National Institute for Communicable Diseases -- Weekly Surveillance Report --
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1 Weekly Surveillance Report Week 43, 216 National Institute for Communicable Diseases -- Weekly Surveillance Report -- Page 2 Laboratory-Based Respiratory & Meningeal Disease Surveillance 3 Neisseria meningitidis 7 Haemophilus influenzae 11 Streptococcus pneumoniae This report reflects only laboratory-confirmed invasive disease, and only as reported to the National Institute for Communicable Diseases to date. Delayed reporting is an inherent limitation of laboratory-based surveillance. Page 1 of 14
2 Laboratory-Based Respiratory & Meningeal Disease Surveillance Reporting period 1/1/216 to 1/11/216 Results until end of epidemiologic week 43 (216) Programme Description: The Centre for Respiratory Diseases and Meningitis (CRDM) at the National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS) monitors invasive disease caused by Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae through a national, active, laboratory-based surveillance system (as part of GERMS-SA). All microbiology diagnostic laboratories throughout South Africa are requested to report laboratoryconfirmed disease (defined as the isolation of Neisseria meningitidis, Haemophilus influenzae, or Streptococcus pneumoniae from normally sterile site specimens e.g. CSF or blood, or for culturenegative cases, any two of the following: a positive antigen latex agglutination test, a consistent Gram stain, and/or positive polymerase chain reaction [PCR]). Reporting laboratories should include all private- and public-sector health care laboratories, and other specialist laboratories e.g. laboratories serving mining or military hospitals. Available isolates are sent to CRDM for confirmation and further characterisation, including serogrouping. Increasingly more culturenegative specimens are being sent for PCR testing. Some of the limitations of this surveillance system are that we include only individuals that arrive at hospitals and have specimens taken, and cases are only counted if laboratories report them to us. Quarterly audits to verify completeness of reporting are conducted for all public-sector laboratories. Frequent communications and visits are conducted to improve case reporting. Isolates for serogrouping are not available for cases identified by audit. Comments: By week 43 in 216, 111 meningococcal cases had been reported to the NICD. Serogrouping results to date include 31 B, 12 C, 21 W and 12 Y. For the same period last year, a total of 133 cases had been reported. Two hundred and fifty (25) cases of H. influenzae have been reported to date in 216. Serotyping results to date include 1 a, 35 b, 2 c, 1 d, 5 e, 7 f and 66 non-typeable. For the same period last year, a total of 287 cases had been reported. To date this year, 1988 pneumococcal cases have been reported, compared to 2219 cases reported for the same period last year. Most cases occurred in children aged <5 years and adults aged 3-44 years. Reductions of cases reported in 216 may reflect the inherent delays of laboratory-based reporting, but may also reflect ongoing operational changes. Page 2 of 14
3 Neisseria meningitidis : Report until end of week 43, 215 and 216 Table 1. Number of Neisseria meningitidis cases Table 2. Number of Neisseria meningitidis by week in South Africa, 215 and 216 cases by province in South Africa, 215 and 216 Week Province* EC FS GA KZ LP MP NC NW WC Total Table 3. Number of Neisseria meningitidis cases 13 3 by serogroup in South Africa, 215 and Serogroup A B C W X Y Neg ABCWXY Non-groupable No serogroup# Total Table 4. Number of Neisseria meningitidis cases by age group in South Africa, 215 and Age group (years) > Unknown Total Table 5. Number of Neisseria meningitidis cases 46 in children <1 years by age in South Africa, 215 and Age (years) < *EC: Eastern Cape; FS: Free State; GA: Gauteng; KZ: KwaZulu-Natal; LP: Limpopo; MP: Mpumalanga; NC: Northern Cape; NW: North West; WC: Western Cape #No serogroup: Cases with serogrouping results not yet available Total Page 3 of 14
4 Neisseria meningitidis 9 Figure 1: Number of Neisseria meningitidis cases by week in South Africa, 215 and 216 (until end week 43) Week Page 4 of 14
5 A B C W X Y Neg ABCWXY Nongroupable No serogroup# Number of cases Number of cases Neisseria meningitidis Figure 2: Number of Neisseria meningitidis cases by province* in South Africa, 215 and 216 (until end week 43) EC FS GA KZ LP MP NC NW WC Province Figure 3: Number of Neisseria meningitidis cases by serogroup in South Africa, 215 and 216 (until end week 43) Serogroup #No serogroup: Cases with serogrouping results not yet available, no isolate, or identified on audit. *EC: Eastern Cape; FS: Free State; GA: Gauteng; KZ: KwaZulu-Natal; LP: Limpopo; MP: Mpumalanga; NC: Northern Cape; NW: North West; WC: Western Cape Page 5 of 14
6 >79 Unknown Number of cases Neisseria meningitidis 7 Figure 4: Number of Neisseria meningitidis cases by age group in South Africa, 215 and 216 (until end week 43) Age group (years) Figure 5: Number of Neisseria meningitidis cases in children <1 years, by age in years, in South Africa, 215 and 216 (until end week 43) < Age (years) Page 6 of 14
7 Haemophilus influenzae : Report until end of week 43, 215 and 216 Table 6. Number of Haemophilus influenzae cases Table 8. Number of Haemophilus influenzae cases by month in South Africa, 215 and 216 by serotype in South Africa, 215 and 216 Month Serotype Jan 2 12 a 11 1 Feb b Mar c 2 2 Apr d 1 1 May e 2 5 Jun f 11 7 Jul NT Aug No serotype# Sep 3 26 Total Oct Nov Table 9. Number of Haemophilus influenzae cases Dec by age group in South Africa, 215 and 216 Total Age group (s) Table 7. Number of Haemophilus influenzae cases by province in South Africa, 215 and Province* EC FS GA KZ > LP 5 6 Unknown MP 9 8 Total NC 1 5 NW 3 5 Table 1. Number of Haemophilus influenzae cases WC in children <1 years by age in South Africa, 215 and 216 Total Age (years) < Total #No serotype: Cases with serotyping results not yet available, no isolate, or identified on audit. *EC: Eastern Cape; FS: Free State; GA: Gauteng; KZ: KwaZulu-Natal; LP: Limpopo; MP: Mpumalanga; NC: Northern Cape; NW: North West; WC: Western Cape Page 7 of 14
8 Haemophilus influenzae Figure 6: Number of Haemophilus influenzae cases by month in South Africa, 215 and 216 (until end week 43) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Month Page 8 of 14
9 Number of cases Haemophilus influenzae Figure 7: Number of Haemophilus influenzae cases by province* in South Africa, 215 and 216 (until end week 43) EC FS GA KZ LP MP NC NW WC Province Figure 8: Number of Haemophilus influenzae cases by serogroup in South Africa, 215 and 216 (until end week 43) a b c d e f NT No serotype# Serotype #No serotype: Cases with serotyping results not yet available, no isolate, or identified on audit. *EC: Eastern Cape; FS: Free State; GA: Gauteng; KZ: KwaZulu-Natal; LP: Limpopo; MP: Mpumalanga; NC: Northern Cape; NW: North West; WC: Western Cape Page 9 of 14
10 >79 Unknown Number of cases Haemophilus influenzae Figure 9: Number of Haemophilus influenzae cases by age group in South Africa, 215 and 216 (until end week 43) Age group (years) Figure 1: Number of Haemophilus influenzae cases in children <1 years, by age in years, in South Africa, 215 and 216 (until end week 43) < Age (years) Page 1 of 14
11 Streptococcus pneumoniae : Report until end of week 43, 215 and 216 Table 11. Number of Streptococcus pneumoniae cases Table 12. Number of Streptococcus pneumoniae by week in South Africa, 215 and 216 cases by province* in South Africa, 215 and 216 Week Province EC FS GA KZ LP MP NC NW WC Total Table 13. Number of Streptococcus pneumoniae cases by PCV13 serotype in children<5 in South Africa, 215 and Serogroup A B F V C A F F Total Table 14. Number of Streptococcus pneumoniae cases by age group in South Africa, 215 and Age group (s) > Unknown Total Table 15. Number and proportion of Streptococcus pneumoniae cases 52 by penicillin susceptibility in South Africa, 215 and Penicillin susceptibility 215 (n) 215 (%) 216(n) 216 (%) Susceptible Intermediate Resistant Unknown Total *EC: Eastern Cape; FS: Free State; GA: Gauteng; KZ: KwaZulu -Natal; LP: Limpopo; MP: Mpumalanga; NC: Northern Cape; NW: North West; WC: Western Cape Page 11 of 14
12 Streptococcus pneumoniae 9 Figure 11: Number of Streptococcus pneumoniae cases by week in South Africa, 215 and 216 (until end week 43) Week Page 12 of 14
13 Number of cases Streptococcus pneumoniae Figure 12: Number of Streptococcus pneumoniae cases by province* in South Africa, 215 and 216 (until end week 43) EC FS GA KZ LP MP NC NW WC Province Figure 13: Number of Streptococcus pneumoniae cases by 13-valent pneumococcal conjugate vaccine (PCV13) serotype in children <5 years in South Africa, 215 and 216 (until end week 43) A 6B 7F 9V 14 18C 19A 19F 23F Total PCV13 Serotype *EC: Eastern Cape; FS: Free State; GA: Gauteng; KZ: KwaZulu-Natal; LP: Limpopo; MP: Mpumalanga; NC: Northern Cape; NW: North West; WC: Western Cape Page 13 of 14
14 >64 Unknown Number of cases Streptococcus pneumoniae 35 3 Figure 14: Number of Streptococcus pneumoniae cases by age category in South Africa, 215 and 216 (until end week 43) Age category (years) Figure 15: Number of Streptococcus pneumoniaecases by penicillin susceptibility, in South Africa, 215 and 216 (until end week 43)^ (n) 216(n) Susceptible Intermediate Resistant Unknown Penicillin susceptibilities ^CLSI breakpoints for penicillin (oral penicillin V) were used: susceptible, <=.6mg/L; intermediately resistant, =.12-1mg/L; resistant, >=2mg/L. #Unknown: Cases with susceptibility results not yet available, no isolate, or identified on audit. Page 14 of 14
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