Skip Navigation LinksHome > March 2010 - Volume 29 - Issue 3 > Invasive Pneumococcal Disease in Alaskan Children: Impact of...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e3181bdbed5
Original Studies

Invasive Pneumococcal Disease in Alaskan Children: Impact of the Seven-Valent Pneumococcal Conjugate Vaccine and the Role of Water Supply

Wenger, Jay D. MD*; Zulz, Tammy MPH*; Bruden, Dana MS*; Singleton, Rosalyn MD, MPH*; Bruce, Michael G. MD, MPH*; Bulkow, Lisa MS*; Parks, Debbie BS*; Rudolph, Karen PhD*; Hurlburt, Debby RN*; Ritter, Troy REHS, MPH†; Klejka, Joseph MD‡; Hennessy, Thomas MD, MPH*

Collapse Box

Abstract

Background: Alaska Native (AN) children, especially those in the Yukon-Kuskokwim region (YK-AN children), suffer some of the highest rates of invasive pneumococcal disease (IPD) in the world. Rates of IPD declined after statewide introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2001, but increased in subsequent years.

Methods: Population-based laboratory surveillance data (1986–2007) for invasive Streptococcus pneumoniae infection in Alaskan children <5 years old were used to evaluate the association of IPD rates and serotype distribution with immunization, socioeconomic status, and in-home water service.

Results: Introduction of PCV7 vaccine resulted in elimination of IPD caused by vaccine serotypes, but was followed by increasing rates of IPD caused by nonvaccine serotypes. Among YK-AN children IPD rates dropped by 60%, but then rose due to non-PCV7 serotypes to levels 5- to 10-fold higher than rates in non-YK-AN children and non-AN children. IPD rates in YK-AN children were twice as high in villages where <10% of houses had in-home piped water compared with villages where more than 80% of houses had in-home piped water (390 cases/100,000 vs. 146 cases/100,000, P = 0.008).

Conclusions: High IPD rates in Alaska are associated with lack of in-home piped water (controlling for household crowding and per capita income). The effect of in-home piped water is most likely mediated through reduced water supply leading to limitations on handwashing.

© 2010 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.