Invasive pneumococcal disease in the Kimberley, 1995-2001.
OBJECTIVE
To describe the epidemiology of invasive pneumococcal disease (IPD) in the Kimberley and examine whether cases could have been prevented by vaccination.


METHODS
Prospective case series of IPD cases from 1 January 1995 to 31 December 2001.


METHODS
The Kimberley region of far north-western Australia.


METHODS
Seventy IPD cases in 37 men and 33 women aged 5 months to 90 years. Aboriginal people comprised 90% (63/70) of cases.


METHODS
Demographic, clinical and microbiological characteristics of IPD cases. Proportion of cases caused by vaccine-preventable serotypes. IPD incidence in the Kimberley.


RESULTS
Pneumonia and bacteraemia were the commonest clinical presentations. Of IPD cases, 15% (children) and 67% (adults) had a risk factor for IPD. The case fatality rate was 13%. Of cases, 46% (95% confidence interval (CI) 35-58%) were caused by serotypes covered by an age-appropriate vaccine. Of the 26 cases eligible for pneumococcal vaccination, only 4 (16%) had been appropriately vaccinated. IPD incidence in Aboriginal people aged 15 years and over declined from 97.8/100,000 person years (95% CI 56.5-139.1) in 1997 to 38.1/100,000 person years (95% CI 22.5-53.9) in 2001.


CONCLUSIONS
The significant proportion of cases caused by vaccine-preventable serotypes and that was, therefore, preventable underscores the importance of pneumococcal vaccination.
Mak
Donna B
DB
School of Public Health, The University of Western Australia, Nedlands, Western Australia 6009, Australia. makho@bigpond.com
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012307:Risk Factors; D012703:Serotyping; D017678:Sex Distribution; D014611:Vaccination / Q000592:standards; D014904:Western Australia
D022242:Pneumococcal Vaccines