The epidemiology of invasive pneumococcal disease in Alaska, 1986-1990--ethnic differences and opportunities for prevention

J Infect Dis. 1994 Aug;170(2):368-76. doi: 10.1093/infdis/170.2.368.

Abstract

To assess prevention strategies for pneumococcal disease in Alaska, prospective surveillance during 1986-1990 identified 672 invasive pneumococcal infections, including 315 among Alaska Natives. Age-adjusted annual incidence was 74 per 100,000 for Alaska Natives and 16 per 100,000 for nonnatives. The annual incidence in Alaska Native children < 2 years old was 624 per 100,000; rates of 84 per 100,000 for meningitis and 290 per 100,000 for bacteremic pneumonia were 8-10 times higher than for other US groups. By age 75, cumulative incidence (7%) and mortality (1%) in Alaska Natives were almost 4 times higher than for nonnatives. Only 17% of Alaska Native adults with predisposing conditions and invasive infections previously received pneumococcal vaccine. For Alaska Natives, a proposed heptavalent conjugate pneumococcal vaccine will include serotypes responsible for 85% of invasive isolates from children < 2 years but only 32% of those from adults. The 23-valent polysaccharide pneumococcal vaccine, which contains > 94% of serotypes identified in Alaska Native toddlers and adults, should be used more widely.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Alaska / epidemiology
  • Bacteremia / epidemiology
  • Bacteremia / ethnology
  • Bacteremia / prevention & control
  • Bacterial Vaccines
  • Child
  • Child, Preschool
  • Cross Infection / epidemiology
  • Cross Infection / ethnology
  • Cross Infection / prevention & control
  • Female
  • Humans
  • Incidence
  • Indians, North American*
  • Infant
  • Inuits*
  • Male
  • Meningitis, Pneumococcal / epidemiology
  • Meningitis, Pneumococcal / ethnology
  • Meningitis, Pneumococcal / prevention & control
  • Middle Aged
  • Otitis Media / epidemiology
  • Otitis Media / ethnology
  • Otitis Media / prevention & control
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / ethnology
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines
  • Pneumonia, Pneumococcal / epidemiology
  • Pneumonia, Pneumococcal / ethnology
  • Pneumonia, Pneumococcal / prevention & control
  • Recurrence
  • Serotyping
  • Sex Factors
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / immunology
  • Vaccination

Substances

  • Bacterial Vaccines
  • Pneumococcal Vaccines