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. 2015 Jul;143(9):1957-63.
doi: 10.1017/S0950268814002490. Epub 2014 Oct 9.

An explosive outbreak of Streptococcus pneumoniae serotype-8 infection in a highly vaccinated residential care home, England, summer 2012

H L Thomas  1 , R Gajraj  2 , M P E Slack  3 , C Sheppard  3 , P Hawkey  4 , S Gossain  4 , C M Drew  2 , R G Pebody  1
Affiliations

An explosive outbreak of Streptococcus pneumoniae serotype-8 infection in a highly vaccinated residential care home, England, summer 2012

H L Thomas et al. Epidemiol Infect. 2015 Jul.

Abstract

In August 2012, an explosive outbreak of severe lower respiratory tract infection (LRTI) due to Streptococcus pneumoniae serotype-8 occurred in a highly vaccinated elderly institutionalized population in England. Fifteen of 23 residents developed LRTI over 4 days (attack rate 65%); 11 had confirmed S. pneumoniae serotype-8 disease, and two died. Following amoxicillin chemoprophylaxis and pneumococcal polysaccharide vaccine (PPV) re-vaccination no further cases occurred in the following 2 months. No association was found between being an outbreak-associated case and age (P = 0.36), underlying comorbidities [relative risk (RR) 0.84 95% confidence interval (CI) 0.34-2.09], or prior receipt of PPV (RR 1.4, 95% CI 0.60-3.33). However, the median number of years since PPV was significantly higher for cases (n = 15, 10.2 years, range 7.3-17.9 years) than non-cases (n = 8, 7.2 years, range 6.8-12.8 years) (P = 0.045), provided evidence of waning immunity. Alternative vaccination strategies should be considered to prevent future S. pneumoniae outbreaks in institutionalized elderly populations.

Keywords: Disease outbreaks; pneumococcal infections; pneumococcal polysaccharide vaccine.

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Conflict of interest statement

P.M.H. has received research funding and/or consultancy payments from bioMérieux, Becton-Dickinson, Eumedica, Merck, Novartis, Magus Communications, Pfizer and Wyeth. P.M.H. is the director of ModusMedica (a medical education company). M.P.E.S. has received research funding and/or support to attend scientific conferences from Pfizer, GSK and MSD. C.S. has received support to attend conferences from Pfizer and Wyeth. The other authors have no interests to declare.

Figures

Fig. 1.
Fig. 1.
Distribution of cases of lower respiratory tract infection by date of onset, residential home, England, August 2012.
See this image and copyright information in PMC

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