The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults.
Pneumococcal disease is more frequent and more deadly in persons with certain comorbidities. We used 1999 and 2000 data from the Active Bacterial Core surveillance (ABCs) and the National Health Interview Survey (NHIS) to determine rates of invasive pneumococcal disease in healthy adults (> or =18 years old) and in adults with various high-risk conditions. The risks of invasive pneumococcal disease in persons with specific chronic illnesses was compared with that in healthy adults, controlling for age, race, and the other chronic illnesses. Overall incidence rates, in cases/100,000 persons, were 8.8 in healthy adults, 51.4 in adults with diabetes, 62.9 in adults with chronic lung disease, 93.7 in adults with chronic heart disease, and 100.4 in adults who abused alcohol. Among the high-risk groups evaluated, risk was highest in adults with solid cancer (300.4), HIV/AIDS (422.9), and hematological cancer (503.1). Incidence rates increased with advancing age in adults with chronic lung disease, diabetes, and solid cancer. Black adults had higher incidence rates than white adults, both in healthy adults and in adults with chronic illnesses. These data support recommendations to provide pneumococcal vaccine to persons in these at-risk groups and underscore the need for better prevention strategies for immunocompromised persons.
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. mkyaw@cdc.gov
Moe H
MH
Kyaw
Charles E
CE
Rose
Alicia M
AM
Fry
James A
JA
Singleton
Zack
Z
Moore
Elizabeth R
ER
Zell
Cynthia G
CG
Whitney
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D044383:Black People; D002908:Chronic Disease; D015897:Comorbidity; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011008:Pneumococcal Infections / Q000453:epidemiology*; D012016:Reference Values; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American