Epidemiology and Infection

Pneumococcal infection and pneumonia

Increasing incidence of invasive pneumococcal disease and pneumonia despite improved vaccination uptake: surveillance in Hull and East Yorkshire, UK, 2002–2009

J. W. T. ELSTONa1 c1, A. SANTANIELLO-NEWTONa2, J. A. MEIGHa3, D. HARMERa2, V. ALLGARa4, T. ALLISONa5, G. RICHARDSONa6, R. MEIGHa3, S. R. PALMERa7 and G. BARLOWa1

a1 Hull and East Yorkshire Hospitals NHS Trust, Department of Infection and Tropical Medicine, Hull, UK

a2 Health Protection Agency, North Yorkshire and the Humber, UK

a3 Hull and East Yorkshire Hospitals NHS Trust, Department of Medical Microbiology, Hull, UK

a4 Hull York Medical School, Department of Medical Statistics, York, UK

a5 NHS East Riding of Yorkshire and East Riding of Yorkshire Council, East Riding of Yorkshire, UK

a6 University of York, Centre for Health Economics, York, UK

a7 Cardiff University, Department of Primary Care and Public Health, Cardiff, UK

SUMMARY

Introduction of pneumococcal polysaccharide (PPV23) and conjugate vaccine (PCV7) programmes were expected to change the epidemiology of invasive pneumococcal disease (IPD) and pneumonia in the UK. We describe the epidemiology of IPD and hospitalization with pneumonia using high-quality surveillance data over an 8-year period, 2002–2009. Although PPV23 uptake increased from 49% to 70% and PCV7 uptake reached 98% by 2009, the overall incidence of IPD increased from 11·8/100 000 to 16·4/100 000 (P=0·13), and the incidence of hospitalization with pneumonia increased from 143/100 000 to 207/100 000 (P<0·001). Although a reduction in the proportion of IPD caused by PCV7 serotypes was observed, concurrent increases in PPV23 and non-vaccine serotype IPD contributed to an increased IPD burden overall. Marked inequalities in the geographical distribution of disease were observed. Existing vaccination programmes have, so far, not been sufficient to address an increasing burden of pneumococcal disease in our locality.

(Accepted August 26 2011)

(Online publication November 01 2011)

Correspondence:

c1 Author for correspondence: Dr J. W. T. Elston, Department of Infection and Tropical Medicine, Main Administration block, Castle Hill Hospital, Cottingham, East Yorkshire, HU16 5JQ, UK. (Email: jameselston2003@yahoo.co.uk)

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