title: Neonatal invasive pneumococcal disease: New Zealand experience in the era of pneumococcal vaccination.
abstract: BACKGROUND
  Invasive pneumococcal disease (IPD) became a notifiable disease in New Zealand in 2008, and in the same year pneumococcal conjugate vaccine (PCV) was added to the childhood immunisation schedule.
  
  
  METHODS
  This was a retrospective study of IPD in infants aged <90 days reported to the national notifiable disease database, EpiSurv, from 1 January 2009 to 31 December 2013. All cases had Streptococcus pneumoniae isolated from a normally sterile site.
  
  
  METHODS
  IPD incidence was calculated for babies aged <90 and <30 days using the number of national IPD cases with a denominator of annual infant live births. Clinical, demographic and outcome data were reviewed for infants aged less than seven days (early onset).
  
  
  RESULTS
  There were 29 cases of IPD in infants aged <90 days and 19 cases in infants aged <30 days. Of the nine early-onset cases, six occurred within the first 48 h. Six of the early-onset cases were infants of NZ Maori ethnicity. One infant died six hours after birth. Three infants developed long-term neurological or respiratory sequelae. Isolates from five of the early-onset cases were S. pneumoniae serotypes not covered by the PCV in use at the time of infection. Maternal vaccination with 23-valent pneumococcal vaccine would have covered 84% (16 of 19) of serotypes responsible for the cases in infants <30 days old.
  
  
  CONCLUSIONS
  Strategies such as maternal vaccination or accelerated neonatal vaccination may be beneficial to protect neonates at high risk of IPD.
authors.affiliation: Department of Paediatrics, University of Auckland, Auckland, New Zealand.
authors.forename: Vicki
authors.initials: V
authors.lastname: Mount
authors.affiliation: Starship Children's Health, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Cameron
authors.initials: C
authors.lastname: Burton
authors.affiliation: Auckland Regional Public Health Service, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Catherine
authors.initials: C
authors.lastname: Jackson
authors.affiliation: Institute of Environmental Science and Research (ESR), Kenepuru Science Centre, Porirua, New Zealand.
authors.forename: Helen
authors.initials: H
authors.lastname: Heffernan
authors.affiliation: Department of Paediatrics, University of Auckland, Auckland, New Zealand.|Starship Children's Health, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Emma
authors.initials: E
authors.lastname: Best
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008586:Meningitis, Pneumococcal / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D009520:New Zealand / Q000453:epidemiology; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D012189:Retrospective Studies; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000145:classification; D014611:Vaccination; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines
keywords: infant; invasive pneumococcal disease; newborn; pneumococcal infection; pneumococcal vaccines