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Invasive pneumococcal disease in Indigenous people in north Queensland: an update, 2005-2007.
Med J Aust. 2008 Jul 07; 189(1):43-6.MJ

Abstract

OBJECTIVE

To examine trends in invasive pneumococcal disease (IPD) in Indigenous people in north Queensland following the introduction of the 7-valent pneumococcal conjugate vaccine (7vPCV).

DESIGN

Trends in IPD were compared over three 3-year periods: before the introduction of 7vPCV for Indigenous children (1999-2001), and two consecutive periods after its introduction (2002-2004 and 2005-2007).

MAIN OUTCOME MEASURES

Incidences of IPD in Indigenous children and adults in 1999-2001 and 2005-2007; trends in IPD caused by 7vPCV and non-7vPCV serotypes; and trends in indirect protective effects and emergence of non-7vPCV serotype IPD.

RESULTS

From 1999-2001 to 2005-2007, there was a 60% decline in IPD, with the virtual elimination of 7vPCV serotype IPD in young (< 5 years) Indigenous children. There is no evidence yet of an increase in non-7vPCV serotype IPD in these children. Although the annual incidence of IPD in Indigenous adults remained virtually unchanged, there was a 75% decline in 7vPCV serotype IPD in these adults (chi2(trend) = 11.65, P < 0.001). However, the incidence of IPD caused by non-7vPCV serotypes more than tripled in adults (chi2(trend) = 7.58, P = 0.006). Serotype 1 IPD has been prominent over the 9 years, but there is no evidence of a recent increase in serotype 19A IPD.

CONCLUSIONS

Vaccinating Indigenous children with 7vPCV has protected Indigenous adults in north Queensland through an indirect "herd immunity" effect. However, this benefit has been offset by a recent increase in non-7vPCV IPD in Indigenous adults. Newer pneumococcal conjugate vaccines could prevent, both directly and indirectly, a considerable amount of the persisting IPD in Indigenous people in the region.

Links

Publisher Full Text
mja.com.au
doi.org
Aggregator Full Text

Authors+Show Affiliations

Hanna JN
Tropical Population Health Network, Queensland Health, Cairns, QLD, Australia. jeffrey_hanna@health.qld.gov.au
Humphreys JL
No affiliation info available
Murphy DM
No affiliation info available

MeSH

AdolescentAdultChildChild, PreschoolHeptavalent Pneumococcal Conjugate VaccineHumansImmunity, HerdIncidenceInfantMass VaccinationMeningococcal VaccinesOceanic Ancestry GroupPneumococcal InfectionsPneumococcal VaccinesQueenslandSerotypingStreptococcus pneumoniae

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18601643

Citation

Hanna, Jeffrey N., et al. "Invasive Pneumococcal Disease in Indigenous People in North Queensland: an Update, 2005-2007." The Medical Journal of Australia, vol. 189, no. 1, 2008, pp. 43-6.
Hanna JN, Humphreys JL, Murphy DM. Invasive pneumococcal disease in Indigenous people in north Queensland: an update, 2005-2007. Med J Aust. 2008;189(1):43-6.
Hanna, J. N., Humphreys, J. L., & Murphy, D. M. (2008). Invasive pneumococcal disease in Indigenous people in north Queensland: an update, 2005-2007. The Medical Journal of Australia, 189(1), 43-6.
Hanna JN, Humphreys JL, Murphy DM. Invasive Pneumococcal Disease in Indigenous People in North Queensland: an Update, 2005-2007. Med J Aust. 2008 Jul 7;189(1):43-6. PubMed PMID: 18601643.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invasive pneumococcal disease in Indigenous people in north Queensland: an update, 2005-2007. AU - Hanna,Jeffrey N, AU - Humphreys,Jan L, AU - Murphy,Denise M, PY - 2008/02/20/received PY - 2008/05/07/accepted PY - 2008/7/8/pubmed PY - 2008/9/30/medline PY - 2008/7/8/entrez SP - 43 EP - 6 JF - The Medical journal of Australia JO - Med J Aust VL - 189 IS - 1 N2 - OBJECTIVE: To examine trends in invasive pneumococcal disease (IPD) in Indigenous people in north Queensland following the introduction of the 7-valent pneumococcal conjugate vaccine (7vPCV). DESIGN: Trends in IPD were compared over three 3-year periods: before the introduction of 7vPCV for Indigenous children (1999-2001), and two consecutive periods after its introduction (2002-2004 and 2005-2007). MAIN OUTCOME MEASURES: Incidences of IPD in Indigenous children and adults in 1999-2001 and 2005-2007; trends in IPD caused by 7vPCV and non-7vPCV serotypes; and trends in indirect protective effects and emergence of non-7vPCV serotype IPD. RESULTS: From 1999-2001 to 2005-2007, there was a 60% decline in IPD, with the virtual elimination of 7vPCV serotype IPD in young (< 5 years) Indigenous children. There is no evidence yet of an increase in non-7vPCV serotype IPD in these children. Although the annual incidence of IPD in Indigenous adults remained virtually unchanged, there was a 75% decline in 7vPCV serotype IPD in these adults (chi2(trend) = 11.65, P < 0.001). However, the incidence of IPD caused by non-7vPCV serotypes more than tripled in adults (chi2(trend) = 7.58, P = 0.006). Serotype 1 IPD has been prominent over the 9 years, but there is no evidence of a recent increase in serotype 19A IPD. CONCLUSIONS: Vaccinating Indigenous children with 7vPCV has protected Indigenous adults in north Queensland through an indirect "herd immunity" effect. However, this benefit has been offset by a recent increase in non-7vPCV IPD in Indigenous adults. Newer pneumococcal conjugate vaccines could prevent, both directly and indirectly, a considerable amount of the persisting IPD in Indigenous people in the region. SN - 0025-729X UR - https://www.unboundmedicine.com/medline/citation/18601643/Invasive_pneumococcal_disease_in_Indigenous_people_in_north_Queensland:_an_update_2005_2007_ L2 - https://www.mja.com.au/public/issues/189_01_070708/han10227_fm.html DB - PRIME DP - Unbound Medicine ER -