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Nasopharyngeal Carriage and Transmission of Streptococcus pneumoniae in American Indian Households after a Decade of Pneumococcal Conjugate Vaccine Use
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Nasopharyngeal Carriage and Transmission of Streptococcus pneumoniae in American Indian Households after a Decade of Pneumococcal Conjugate Vaccine Use
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Journal Article
Nasopharyngeal Carriage and Transmission of Streptococcus pneumoniae in American Indian Households after a Decade of Pneumococcal Conjugate Vaccine Use
2014
Overview
Young children played a major role in pneumococcal nasopharyngeal carriage, acquisition, and transmission in the era before pneumococcal conjugate vaccine (PCV) use. Few studies document pneumococcal household dynamics in the routine-PCV7 era.
We investigated age-specific acquisition, household introduction, carriage clearance, and intra-household transmission in a prospective, longitudinal, observational cohort study of pneumococcal nasopharyngeal carriage in 300 American Indian households comprising 1,072 participants between March 2006 and March 2008.
Pneumococcal acquisition rates were 2-6 times higher in children than adults. More household introductions of new pneumococcal strains were attributable to children <9 years than adults ≥17 years (p<0.001), and older children (2-8 years) than younger children (<2 years) (p<0.008). Compared to children <2 years, carriage clearance was more rapid in older children (2-4 years, HRclearance 1.53 [95% CI: 1.22, 1.91]; 5-8 years, HRclearance 1.71 [1.36, 2.15]) and adults (HRclearance 1.75 [1.16, 2.64]). Exposure to serotype-specific carriage in older children (2-8 years) most consistently increased the odds of subsequently acquiring that serotype for other household members.
In this community with a high burden of pneumococcal colonization and disease and routine PCV7 use, children (particularly older children 2-8 years) drive intra-household pneumococcal transmission: first, by acquiring, introducing, and harboring pneumococcus within the household, and then by transmitting acquired serotypes more efficiently than household members of other ages.
Publisher
Public Library of Science,Public Library of Science (PLoS)
Subject
/ Adults
/ Age
/ Biology
/ Carrier State - epidemiology
/ Carrier State - microbiology
/ Carrier State - prevention & control
/ Carrier State - transmission
/ Child
/ Children
/ Female
/ Humans
/ Male
/ Medicine
/ Pneumococcal Infections - epidemiology
/ Pneumococcal Infections - immunology
/ Pneumococcal Infections - microbiology
/ Pneumococcal Infections - prevention & control
/ Pneumococcal Infections - transmission
/ Pneumococcal Vaccines - immunology
/ Pneumococcal Vaccines - supply & distribution
/ Streptococcus pneumoniae - immunology
/ Vaccines
