Changing epidemiology of invasive pneumococcal disease in central Australia prior to conjugate vaccine: A 16-year study

This study reports a 16-year prospective surveillance of invasive disease isolates in central Australian Aborigines. There were 621 (89.6% of total) isolates recovered from Aborigines. The mortality in children less than 5 years of age was 4% but rose to 34.5% in those over 49 years of age. The study documented continuing high rates of disease overall, but with significant reductions in incidence rates for children. In children under 2 years of age, the incidence fell by 32% from 2053 per 100,000 in the period 1985-1990 to 1184 per 100,000 in the period 1996-2000. Rates of disease in adults showed no reduction despite an adult immunisation programme with 23 valent vaccine which occurred in the 1990s. Epidemics of serotypes 1, 5 and 12F were documented during the study period. (C) 2006 Elsevier Ltd. All rights reserved.