Volume 14, Number 1—January 2008
THEME ISSUE
International Polar Year
Research
International Circumpolar Surveillance System for Invasive Pneumococcal Disease, 1999–2005
, 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
Table 4
Rates/100,000 cases of IPD in Alaska and Northern Canada before and after introduction of PCV7*
| Group | Alaska | Northern Canada | |||||
|---|---|---|---|---|---|---|---|
| Prevaccine (1999–2000) | Postvaccine (2001–2005) | p value | Prevaccine (1999–2002) | Vaccine implementation (2003–2005) | p value | ||
| Total no. cases | 257 | 512 | NA | 165 | 86 | NA | |
| All ages, y | 20.6 (257) | 15.8 (512) | 0.0004 | 31.0 (165) | 21.6 (86) | 0.007 | |
| <2 | 173.5 (69) | 79.2 (82) | <0.0001 | 185.6 (36) | 110.0 (16) | 0.10 | |
| 2–19 | 10.7 (40) | 6.6 (64) | 0.02 | 22.9 (41) | 9.7 (13) | 0.009 | |
| 20–64 | 13.7 (104) | 14.1 (278) | 0.82 | 23.8 (74) | 18.8 (44) | 0.24 | |
| >65 | 57.9 (44) | 44.5 (88) | 0.17 | 64.4 (14) | 73.5 (12) | 0.84 | |
| Indigenous, all ages | 56.0 (133) | 38.1 (239) | 0.0003 | 44.2 (134) | 25.0 (57) | 0.0005 | |
| <2 y | 440.6 (47) | 177.5 (50) | <0.0001 | 229.3 (33) | 92.6 (10) | 0.01 | |
| Nonindigenous, all ages | 12.3 (124) | 10.4 (273) | 0.13 | 9.6 (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, y | 9.6 (120) | 3.4 (110) | <0.0001 | 12.6 (67) | 3.8 (15) | <0.0001 | |
| <2 | 128.3 (51) | 15.5 (16) | <0.0001 | 128.9 (25) | 20.6 (3) | 0.0008 | |
| 2–19 | 5.6 (21) | 1.6 (16) | 0.0003 | 8.4 (15) | 1.5 (2) | 0.01 | |
| 20–64 | 4.1 (31) | 2.8 (55) | 0.09 | 7.1 (22) | 1.7 (4) | 0.005 | |
| ≥65 | 22.4 (17) | 11.6 (23) | 0.05 | 23.0 (5) | 36.8 (6) | 0.55 | |
| Indigenous, all ages | 24.9 (59) | 4.9 (31) | <0.0001 | 17.1 (52) | 3.5 (8) | <0.0001 | |
| <2 y | 318.7 (34) | 21.3 (6) | <0.0001 | 159.8 (23) | 9.3 (1) | 0.0001 | |
| Nonindigenous, all ages | 6.0 (61) | 3.0 (79) | <0.0001 | 6.2 (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, y | 8.3 (104) | 10.5 (341) | 0.04 | 17.1 (91) | 16.8 (67) | 0.94 | |
| <2 | 27.7 (11) | 59.0 (61) | 0.03 | 41.2 (8) | 75.6 (11) | 0.25 | |
| 2–19 | 3.5 (13) | 4.1 (40) | 0.65 | 14.5 (26) | 7.4 (10) | 0.09 | |
| 20–64 | 7.3 (55) | 9.6 (189) | 0.07 | 15.4 (48) | 16.7 (39) | 0.75 | |
| >65 | 32.9 (25) | 25.8 (51) | 0.31 | 41.4 (9) | 36.8 (6) | 1.00 | |
| Indigenous, all ages | 20.2 (48) | 29.8 (187) | 0.01 | 25.4 (77) | 20.2 (46) | 0.24 | |
| <2 y | 65.6 (7) | 145.6 (41) | 0.05 | 48.6 (7) | 74.1 (8) | 0.44 | |
| Nonindigenous, all ages | 5.5 (56) | 5.9 (154) | 0.71 | 2.9 (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 ages | 4.0 (50) | 2.1 (68) | 0.0004 | 1.5 (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 ages | 5.6 (70) | 3.0 (96) | 0.0003 | 2.6 (14) | 1.8 (7) | 0.50 | |
| <2 y | 90.5 (36) | 25.1 (26) | <0.0001 | 15.5 (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.
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)