ABSTRACT
UNLABELLED: In a prospective surveillance study covering all pediatric wards in Austria, 308 cases of invasive pneumococcal disease (IPD) were reported in hospitalized children <5 years of age between 2002 and 2012. Incidence was 7.1 per 100,000 per year for IPD with a case fatality rate of 3 %, and 1.9 per 100,000 per year for pneumococcal meningitis with a case fatality rate of 9 %. At hospital discharge, 17 % of the children were not fully recovered and suffered from problems such as hearing or motor deficits. Persistent sequelae 6 months after hospital discharge were present in 13 % of the children, a finding that emphasizes the seriousness of IPD. From 2007 onwards, we observed a shift of pneumococcal serotypes from those covered by the heptavalent vaccine to serotypes consequently added to 10- and 13-valent vaccines, particularly regarding serotype 19A. Among antimicrobial resistances detected, macrolide resistance was predominant; however, between 2002 and 2012, we saw an overall decrease of resistance rates. CONCLUSION: Considering this change of serotypes and the high rate of permanent sequelae after IPD, our data show the importance of pediatric pneumococcal vaccination and the relevance of continuous monitoring of circulating serotypes. By the end of 2012, which was the first year of universal mass vaccination against pneumococcal disease in Austria, no change in the incidence of invasive pneumococcal disease was observed yet.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Pneumococcal Infections/epidemiology , Pneumococcal Vaccines/immunology , Streptococcus pneumoniae/isolation & purification , Austria/epidemiology , Child , Child, Hospitalized , Child, Preschool , Female , Humans , Incidence , Infant , Male , Pneumococcal Infections/drug therapy , Pneumococcal Infections/prevention & control , Population Surveillance , Prospective Studies , Streptococcus pneumoniae/immunology , Survival RateABSTRACT
In a sample of originally 430 healthy adults (18-84 years of age) with documented basic and booster immunization against tick borne encephalitis, cumulative seroprotection rates 8 (n=178) and 10 years (n=183) after the last booster dose were 86.8% and 77.3% according to the neutralization test, respectively. In subjects aged 50 years and older, antibody titers were significantly lower compared to subjects younger than 50 years. History of any allergy but not previous exposure to other flaviviral antigens was associated with higher neutralization titers. In subjects with waning immunity, a single booster dose induced a strong anamnestic antibody response.
Subject(s)
Encephalitis Viruses, Tick-Borne/immunology , Vaccination/methods , Viral Vaccines/administration & dosage , Viral Vaccines/immunology , Adolescent , Adult , Age Factors , Aged , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Female , Humans , Immunologic Memory , Male , Middle Aged , Time Factors , Young AdultABSTRACT
Five and 6 years post-booster, immunity to tick-borne encephalitis (TBE) virus was assessed in 225 and 195 vaccinees, respectively, out of 430 healthy volunteers with at least three TBE-immunizations prior to study inclusion and booster intervals exceeding recommended limits. Neutralizing antibody titers of > or = 1:10 (reliable level of protection) were present in 86-96% depending on age group, with lower percentages in participants >60 years. TBE antibody levels remained stable for many years in most vaccinees. However, in a few persons a shorter period of protection against TBE was indicated. Therefore, recommendations on booster intervals in TBE endemic areas should be adapted by weighting the risk of infection against the risk of short-lived immunity.
Subject(s)
Encephalitis, Tick-Borne/prevention & control , Immunization, Secondary , Viral Vaccines/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Encephalitis, Tick-Borne/immunology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neutralization Tests , Young AdultABSTRACT
In order to evaluate the long-term immunity 2 and 3 years after booster vaccination against tick-borne encephalitis (TBE) following time intervals 3 years and longer since last TBE immunization, 195 (mean age 50.5+/-15.1 years) and 240 subjects (mean age 47.0+/-15.4 years), respectively, who had received a single booster dose in a preceding study, returned for a serological follow-up. Antibody concentrations were measured by neutralization test (NT) and ELISA. Protective TBE antibody levels (NT>or=10) were noted in 96% (187/195) of the subjects at year 2 and 97% (232/240) at year 3 post-booster. At both years, GMTs (NT) of all age groups were above detection limit (>or=2), showing GMT-NT of 54.5 (95% CI: 47.7-62.4) and 69.1 (95% CI: 60.7-78.6), respectively. GMTs were significantly lower in vaccinees>or=50 years of age (p<0.001 for both years). Comparison of GMTs at years 2 and 3 post-booster vaccination with pre-booster values revealed similar antibody titers at all three reading points. Besides an expected rapid decline of TBE antibodies shortly after booster administration, the kinetic curve also suggested maintenance of high values of neutralizing TBE antibodies for a period longer than expected, thus confirming the recent recommendations regarding the extension of TBE booster intervals.
