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Volume 14, Number 1—January 2008
THEME ISSUE
International Polar Year

Research

International Circumpolar Surveillance System for Invasive Pneumococcal Disease, 1999–2005

Michael G. Bruce*Comments to Author , Shelley L. Deeks†1, Tammy Zulz*, Dana Bruden*, Christine Navarro†, Marguerite Lovgren‡, Louise Jette§, Karl G. Kristinsson¶, Gudrun Sigmundsdottir¶, Knud Brinkløv Jensen#, Oistein Lovoll**, J. Pekka Nuorti††, Elja Herva‡‡, Anders Nystedt§§, Anders Sjostedt¶¶, Anders Koch##, Thomas W. Hennessy*, Alan J. Parkinson*, and the International Circumpolar Surveillance System for Invasive Pneumococcal Disease Working Group
Author affiliations: *Centers for Disease Control and Prevention, Anchorage, Alaska, USA; †Public Health Agency of Canada, Ottawa, Ontario, Canada; ‡National Centre for Streptococcus, Edmonton, Alberta, Canada; §Quebec Public Health Laboratory, Ste. Anne-de-Bellevue, Quebec, Canada; ¶Landspitali University Hospital, Reykjavik, Iceland; #Institution of the Chief Medical Officer, Nuuk, Greenland; **Norwegian Institute of Public Health, Oslo, Norway; ††National Public Health Institute, Helsinki, Finland; ‡‡National Public Health Institute, Oulu, Finland; §§Sunderby Hospital, Lulea, Sweden; ¶¶Umea University, Umea, Sweden; ##Statens Serum Institut, Copenhagen, Denmark;

Main Article

Table 4

Rates/100,000 cases of IPD in Alaska and Northern Canada before and after introduction of PCV7*

GroupAlaska
Northern Canada
Prevaccine (1999–2000)Postvaccine (2001–2005)p valuePrevaccine (1999–2002)Vaccine implementation (2003–2005)p value
Total no. cases257512NA16586NA
All ages, y20.6 (257)15.8 (512)0.000431.0 (165)21.6 (86)0.007
<2173.5 (69)79.2 (82)<0.0001185.6 (36)110.0 (16)0.10
2–1910.7 (40)6.6 (64)0.0222.9 (41)9.7 (13)0.009
20–6413.7 (104)14.1 (278)0.8223.8 (74)18.8 (44)0.24
>6557.9 (44)44.5 (88)0.1764.4 (14)73.5 (12)0.84
Indigenous, all ages56.0 (133)38.1 (239)0.000344.2 (134)25.0 (57)0.0005
<2 y440.6 (47)177.5 (50)<0.0001229.3 (33)92.6 (10)0.01
Nonindigenous, all ages12.3 (124)10.4 (273)0.139.6 (20)10.2 (16)0.86
<2 y
75.7 (22)
42.5 (32)
0.05

65.4 (3)
87.2 (3)
1.00
PCV 7 serotypes (4, 6B, 9V, 14, 18C, 19F, 23F)†
All ages, y9.6 (120)3.4 (110)<0.000112.6 (67)3.8 (15)<0.0001
<2128.3 (51)15.5 (16)<0.0001128.9 (25)20.6 (3)0.0008
2–195.6 (21)1.6 (16)0.00038.4 (15)1.5 (2)0.01
20–644.1 (31)2.8 (55)0.097.1 (22)1.7 (4)0.005
  ≥6522.4 (17)11.6 (23)0.0523.0 (5)36.8 (6)0.55
Indigenous, all ages24.9 (59)4.9 (31)<0.000117.1 (52)3.5 (8)<0.0001
<2 y318.7 (34)21.3 (6)<0.0001159.8 (23)9.3 (1)0.0001
Nonindigenous, all ages6.0 (61)3.0 (79)<0.00016.2 (13)3.2 (5)0.24
<2 y
58.5 (17)
13.3 (10)
<0.0001

43.6 (2)
29.1 (1)
1.00
Non-PCV7 serotypes†
All ages, y8.3 (104)10.5 (341)0.0417.1 (91)16.8 (67)0.94
  <227.7 (11)59.0 (61)0.0341.2 (8)75.6 (11)0.25
  2–193.5 (13)4.1 (40)0.6514.5 (26)7.4 (10)0.09
  20–647.3 (55)9.6 (189)0.0715.4 (48)16.7 (39)0.75
  >6532.9 (25)25.8 (51)0.3141.4 (9)36.8 (6)1.00
Indigenous, all ages20.2 (48)29.8 (187)0.0125.4 (77)20.2 (46)0.24
<2 y65.6 (7)145.6 (41)0.0548.6 (7)74.1 (8)0.44
Nonindigenous, all ages5.5 (56)5.9 (154)0.712.9 (6)7.0 (11)0.09
<2 y
13.8 (4)
26.6 (20)
0.26

21.8 (1)
58.1 (2)
0.58
Penicillin nonsusceptible IPD, all serotypes‡
All ages4.0 (50)2.1 (68)0.00041.5 (8)0.8 (3)0.37
<2 y
62.9 (25)
21.3 (22)
<0.0001

10.3 (2)
0.0 (0)
0.51
Cotrimoxazole nonsusceptible IPD, all serotypes‡
All ages5.6 (70)3.0 (96)0.00032.6 (14)1.8 (7)0.50
<2 y90.5 (36)25.1 (26)<0.000115.5 (3)13.7 (2)1.00

*IPD, invasive pneumococcal disease, PCV7, 7-valent pneumococcal conjugate vaccine; NA, not available. Values in parentheses are no. cases.
†Serotype available for 675 (88%) of 769 Alaska isolates and 240 (96%) of 251 Northern Canada isolates.
‡Antimicrobial drug susceptibility available for 677 (88%) of 769 Alaska isolates and 236 (94%) of 251 northern Canada isolates.

Main Article

1Current affiliation: National Centre for Immunisation, Research and Surveillance, Westmead, New South Wales, Australia

2The International Circumpolar Surveillance System for Invasive Pneumococcal Disease Working Group: Jean-François Proulx (Department of Public Health, Nunavik Regional Board of Health and Social Services, Quebec City, Quebec, Canada); Robert Carlin (Department of Public Health, Cree Board of Health and Social Services of James Bay, Montreal, Quebec, Canada); Andre Corriveau, Cheryl Case (Northwest Territory Department of Health and Social Services, Yellowknife, Northwest Territories, Canada); Bryce Larke, Colleen Hemsley (Yukon Health and Social Services, Whitehorse, Yukon, Canada); Isaac Sobel, Carolina Palacios (Nunavut Department of Health, Iqaluit, Nunavut, Canada); Gregory Tyrell, Marguerite Lovgren (National Centre for Streptococcus, Edmonton, Alberta, Canada); Alisa Reasonover, Michael G. Bruce, Tammy Zulz, Dana Bruden, Thomas W. Hennessy, Alan J. Parkinson (Centers for Disease Control and Prevention, Anchorage, Alaska, USA); Shelley L. Deeks (National Centre for Immunisation, Research and Surveillance, Westmead, New South Wales, Australia); Christine Navarro (Public Health Agency of Canada, Ottawa, Ontario, Canada); Louise Jette (Quebec Public Health Laboratory, Ste. Anne-de-Bellevue, Quebec, Canada); Karl Kristinsson, Gudrun Sigmundsdottir (Landspitali University Hospital, Reykjavik, Iceland); Knud Brinkløv Jensen (Institution of the Chief Medical Officer, Nuuk, Greenland); Oistein Lovoll (Norwegian Institute of Public Health, Oslo, Norway); J. Pekka Nuorti (National Public Health Institute, Helsinki, Finland); Elja Herva (National Public Health Institute, Oulu, Finland); Anders Sjostedt (Umea University, Umea, Sweden); Anders Nystedt (Sunderby Hospital, Lulea, Sweden); and Anders Koch (Statens Serum Institut, Copenhagen, Denmark)

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