Tom Blackwell
National Post
06/05/2010

The bacterial pneumonia vaccine given to tens of thousands of Canadians a year appears to do nothing to prevent repeat, often-deadly episodes of the infectious disease, a new study concludes.

Far better immunization strategies are “urgently needed” to curb the number of deaths and illnesses from the pneumococcus bug, say the doctors from Nova Scotia, Ontario and Alberta who spearheaded the research.

As it is now, half of patients hospitalized for pneumonia die or end up in hospital again within five years from another bout of potentially preventable pneumonia or related disease — whether they got the vaccine or not, the study indicated.

Read the rest of the story.

Robert Preidt
HealthDay News
04/21/2010

The advent in 2000 of the PCV7 vaccine to battle bacteria that causes pneumonia, meningitis and sepsis (blood infection) in children has caused notable changes in strains that cause these illnesses, researchers report.

Most worrisome is the recent spread of strains not covered by the vaccine, the team aid.

Immunizations with the PCV7 vaccine is now recommended for all children before the age of 2.

American researchers found that the most common cause of invasive pneumococcal infections is now a strain called serotype 19A, which is not covered by the PCV7 vaccine. The studies also found a rise in infections caused by antibiotic-resistant pneumococci.

One study, an analysis of 2001-07 data by Boston University researchers, revealed that only 15 percent of serious pneumococcal infections in Massachusetts were caused by one of the seven strains covered by the PCV7 vaccine. The remaining 85 percent were caused by other strains, most commonly serotype 19A.

Because infections with PCV7-targeted strains decreased and infections with strains not covered by the vaccine increased, there was little change in the overall rate of serious infections. The fatality rate among children with serious infections was 1.4 percent, and most of the deaths occurred in patients younger than 1 year old.

An increase in serious infections caused by serotype 19A since the introduction of PCV7 was also noted by researchers at the University of Texas Southwestern Medical Center in Dallas.

Both teams also found a significant rise in infections caused by antibiotic-resistant pneumococci — mainly serotype 19A — and stressed the need for continued monitoring of trends in invasive pneumococcal infections.

The studies are published in the April issue of the Pediatric Infectious Disease Journal.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about pneumococcal disease.

– Robert Preidt

SOURCE: The Pediatric Infectious Disease Journal, news release, April 12, 2010

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Medical News Today
04/13/2010

In the decade since the introduction of pneumococcal vaccination, significant shifts have occurred in the bacterial strains causing serious pneumococcal infections in children, according to a pair of studies in the April issue of The Pediatric Infectious Disease Journal. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

The two studies one from Massachusetts and one from Texas find that the most common cause of invasive pneumococcal infections is now a strain called serotype 19A, which is not prevented by the current pneumococcal vaccine. The studies also document a rising rate of infections caused by antibiotic-resistant pneumococci.

In Massachusetts, Serotype 19A Is Now Most Common Cause of Infection

A study led by Dr. Katherine K. Hsu of Boston University used a microbiology database to analyze trends in pneumococcal infection among Massachusetts children since introduction of the “PCV7″ pneumococcal vaccine in 2000. Before PCV7 vaccination, pneumococci were the leading cause of invasive bacterial infections in children, including pneumonia, meningitis, and bloodstream infection.

Pneumococcal vaccination is currently recommended for all children before age two. The vaccine is called PC7 because it protects against seven major disease-causing strains of pneumococci.

From 2001 to 2007, only 15 percent of serious pneumococcal infections in Massachusetts were caused by one of the seven strains covered by the PC7 vaccine. The remaining 85 percent were caused by other strains, most commonly serotype 19A.

As infections with PC7-covered strains decreased, infections with strains not covered by PC7 increased as a result, the overall rate of serious infections remained about the same. Although most of the children recovered from their infection, the fatality rate was 1.4 percent. Most of the deaths occurred in infants less than one year old.

Texas Study Shows Increase in Antibiotic-Resistant Pneumococci

A study led by Dr. Chonnamet Techasaensrir of University of Texas Southwestern Medical Center, Dallas, found that invasive pneumococcal infections decreased after the introduction of PCV7. However, from 2006 to 2008, the infection rate began to rise again. As in Massachusetts, more infections were caused by serotype 19A.

There was also a significant increase in infections caused by antibiotic-resistant pneumococc mainly serotype 19A. This is of special concern because these antibiotic-resistant bacteria were not previously identified in Dallas; the Massachusetts study also showed an increased rate of antibiotic resistance. Both groups of researchers highlight the need for continued surveillance to monitor trends in invasive pneumococcal infections and the emergence of antibiotic-resistant strains.

The new results are consistent with worldwide data on trends in pneumococcal infection, according to an accompanying editorial by Dr. Steve Black of Cincinnati Children’s Hospital. He stresses that the fluctuations in infection rates and the emergence of antibiotic-resistant bacteria do not mean that the PCV7 vaccination program is a failure patterns of antibiotic use have probably played a more important role in the shift toward serotype 19A. “It must be emphasized that introduction of PCV7 in the United States has resulted in an overall reduction in invasive pneumococcal disease in children of almost 80 percent,” Dr. Black writes.

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By Trang Do
Waff48News
04/12/2010

HUNTSVILLE, AL (WAFF) – Children in Alabama will have to roll up their sleeves a couple of extra times.

They’re now being required to get two additional vaccinations.

These extra shots will mean better health for our children.

They have been available and recommended for the past few years, but after some extensive studying, state health officials have decided to make them mandatory.

Alabama has seen a marked increase in whooping cough cases recently, a move that has prompted state health officials to try to get ahead of the problem.

“It’s nothing more than an aggravating cough for most people,” said Dr. Larry Robey, Madison County Public Health Officer. ”But when an adult or adolescent has whooping cough, they can infect a baby where it can be a serious life threatening disease.”

Before they enter the sixth grade, children 11 years of age or older now must get the TDAP vaccine, which prevents pertussis, more widely known as whooping cough.

In 2009, Alabama had 314 reported cases, when for the past decade numbers averaged at fewer than 100 cases per year.

Madison County had the third highest instance of whooping cough in 2009, at 26 cases.

“We don’t want to see the disease,” Dr. Robey said. “We would prefer to be able to give the vaccine and say we really prevented it, but now that we’re seeing an increase it makes the vaccine that much more important.”

Effective immediately, children under five years of age entering daycare or preschool will be required to get the pneumococcal vaccine, one that protects against the most common cause of meningitis in children.

“This new vaccine is much stronger, gives better protection with less side effects,” Dr. Robey said. ”It has been offered for the past couple of years, we’re now making it mandatory for pre school children.”

Dr. Robey said vaccines have been such an effective tool in preventing the spread of disease, that many people don’t realize some diseases, like whooping cough, are still around.

The Madison County Health Department has both vaccines in stock. Dr. Robey said they also should be available at your family doctor or pediatrician’s office.

Children entering the sixth grade will have to have an immunization certificate showing they received the vaccination before they enter school in the fall.

Children under five will have to do the same before they enter daycare or preschool.