International Union for Circumpolar Health
 Ministry of Public Health and Social Development of RF
Russian Academy of Medical Sciences
Siberian Branch of Russian Academy of Medical Sciences
Siberian Branch of Russian Academy of Sciences
Medical Polar Fund “Science”
The Northern Forum

13 International Congress on Circumpolar Health
Gateway to the International Polar Year

NOVOSIBIRSK, RUSSIA June 12 -16, 2006 Proceedings ICCH13
The Absract Book

Abstracts

Seminar Infection Diseases in Arctic

The International Circumpolar Surveillance System for Population-based Surveillance of Invasive Pneumococcal Disease 1999-2004

Bruce MG 1, Cottle T 1, Deeks S 2, Lovgren M 3, Jette L 4, Hennessy T 1, Parks D 1, Kristinsson K 5, Brinkløv Jensen K 6, Lovoll O 7, Nuorti P 8, Nystedt A 9, Herva E 8, Koch A 10, Parkinson A 1

1CDC,
Anchorage,
AK,
2Centre for Infectious Disease Prevention and Control; Public Health Agency of Canada,
Ottawa,
ON Canada; 3National Centre for Streptococcus,
Edmonton,
AB,
Canada; 4Quebec Public Health Laboratory,
Quebec,
PQ,
Canada; 5Dept of Clinical Microbiology,
Landspitali University Hospital,
Reykjavik,
Iceland; 6Institution of the Chief Medical Officer,
Nuuk,
Greenland; 7Norwegian Institute of Public Health,
Oslo,
Norway; 8National Public Health Institute,
Helsinki & Oulu,
Finland; 9Department of Infectious Diseases,
Sunderby Hospital,
Lulea,
Sweden; 10Statens Serum Institut,
Copenhagen,
Denmark

Background: The International Circumpolar Surveillance (ICS) Project is a population-based surveillance network for invasive bacterial disease in the US Arctic, Alaska (AK), Northern Canada (N Can), Greenland (GN), Iceland (IC), Norway (Nor), Northern Sweden (N Sweden) and Finland (Fin). Among circumpolar countries, the 7-valent conjugate vaccine (pcv7) has been used for routine infant immunization in AK since 2001 and in selected areas in N Can since 2002.

Methods: We defined a case of invasive pneumococcal disease (IPD) as illness in a surveillance area resident with isolation of Streptococcus pneumoniae from a normally-sterile site. We analyzed data on IPD from AK and N Can (Jan 1999-Dec 2004), and from GN, IC, Nor, Fin (Jan 2000-Dec 2004) and N Sweden (2003-2004) to determine: 1) Common clinical syndromes, 2) Disease rates by country, 3) Serotype distribution and 4) Antimicrobial susceptibility patterns. Results: A total of 9,251 cases of laboratory-confirmed IPD were reported from AK (647), N Can (226), GN (51), IC (236), Nor (4,712), N Sweden (65) and Fin (3,314). Case-fatality ratios varied from 5.0-27.0%. Pneumonia (46%), septicemia (26%), and meningitis (8%) were the most common clinical presentations. Annualized rates of IPD in aboriginals in AK and N Can were 43 and 38 cases per 100,000 persons, respectively. Rates of IPD in children < 2 years of age and persons > 2 years of age ranged from 21-137 and 9-24 cases per 100,000 persons, respectively. In AK, the rate of IPD in children < 2 with pcv7 serotypes declined by >85% after routine vaccination; from 137 in 1999-2000 to 18 in 2001-2004 (p<.001). The proportion of isolates fully-resistant to penicillin varied from <1% in Fin to 5.6% in AK.

Conclusions: Rates of IPD are high in aboriginals and children < 2 years of age residing in Arctic countries. After introduction of pcv7 in AK, rates of disease in children < 2 years of age with pcv7 serotypes rapidly declined. Continued surveillance is needed to determine the impact of pcv7 in AK and areas of N Can. High IPD rates in children < 2 warrant consideration of pcv7 use in other circumpolar countries.

Note. Abstracts are published in author's edition

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