Invsive Pneumococcl Disese Qurterly Report July Septemer Introduction Since 17 Octoer 2008, invsive pneumococcl disese (IPD) hs een notifile to the locl Medicl Officer of Helth under the Helth Act 1956. The pneumococcl conjugte vccine (PCV) ws dded to the New Zelnd childhood immunistion schedule on 1 June 2008, nd hs since undergone numer of chnges: Prevenr (PCV7) ws used from June 2008 to June 2011, Synflorix (PCV10) ws used from July 2011 to June 2014, Prevenr13 () ws used from July 2014 to June 2017, Synflorix (PCV10) hs een used since July 2017. PCV10 includes the seven serotypes in PCV7 (4, 6B, 9V, 14, 18C, 19F nd 23F) s well s serotypes 1, 5 nd 7F, nd cross-rectivity to serotype 19A. includes the 10 serotypes in PCV10 s well s serotypes 3, 6A nd 19A. The recommended schedule is four doses, given t 6 weeks, 3 months, 5 months nd 15 months of ge. The 23-vlent pneumococcl polyscchride vccine (23PPV, Pneumovx 23) is recommended for children ged 2 yers nd older with medicl conditions tht increse the risk of IPD. It includes the 13 serotypes of s well s serotypes 2, 8, 9N, 10A, 11A, 12F, 15B, 17F, 20, 22F nd 33F. The dt presented in this report (except for immunistion sttus) is sed on the informtion recorded on EpiSurv, the ntionl notifile disese surveillnce system, s t 8 Novemer. Any chnges mde to EpiSurv dt y pulic helth unit stff fter this dte will not e reflected in this report. Immunistion sttus of cses tht were eligile for PCV vccintion ws extrcted from the Ntionl Immunistion Register (NIR). These qurterly reports re prt of n enhnced surveillnce progrmme to monitor the impct of PCV vccintion, including the chnges in vccine vlency, on the epidemiology of IPD in New Zelnd Results This report ws mended on 18 Ferury 2019. There were 228 IPD cses notified in the July Septemer qurter, compred with 208 cses in the sme qurter in 2017. IPD displys distinct sesonl pttern with winter pek nd summer trough (Figure 1). The notifiction rte for the ltest 12-month period Septemer (11.5 per 100,000 popultion, 549 cses) ws similr to the rte for the previous 12-month period Septemer 2017 (11.2 per 100,000, 526 cses) (Tle 1). INSTITUTE OF ENVIRONMENTAL SCIENCE AND RESEARCH LIMITED 1
Numer of notifictions Figure 1. Numer of cses of invsive pneumococcl disese y qurter reported, Jnury 2010-Septemer 250 200 150 100 50 0 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 2010 2011 2012 2013 2014 2015 2016 2017 Yer (Qurter) The distriution of IPD cses nd rtes y ge group is presented in Tle 1 During the ltest 12- month period, the highest rte ws in the 65 yers ge group (30.3 per 100,000 popultion, 219 cses). Compring the ltest 12-month period with the previous 12-month period, there were no significnt chnges in the ge-specific rtes. Tle 1. Numer of cses nd rtes of invsive pneumococcl disese y ge group Age group Jul Sep Sep Sep 2017 Cses Cses Rte Cses Rte <2 yers 10 32 26.4 25 20.9 2 4 yers 9 20 10.8 23 12.4 5 64 yers 112 278 7.4 247 6.7 65 yers 97 219 30.3 231 33.1 Totl 228 549 11.5 526 11.2 Rte is expressed s cses per 100,000 popultion clculted using the 2017 mid-yer popultion estimtes. INSTITUTE OF ENVIRONMENTAL SCIENCE AND RESEARCH LIMITED 2
The distriution of IPD cses nd rtes y region is presented in Tle 2. Numer of cses nd rtes of invsive pneumococcl disese y region. The highest rte for the ltest 12-month period ws in the Midlnd region (13.3 per 100,000 popultion, 122 cses). Compring the ltest 12-month period with the previous 12-month period, there ws significnt chnge in the Centrl region only (104 to 137 cses), nd in the Hwke s By District Helth Bord (16 to 35 cses) Region Tle 2. Numer of cses nd rtes of invsive pneumococcl disese y region Jul-Sep Sep Rte is expressed s cses per 100,000 popultion clculted using the 2017 mid-yer popultion estimtes. Includes Northlnd, Witemt, Aucklnd nd Counties Mnuku DHBs. c Includes Wikto, Lkes, By of Plenty, Tirwhiti nd Trnki DHBs. d Includes Hwke s By, Whngnui, MidCentrl, Hutt Vlley, Cpitl & Cost, Wirrp nd Nelson Mrlorough DHBs. e Includes West Cost, Cnterury, South Cnterury nd Southern DHBs. Sep 2017 Cses Cses Rte Cses Rte Northern 86 207 11.2 209 11.6 Midlnd c 50 122 13.3 123 13.7 Centrl d 56 137 12.9 104 10.0 Southern e 36 83 8.6 90 9.5 Totl 228 549 11.5 526 11.2 A culture ws received t ESR for serotyping from 223 (97.8%) of the 228 cses notified in the July- Septemer qurter. Tle 3 shows the numer of IPD cses due to ech of the serotypes included in PCV7, PCV10 nd, nd due to non- serotypes. The numer of IPD cses due to serotypes decresed 6.7% etween the lst two 12-month periods (179 to 167 cses). In contrst, the numer of IPD cses due to non- serotypes incresed 11.7% (314 to 355 cses). The increse in IPD due to non- types occurred cross ll ge groups, nd ws gretest in the 2 4 yer ge group (8 to 14 cses). The six most prevlent serotypes during the lst were 19A, 8, 12F, 22F, 3 nd 7F (Tle 3). Between the lst two 12-month periods, cses of IPD due to type 19A did not chnge (70 cses). There were increses in types 8, 12F, 22F nd 3: 35% (40 to 54 cses), 176% (17 to 47 cses), 15.4% (39 to 45 cses) nd 27.6% (29 to 37 cses), respectively. INSTITUTE OF ENVIRONMENTAL SCIENCE AND RESEARCH LIMITED 3
Tle 3. Numer of invsive pneumococcl disese cses y serotype nd ge group Serotypes Age group <2 yers 2 4 yers 5 yers Totl 2017 2017 2017 2017 4 0 0 1 0 0 0 2 7 18 2 7 19 6B 0 0 0 0 0 0 0 1 2 0 1 2 9V 0 0 0 0 0 1 1 2 3 1 2 4 14 0 0 0 0 0 1 1 1 2 1 1 3 18C 0 0 0 0 0 0 1 1 1 1 1 1 19F 0 0 0 0 0 0 5 7 17 5 7 17 23F 0 0 0 0 0 0 0 2 1 0 2 1 Totl PCV7 0 0 1 0 0 2 10 21 44 10 21 47 1 0 1 0 0 0 0 1 6 0 1 7 0 5 0 0 0 0 0 0 0 0 0 0 0 0 7F 0 0 1 0 0 0 11 28 31 11 28 32 Totl PCV10 0 1 2 0 0 2 22 55 75 22 56 79 3 1 2 4 0 0 2 12 35 23 13 37 29 6A 0 0 0 0 0 0 2 4 1 2 4 1 19A 1 1 1 2 3 4 31 66 65 34 70 70 Totl 2 4 7 2 3 8 67 160 164 71 167 179 10A 0 2 2 0 0 0 7 16 10 7 18 12 11A 0 0 0 0 0 0 2 11 17 2 11 17 12F 1 4 2 1 2 0 23 41 15 25 47 17 15A 2 3 0 1 2 1 3 11 16 6 16 17 15B 0 1 2 1 1 0 8 13 13 9 15 15 16F 0 0 0 0 0 0 8 15 14 8 15 14 22F 1 2 2 0 2 2 24 41 35 25 45 39 23A 1 2 0 0 0 1 4 10 12 5 12 13 23B 0 0 1 1 2 0 5 20 15 6 22 16 31 0 0 0 0 0 0 3 5 8 3 5 8 33F 0 1 1 0 1 2 9 16 14 9 18 17 38 0 4 0 0 0 0 1 5 10 1 9 10 6C 0 0 0 0 1 1 3 12 14 3 13 15 8 0 1 1 0 0 0 17 53 39 17 54 40 9N 0 0 1 0 0 0 7 16 15 7 16 16 Other types 2 4 3 3 4 1 14 31 44 19 29 48 Totl non- 7 24 15 7 15 8 138 316 291 152 355 314 The indictions for PCV10 include cross-protection ginst 19A disese. Any of these other types ccounted for <5 IPD cses during the 30 Septemer. INSTITUTE OF ENVIRONMENTAL SCIENCE AND RESEARCH LIMITED 4
Tle 4 shows the immunistion sttus for cses notified in the July Septemer qurter in children who were ge-eligile for PCV (i.e. cses orn fter 1 Jnury 2008 nd ged 6 weeks). There were 29 cses in children who were eligile for PCV, of which one ws due to serotype 3, five were due to 19A nd 21 were due to non-pcv serotypes. Serotype informtion ws not ville for two cses. Two 19A cses were recorded s hving four doses of PCV7 nd therefore were not covered for this serotype. A third 19A cse, ged less thn five months t illness onset, hd received two doses of PCV10. The fourth cse, ged 4 yers, hd received three doses of PCV10 nd one dose of which is considered vccine filure. The fifth cse, ged 3 yers, hd received four doses of nd is lso considered vccine filure, however, informtion on underlying helth conditions is not yet ville. Tle 4. Immunistion sttus of the invsive pneumococcl disese cses notified in the July-Septemer qurter in children who were eligile for PCV Numer of doses received Cses due to PCV7 serotypes: 4, 6B, 9V, 14, 18C, 19F or 23F Cses due to dditionl PCV10 serotypes: 1, 5, 7F Cses due to dditionl serotypes: 3, 6A, 19A Cses due to non- serotypes Totl,c Numer Numer Numer Numer Numer 0 0 0 0 0 0 1 0 0 1 1 2 2 0 0 0 2 2 3 0 0 1 d 2 3 4 0 0 4 d 16 22 Totl 0 0 6 21 29 Numer of doses received prior to 14 dys efore onset of IPD. Onset of IPD ws determined using the erliest episode dte ville from onset of illness dte, hospitlised dte or dte cse notified to the pulic helth unit. Only IPD cses eligile for PCV s prt of the childhood immunistion schedule (ie, cses orn fter 1 Jnury 2008 nd ged 6 weeks) re presented. c The totl numer of cses includes two cses for whom serotype informtion ws not ville. d Due to serotype 19A. Note: Immunistion sttus is sed on informtion recorded in the Ntionl Immunistion Register (NIR). INSTITUTE OF ENVIRONMENTAL SCIENCE AND RESEARCH LIMITED 5