KEYWORD1:
Streptococcus pneumoniae, surveillance, pneumococcal conjugate vaccine, and children.

BACKGROUND:
Invasive Streptococcus pneumoniae (SPN) is the leading cause of pneumonia, bacteremia, sinusitis, and acute otitis media in the United States. The highest rates of pneumococcal disease occur among young children. In February 2000, the FDA licensed a 7-valent pneumococcal conjugate vaccine (Prevnar ®, Wyeth Averst Laboratories) for use among children < 5 years. The seven serotypes included in the vaccine are estimated to cover > 80% of invasive SPN disease in children. States participating in the CDC Emerging Infections Program (EIP) conduct active population based surveillance on select foodborne and invasive bacterial diseases, including invasive SPN. In NYS, seven Rochester and eight Albany area counties participate in the EIP.

OBJECTIVE:
Conduct complete and timely surveillance of invasive SPN to monitor changes in the incidence of disease, factors associated with illness, drug resistance, vaccine use and failure, and serotype distribution.

METHOD:
Cases of invasive pneumococcal disease were identified through utilization of the NYS Health Information Network (HIN) and the Clinical Laboratory Information Management System (CLIMS) for 1999-2002.

RESULT:
In 2001 there was an 80% decease in the number of SPN cases among children < 1 year and a 38.5% decrease in children 1-4 years of age, compared to 1999/2000. To date, there have been 2 vaccine failures identified in the 15 county NYS EIP catchment area.

CONCLUSION:
The pneumococcal conjugate vaccine appears to have had a significant impact on the number of cases of invasive SPN reported among young children. Continued surveillance of invasive SPN, including susceptibility and serpotype testing, is critical in determining the potential for future vaccine failures, replacement disease, and herd immunity.
LEARNINGOBJECTIVES:
To quantify the effect a new vaccine has on its intended population, employing active population disease surveillance methods.