Epidemiology of invasive pneumococcal disease in southern California: implications for the design and conduct of a pneumococcal conjugate vaccine efficacy trial.
Population-based prospective surveillance of invasive pneumococcal disease was done in Southern California from 31 March 1992 to 1 April 1995; 814 cases were identified, for an incidence of 12.5/100,000 persons/year. The incidence among persons < or = 2, < or = 5, and > or = 65 years of age was 145, 72, and 32/100,000, respectively. More than 95% of cases included bacteremia; incidence of meningitis was 0.8/100,000. Among children < or = 2 years of age, 79% of isolates were obtained in the outpatient setting, compared with 16% of isolates among persons > or = 15 years of age. Eighty percent of isolates were serotypes included in heptavalent pneumococcal conjugate vaccines currently being evaluated. Children < or = 2 years of age were at highest risk of having an isolate resistant to penicillin. Among resistant isolates, high-level resistance increased from 4% to 21% over a 3-year period. Prospective epidemiologic data are needed to perform a protective efficacy trail of pneumococcal conjugate vaccines in infants, among whom most invasive pneumococcal disease is vaccine-preventable.
Zangwill
K M
KM
Harbor-UCLA Medical Center, UCLA Center for Vaccine Research, Torrance 90502, USA.
Vadheim
C M
CM
Vannier
A M
AM
Hemenway
L S
LS
Greenberg
D P
DP
Ward
J I
JI
D000293:Adolescent; D000328:Adult; D000368:Aged; D001428:Bacterial Vaccines / Q000276:immunology*; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D012107:Research Design; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology*; D018074:Vaccines, Conjugate / Q000276:immunology
D001428:Bacterial Vaccines; D018074:Vaccines, Conjugate