Pneumococcus

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epidemiology

• 1.19mi. deaths in 2016
• 197.05 mil. episodes in 2016
• the leading cause of lower respiratory infections followed by H. influenzae, influenza /B and RS virus
• 50% of pneumococcal deaths in India, Nigeria, DRC and Pakistan

serotype

• all serotypes known more than 90 are pathogenic for human
• differentiation of serotypes is important for epidemiology

antimicrobial resitance

• first reported in late 1960s

Vaccine

• PPSV does not induce T-cell dependent immunity
• PCV induces T-cell dependent immunity
• new product "Pneumosil" from India
  • 10-valent
  • serotypes 1, 5, 6A, 6B, 7F, 9V, 14, 19A, 19F, 23F
• the reason why PCV13 for older population failed to show persistent efficacy against IPD in the U.S. may be contributed by spread of PCV13 for children which has caused serotype substitutions in community

History of Pneumococcal vaccines in Japan

	Brand name	Approval for children	Introduction to childhood routine immunization	Approval for adults	Introduction to adult routine immunization
PPSV23	ニューモバックスNP Pneumovax NP	1988（昭和63年） ≥ 2 year	nil covered by Public Health Insurance for asplenia	1988（昭和63年）	nil covered by Public Health Insurance for asplenia