Invasive pneumococcal disease in the Kimberley, 1995–2001
Mak, D. M. (2004). Invasive pneumococcal disease in the Kimberley, 1995–2001. Australian Journal of Rural Health, 12(6), 237-240. doi: 10.1111/j.1440-1854.2004.00621.x
To describe the epidemiology of invasive pneumococcal disease (IPD) in the Kimberley and examine whether cases could have been prevented by vaccination.Prospective case series of IPD cases from 1 January 1995 to 31 December 2001.The Kimberley region of far north-western Australia.Seventy IPD cases in 37 men and 33 women aged 5 months to 90 years. Aboriginal people comprised 90% (63/70) of cases.Demographic, clinical and microbiological characteristics of IPD cases. Proportion of cases caused by vaccine-preventable serotypes. IPD incidence in the Kimberley.Pneumonia and bacteraemia were the commonest clinical presentations. Of IPD cases, 15% (children) and 67% (adults) had a risk factor for IPD. The case fatality rate was 13%. Of cases, 46% (95% confidence interval (CI) 35–58%) were caused by serotypes covered by an age-appropriate vaccine. Of the 26 cases eligible for pneumococcal vaccination, only 4 (16%) had been appropriately vaccinated. IPD incidence in Aboriginal people aged 15 years and over declined from 97.8/100 000 person years (95% CI 56.5–139.1) in 1997 to 38.1/100 000 person years (95% CI 22.5–53.9) in 2001.The significant proportion of cases caused by vaccine-preventable serotypes and that was, therefore, preventable underscores the importance of pneumococcal vaccination.What is already known? IPD is a major cause of morbidity and mortality worldwide, and especially in Indigenous Australian populations; however, there is little published information about the epidemiology of this illness in the Kimberley region of Western Australia, which has a large Indigenous population. What does this study add? Many Kimberley IPD cases are caused by vaccine-preventable serotypes and are, therefore, potentially preventable. Following the introduction of an adult pnuemococcal vaccination program in 1996, IPD incidence in Kimberley Aboriginal adults fell significantly.
pneumococcal pneumonia, epidemiology, vaccination, preventive medicine, immunisation