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CSTE
Position
Statements 2000 ID-#6 COMMITTEE:
Infectious Diseases TITLE:
Surveillance for invasive pneumococcal disease in children less than five
years of age. ISSUE:
Streptococcus pneumoniae
causes 3000 cases of meningitis, 60,000 cases of bacteremia, over 125,000
hospitalizations for pneumonia and 10-15,000 deaths annually.
Increasing resistance of S. pneumoniae
to antibiotics in the last in the last decade is a serious public
health concern. Children less than 5 years of age are disproportionately
affected by invasive pneumococcal disease and drug-resistant infections.
With the licensing of the conjugate pneumococcal vaccine, infections in
this age group are now preventable. Despite
the seriousness of this organism, there is no national disease surveillance for S.
pneumoniae. POSITION
TO BE ADOPTED: Invasive pneumococcal disease in children less
than 5 years of age should be placed under national surveillance according to
the National Public Health Surveillance System (NPHSS).
Although
this Statement addresses invasive pneumococcal disease in children less than 5
years of age, states and territories are encouraged to institute surveillance
for invasive pneumococcal disease in all age groups, especially using legally
mandated notification from laboratories. CDC should
work with states to identify resources needed to support the additional
surveillance activity required. GOALS
FOR SURVEILLANCE: National surveillance will allow for assessment of
the impact of the recently licensed conjugate pneumococcal vaccine in children
and the impact of increasing pneumococcal vaccination coverage among older
adults. On a state level,
surveillance will allow states to raise awareness of vaccine recommendations,
identify areas or populations in which vaccine use is sub-optimal, and monitor
implementation of pneumococcal vaccine programs.
Surveillance of invasive pneumococcal disease will complement the current
reporting of drug-resistant strains and will enable tracking of the proportion
of pneumococcal isolates that are drug-resistant.
Pneumococcus is also a target organism for judicious antibiotic use
campaigns and surveillance will assist in evaluating the impact and progress of
these campaigns. METHODS
FOR SURVEILLANCE: Core
surveillance elements from all cases of invasive pneumococcal disease in a child
less than 5 years of age should be collected from laboratories and transmitted
weekly to CDC by states and territories. CASE
DEFINITION: For purposes of this surveillance recommendation,
invasive pneumococcal disease is defined as S.
pneumoniae isolated from
a normally sterile site (e.g., CSF, blood, joint fluid, pleural fluid,
pericardial fluid, other). DATA
TO BE COLLECTED: Epidemiologically important data, including
demographics, antimicrobial susceptibility, underlying illnesses that are
indications for pneumococcal conjugate vaccine, and vaccination status. PERIOD
FOR SURVEILLANCE: Permanent BACKGROUND
AND JUSTIFICATION: Each year in the United States, invasive Streptococcus
pneumoniae causes approximately 3,000 cases of meningitis, 60,000
cases of bacteremia, over 125,000 cases of pneumonia requiring hospitalization,
and 10-15,000 deaths. The
Food and Drug Administration (FDA) recently approved a conjugate heptavalent
pneumococcal vaccine (Prevnar®) for prevention of invasive pneumococcal disease
in infants and children. The
Advisory Committee on Immunization Practices (ACIP) will recommend vaccination
in all children at the ages of 2, 4, 6 and 12-15 months and a catch-up schedule
for children through age 59 months. National
Healthy People 2010 objective 14-5 calls for reduction of invasive pneumococcal
disease to 46 per 100,000 children less than 5 years of age . As of
January 1, 1999, 23 states required reporting of invasive pneumococcal disease
and 28 required reporting of drug-resistant S.
pneumoniae (Roush et al., JAMA 1999;282).
Currently there is no national reporting system for invasive pneumococcal
disease. Establishing a national
system would help to monitor the impact of immunization programs, tracking
progress toward Healthy People 2010 objectives, and, in conjunction with
reporting of drug-resistant strains, permit the assessment of the proportion of
pneumococcal isolates that are drug-resistant. COORDINATION
WITH OTHER ORGANIZATIONS: Agencies for
Response: National
Immunization Program Walter Orenstein, MD National
Immunization Program 1600
Clifton Road, NE Mailstop
E-5 Atlanta, GA 30333 National
Center for Infectious Diseases James Hughes 1600
Clifton Road, NE Mailstop
C-12 Atlanta, GA 30333 Association
of Public Health Laboratories (APHL) President,
APHL in care of : Scott
Becker, Executive Director 1211
Connecticut Avenue, NW, Suite 608 CONTACT: Jerry
Gibson, M.D., M.P.H. State
Epidemiologist South
Carolina Department of Health and Control Environmental
Control Mills
Jarrett Building Columbia,
SC 29211 Phone:
(803)898-0713 Fax:
(803)898-0573 e-mail: gibsonjj@columb60.dhec.state.sc.us CSTE
Position
Statements 2000 ID-#6 COMMITTEE:
Infectious Diseases TITLE:
Surveillance for invasive pneumococcal disease in children less than five
years of age. ISSUE:
Streptococcus pneumoniae
causes 3000 cases of meningitis, 60,000 cases of bacteremia, over 125,000
hospitalizations for pneumonia and 10-15,000 deaths annually.
Increasing resistance of S. pneumoniae
to antibiotics in the last in the last decade is a serious public
health concern. Children less than 5 years of age are disproportionately
affected by invasive pneumococcal disease and drug-resistant infections.
With the licensing of the conjugate pneumococcal vaccine, infections in
this age group are now preventable. Despite
the seriousness of this organism, there is no national disease surveillance for S.
pneumoniae. POSITION
TO BE ADOPTED: Invasive pneumococcal disease in children less
than 5 years of age should be placed under national surveillance according to
the National Public Health Surveillance System (NPHSS).
Although
this Statement addresses invasive pneumococcal disease in children less than 5
years of age, states and territories are encouraged to institute surveillance
for invasive pneumococcal disease in all age groups, especially using legally
mandated notification from laboratories. CDC should
work with states to identify resources needed to support the additional
surveillance activity required. GOALS
FOR SURVEILLANCE: National surveillance will allow for assessment of
the impact of the recently licensed conjugate pneumococcal vaccine in children
and the impact of increasing pneumococcal vaccination coverage among older
adults. On a state level,
surveillance will allow states to raise awareness of vaccine recommendations,
identify areas or populations in which vaccine use is sub-optimal, and monitor
implementation of pneumococcal vaccine programs.
Surveillance of invasive pneumococcal disease will complement the current
reporting of drug-resistant strains and will enable tracking of the proportion
of pneumococcal isolates that are drug-resistant.
Pneumococcus is also a target organism for judicious antibiotic use
campaigns and surveillance will assist in evaluating the impact and progress of
these campaigns. METHODS
FOR SURVEILLANCE: Core
surveillance elements from all cases of invasive pneumococcal disease in a child
less than 5 years of age should be collected from laboratories and transmitted
weekly to CDC by states and territories. CASE
DEFINITION: For purposes of this surveillance recommendation,
invasive pneumococcal disease is defined as S.
pneumoniae isolated from
a normally sterile site (e.g., CSF, blood, joint fluid, pleural fluid,
pericardial fluid, other). DATA
TO BE COLLECTED: Epidemiologically important data, including
demographics, antimicrobial susceptibility, underlying illnesses that are
indications for pneumococcal conjugate vaccine, and vaccination status. PERIOD
FOR SURVEILLANCE: Permanent BACKGROUND
AND JUSTIFICATION: Each year in the United States, invasive Streptococcus
pneumoniae causes approximately 3,000 cases of meningitis, 60,000
cases of bacteremia, over 125,000 cases of pneumonia requiring hospitalization,
and 10-15,000 deaths. The
Food and Drug Administration (FDA) recently approved a conjugate heptavalent
pneumococcal vaccine (Prevnar®) for prevention of invasive pneumococcal disease
in infants and children. The
Advisory Committee on Immunization Practices (ACIP) will recommend vaccination
in all children at the ages of 2, 4, 6 and 12-15 months and a catch-up schedule
for children through age 59 months. National
Healthy People 2010 objective 14-5 calls for reduction of invasive pneumococcal
disease to 46 per 100,000 children less than 5 years of age . As of
January 1, 1999, 23 states required reporting of invasive pneumococcal disease
and 28 required reporting of drug-resistant S.
pneumoniae (Roush et al., JAMA 1999;282).
Currently there is no national reporting system for invasive pneumococcal
disease. Establishing a national
system would help to monitor the impact of immunization programs, tracking
progress toward Healthy People 2010 objectives, and, in conjunction with
reporting of drug-resistant strains, permit the assessment of the proportion of
pneumococcal isolates that are drug-resistant. COORDINATION
WITH OTHER ORGANIZATIONS: Agencies for
Response: National
Immunization Program Walter Orenstein, MD National
Immunization Program 1600
Clifton Road, NE Mailstop
E-5 Atlanta, GA 30333 National
Center for Infectious Diseases James Hughes 1600
Clifton Road, NE Mailstop
C-12 Atlanta, GA 30333 Association
of Public Health Laboratories (APHL) President,
APHL in care of : Scott
Becker, Executive Director 1211
Connecticut Avenue, NW, Suite 608 CONTACT: Jerry
Gibson, M.D., M.P.H. State
Epidemiologist South
Carolina Department of Health and Control Environmental
Control Mills
Jarrett Building Columbia,
SC 29211 Phone:
(803)898-0713 Fax:
(803)898-0573 e-mail: gibsonjj@columb60.dhec.state.sc.us
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