The epidemiology of invasive pneumococcal disease in Alaska, 1986-1990--ethnic differences and opportunities for prevention.
To assess prevention strategies for pneumococcal disease in Alaska, prospective surveillance during 1986-1990 identified 672 invasive pneumococcal infections, including 315 among Alaska Natives. Age-adjusted annual incidence was 74 per 100,000 for Alaska Natives and 16 per 100,000 for nonnatives. The annual incidence in Alaska Native children < 2 years old was 624 per 100,000; rates of 84 per 100,000 for meningitis and 290 per 100,000 for bacteremic pneumonia were 8-10 times higher than for other US groups. By age 75, cumulative incidence (7%) and mortality (1%) in Alaska Natives were almost 4 times higher than for nonnatives. Only 17% of Alaska Native adults with predisposing conditions and invasive infections previously received pneumococcal vaccine. For Alaska Natives, a proposed heptavalent conjugate pneumococcal vaccine will include serotypes responsible for 85% of invasive isolates from children < 2 years but only 32% of those from adults. The 23-valent polysaccharide pneumococcal vaccine, which contains > 94% of serotypes identified in Alaska Native toddlers and adults, should be used more widely.
Davidson
M
M
Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska 99501.
Parkinson
A J
AJ
Bulkow
L R
LR
Fitzgerald
M A
MA
Peters
H V
HV
Parks
D J
DJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D001428:Bacterial Vaccines; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D007223:Infant; D004930:Inuit; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D008875:Middle Aged; D010033:Otitis Media / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D012008:Recurrence; D012703:Serotyping; D012737:Sex Factors; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology; D014611:Vaccination
D001428:Bacterial Vaccines; D022242:Pneumococcal Vaccines