CJ, Hsu KK, Kellenberg J et al (2007) Emergence of 19A as virulent and multidrug resistant Pneumococcus in Massachusetts following universal immunization of infants with pneumococcal conjugate vaccine. Pediatr Infect Dis J 26(6):468–472CrossRefGoogle Scholar
  44. 44.
    Pai R, Moore MR, Pilishvili T, Gertz RE, Whitney CG, Beall B (2005) Postvaccine genetic structure of Streptococcus pneumoniae serotype 19A from children in the United States. J Infect Dis 192(11):1988–1995CrossRefGoogle Scholar
  45. 45.
    Yildirim I, Stevenson A, Hsu KK, Pelton SI (2012) Evolving picture of invasive pneumococcal disease in Massachusetts children: a comparison of disease in 2007–2009 with earlier periods. Pediatr Infect Dis J 31(10):1016–1021PubMedGoogle Scholar
  46. 46.
    Vanderkooi OG, Scheifele DW, Girgenti D, Halperin SA, Patterson SD, Gruber WC et al (2012) Safety and immunogenicity of a 13-valent pneumococcal conjugate vaccine in healthy infants and toddlers given with routine pediatric vaccinations in Canada. Pediatr Infect Dis J 31(1):72–77CrossRefGoogle Scholar
  47. 47.
    European Centre for Disease Prevention and Control (2017) Invasive pneumococcal disease. Stockholm. https://ecdc.europa.eu/en/publications-data/invasive-pneumococcal-disease-annual-epidemiological-report-2017. Accessed 12 May 2018
  48. 48.
    World Health Organization, UNICEF (2013) Ending preventable child deaths from pneumonia and diarrhoea by 2025: The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD)Google Scholar
  49. 49.
    Troeger C, Forouzanfar M, Rao PC, Khalil I, Brown A, Reiner RC Jr et al (2017) Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis 3099(17):1–40Google Scholar
  50. 50.
    Lucero M, Dulalia V, Nillos L, Williams G, Parreño R, Nohynek H et al (2009) Pneumococcal conjugate vaccines for preventing vaccine-type invasive pneumococcal disease and X-ray defined pneumonia in children less than two years of age. Cochrane Database Syst Rev 4:CD004977Google Scholar
  51. 51.
    Ewald H, Briel M, Vuichard D, Kreutle V, Zhydkov A, Gloy V (2016) The clinical effectiveness of pneumococcal conjugate vaccines: a systematic review and metaanalysis of randomized controlled trials. Dtsch Arztebl Int 113(9):139–146PubMedPubMedCentralGoogle Scholar
  52. 52.
    Whitney CG, Farley MM, Hadler J, Harrison LH, Lexau C, Reingold A et al (2000) Active bacterial core surveillance program of the emerging infections program network. Increasing prevalence of multidrug-resistant streptococcus pneumoniae in the United States. N Engl J Med 343(26):1917–1924CrossRefGoogle Scholar
  53. 53.
    Richter SS, Heilmann KP, Dohrn CL, Riahi F, Diekema DJ, Doern GV (2013) Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999–2011. Emerg Infect Dis 19(7):1074–1083CrossRefGoogle Scholar
  54. 54.
    Hanquet G, Kissling E, Fenoll A, George R, Lepoutre A, Lernout T et al (2010) Pneumococcal serotypes in children in 4 European countries. Emerg Infect Dis 16(9):1428–1439CrossRefGoogle Scholar
  55. 55.
    Janoir C, Lepoutre A, Gutmann L, Varon E (2016) Insight into resistance phenotypes of emergent non 13-valent pneumococcal conjugate vaccine type pneumococci isolated from invasive disease after 13-valent Pneumococcal conjugate vaccine implementation in France. Open Forum Infect Dis 3(1):ofw020CrossRefGoogle Scholar
  56. 56.
    Mahjoub-Messai F, Doit C, Koeck JL, Billard T, Evrard B, Bidet P et al (2009) Population snapshot of Streptococcus pneumoniae serotype 19A isolates before and after introduction of seven-valent pneumococcal vaccination for French children. J Clin Microbiol 47(3):837–840CrossRefGoogle Scholar
  57. 57.
    Cohen C, von Mollendorf C, de Gouveia L, Naidoo N, Meiring S, Quan V et al (2014) Effectiveness of 7-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in HIV-infected and -uninfected children in South Africa: a matched case-control study. Clin Infect Dis 59:808–818CrossRefGoogle Scholar
  58. 58.
    Von Gottberg A, de Gouveia L, Tempia S, Quan V, Meiring S, Von Mollendorf C et al (2014) Effects of vaccination on invasive pneumococcal disease in South Africa. N Engl J Med 371(20):1889–1899CrossRefGoogle Scholar
  59. 59.
    Moore MR, Link-Gelles R, Schaffner W et al (2016) Effectiveness of 13- valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease in children in the USA: a matched case- control study. Lancet Respir Med 4:399–406CrossRefGoogle Scholar
  60. 60.
    Isturiz R, Sings HL, Hilton B, Arguedas A, Reinert RR, Jodar L (2017) Streptococcus pneumoniae serotype 19A: worldwide epidemiology. Expert Rev Vaccines 16(10):1007–1027CrossRefGoogle Scholar
  61. 61.
    Gaviria-Agudelo CL, Jordan-Villegas A, Garcia C, McCracken GH Jr (2017) The effect of 13-valent pneumococcal conjugate vaccine on the serotype distribution and antibiotic resistance profiles in children with invasive pneumococcal disease. J Pediatr Infect Dis Soc 6(3):253–259CrossRefGoogle Scholar
  62. 62.
    Balsells E, Guillot L, Nair H, Kyaw MH (2017) Serotype distribution of Streptococcus pneumoniae causing invasive disease in children in the post-PCV era: A systematic review and meta-analysis. PLoS One 12(5):e0177113CrossRefGoogle Scholar
  63. 63.
    Tomczyk S, Bennett NM, Stoecker C, Gierke R, Moore MR, Whitney CG, Centre for Disease Control and Prevention (CDC) et al (2014) Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep 63:822–825Google Scholar
  64. 64.
    Persons I (2013) Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among children aged 6–18 years with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Wkly Rep 62(25):521Google Scholar
  65. 65.
    Huss A, Scott P, Stuck AE, Trotter C, Egger M (2009) Efficacy of pneumococcal vaccination in adults: a meta-analysis. Can Med Assoc J 180:48–58CrossRefGoogle Scholar
  66. 66.
    Poolman J, Borrow R (2011) Hyporesponsiveness and its clinical implications after vaccination with polysaccharide or glycoconjugate vaccines. Expert Rev Vaccines 10:307–322CrossRefGoogle Scholar
  67. 67.
    VIEW-hub [Internet]. PCV: Current vaccine intro status. [Cited 2018 May12]. http://view-hub.org/viz/

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Godwin Oligbu
    • 1
    • 2
    Email author
  • Norman K. Fry
    • 2
    • 3
  • Shamez N. Ladhani
    • 1
    • 2
  1. 1.Paediatric Infectious Diseases Research Group, Institute for Infection and ImmunitySt. George’s, University of LondonLondonUK
  2. 2.Immunisation and Countermeasures DivisionNational Infection Service, Public Health EnglandLondonUK
  3. 3.Respiratory and Vaccine Preventable Bacterial Reference Unit (RVPBRU)National Infection Service Laboratories, Public health EnglandLondonUK

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