RESUMO
For decades, vaccination with the 23-valent polysaccharide pneumococcal vaccine (PPV23) has been available for risk groups aged ⩾2 years to prevent invasive pneumococcal disease (IPD). Recently, a 13-valent pneumococcal conjugated vaccine (PCV13) has been licensed for use in all age groups. PCV13 may induce better protection than PPV23 because of different immunogenic properties. This called for a revision of vaccine recommendations for risk groups. We therefore reviewed literature on risk groups for IPD, and effectiveness and safety of pneumococcal vaccines and supplemented that with information from public health institutes, expert consultations and data on IPD epidemiology. We included 187 articles. We discuss the implications of the heterogenic vulnerability for IPD within and between risk groups, large indirect effects of childhood immunization, and limited knowledge on additional clinical benefits of PCV13 in combination with PPV23 for the Norwegian recommendations. These are now step-wise and consider the need for vaccination, choice of pneumococcal vaccines, and re-vaccination interval by risk group.
Assuntos
Infecções Pneumocócicas/imunologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/imunologia , Adolescente , Adulto , Criança , Pré-Escolar , Política de Saúde , Humanos , Noruega/epidemiologia , Infecções Pneumocócicas/epidemiologia , Vacinas ConjugadasRESUMO
Between 16 September and 5 October 2011 rabies was diagnosed in two arctic foxes and eight reindeer in the Svalbard archipelago, in Norway. This outbreak occurs at the end of the reindeer hunting season and poses an increased risk to many people that were involved in the hunt. As of 28 September 2011, 280 people had received post-exposure prophylaxis. No human cases of rabies have occurred.
