肺炎链球菌和流感嗜血杆菌__培训课件.ppt

* * GFCV Eligible countries RED - Eligible countries approved or applied YELLOW - Eligible countries not yet applied * * * * Reminder that other factors such as better household conditions, less overcrowding, better nutrition, discovery of penicillin and of course vaccines all had a role to play in reduction of pneumonia mortality. Probably have a better chance of introducing vaccine than reducing poverty. Has been shown that as U5MR increases the proportion of disease due to pneumonia also increases. * This slide reminds us that the reservoir of Streptococcus pneumoniae is in human carriers and that the mode of transmission is respiratory. * No immunologic cross-reactivity between serogroups Some cross-reactivity within some serogroups and some cross-protection Geographical and temporal variation Variation in invasiveness A small number of serogroups account for the majority of invasive disease in children ? 40 serogroups (e.g., 19) ? 90 serotypes (e.g., 19A, 19C, 19F) * Streptococcus pneumoniae: Major cause of illness and death worldwide 1 million pneumonia deaths annually Incidence of invasive disease varies globally In the United States: Most common cause of vaccine-preventable death Leading cause of community-acquired pneumonia and bacterial meningitis Increasing antibiotic resistance - In children, bacteremia without known site of infection is most common clinical presentation - After routine use of Hib vaccines, S. pneumoniae became the most common cause of bacterial meningitis in infants and young children Common cause of acute otitis media * * Age-associated increase in the risk of disease and mortality Rates highest among elderly and young children Case-fatality ratio overall about 10%; 20% in older adults * Asthma? * Geographic variation in serotypes * * * * THE TRIAL RESULTS WERE: overall reduction of childhood mortality by 16% in children vaccinated with the 9-valent in other words, 7 child deaths were prevented for every 1000 vaccinated child