A summary of CDC's surveillance page for public health professionals.
Invasive pneumococcal disease (IPD) is when Streptococcus pneumoniae invades parts of the body that are normally germ-free, such as the blood. CDC tracks IPD through two surveillance systems; it does not track non-invasive disease such as pneumococcal ear infections.
The two systems
| System | What it does |
|---|---|
| National Notifiable Diseases Surveillance System (NNDSS) | Invasive diseases, such as meningitis and bacteraemia, are the only nationally notifiable diseases caused by S. pneumoniae. CDC receives NNDSS data weekly from state and public health partners |
| Active Bacterial Core surveillance (ABCs) | Run with some state health departments as part of CDC's Emerging Infections Program; covers IPD such as meningitis, bacteraemia, osteomyelitis and septic arthritis. The Bact Facts Interactive dashboard lets anyone analyse its IPD data |
The most recent case definition for IPD was issued by the Council of State and Territorial Epidemiologists in 2017.
Trends in the United States
- Since 1998, when IPD surveillance began, rates in children and adults have fallen dramatically, especially after pneumococcal conjugate vaccines (PCVs) came into use in 2000.
- Season: pneumococcal infections are more common in winter and early spring, when respiratory illnesses are more widespread.
- Antibiotic resistance: in more than 40% of IPD cases the bacteria are not susceptible to one or more classes of antibiotics.
When CDC recommended each conjugate vaccine
| Vaccine | Recommended |
|---|---|
| PCV7 | 2000, children |
| PCV13 | 2010, children; 2012, adults with risk conditions; 2014–2019, adults 65 or older |
| PCV15 | 2021, adults; 2022, children |
| PCV20 | 2021, adults; 2023, children |
Children
From 1998 through 2021, IPD rates in children under 5 fell by:
- 95% overall;
- 99% for disease caused by the serotypes PCV13 covers.
Adults
Adult IPD rates fell after children began receiving PCVs, because vaccinating children can give herd immunity that protects adults. IPD caused by the serotypes in the 23-valent polysaccharide vaccine (PPSV23, available since 1984) also fell — but only because of declines in the serotypes it shares with PCV13.
Worldwide
- S. pneumoniae remains a leading cause of illness and death in children under 5, mostly in developing countries.
- It is the leading cause of bacterial pneumonia globally; CDC cites a study finding it accounted for more deaths than all other causes combined in 2016, most of them in Africa and Asia.
- Gavi, the Vaccine Alliance, has helped many low-income countries add a PCV to their immunisation programmes, and countries that did have seen large falls in IPD and pneumonia.
Sources
- Centers for Disease Control and Prevention, "Pneumococcal Disease Surveillance and Trends." https://www.cdc.gov/pneumococcal/php/surveillance/index.html
- Data: NNDSS infectious disease tables and ABCs annual reports for IPD. Further: the pneumococcal chapter of CDC's Manual for the Surveillance of Vaccine-Preventable Diseases and Antibiotic Resistance Threats in the United States, 2019.
- Rewritten in hubnx's own words.
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