EPIDEMIOLOGY OF PNEUMOCOCCAL DISEASE IN CHILDREN

Abstract

The pneumococcus is the pathogen recovered most often from blood cultures in our hospital. We identified 205 episodes of systemic pneumococcal infections in 201 children during a 34 mo. period. There were 54 infections in 1978 (10 months), 64 in 1979 and 87 in 1980. The frequency of infections was highest in May and April (mean number of episodes/month 10.3 and 9.3 respectively) and was lowest in August and September (1.3 and 1.6). Children with pneumococcal infection ranged in age from 1 month to 14 years (mean age of 20 months). There were 126 boys and 75 girls. Seventy six percent of the children were black. Occult bacteremia (128 episodes) was the most frequently seen illness. There were 40 instances of pneumonia with bacteremia, 31 of meningitis, 4 of cellulitis and 2 of septic arthritis. Three children had recurrent infections: one with sickle cell anemia had three separate episodes caused by type 23F despite having received pneumococcal vaccine. Four children died: two had meningitis, one (asplenic child) had bacteremia and one (with myocarditis) had bacteremic pneumonia. One hundred thirty isolates were serotyped. The serotypes encountered were: type 14(32%), type 4(13%), type 23F(9%), type 6B(8%), type 19F(8%), type 18C(7.7%), type 9V(7%), types 3, 6A and 22F (2%each), types 15C and 19A(1.5%each), types 8, 10A, 16, 21 and 33F(0.8%each). One isolate was nontypable. Seventy five percent of the isolates were vaccine types; however, almost 3/4 of these isolates belonged to serotypes 4, 6A, 14, and 23F that induce weak immune response in young children.

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