LOS ANGELES--Los Angeles County Department of Health Services is adding invasive pneumococcal disease (IPD) to its list of reportable diseases to enhance surveillance of the increasingly deleterious infection. IPD is a leading cause of pneumonia, bacteremia and meningitis in the United States. Since 1995, the county health department has followed the cases in the county as a special surveillance project to identify antibiotic resistance patterns, monitor the effectiveness of the recently released pneumococcal vaccine and measure the number of IPD cases in the county.
“IPD causes a significant number of illness in children and illness and death in the elderly,” said Jonathan Fielding, M.D., M.P.H., Director of Public Health and County Health Officer.
The CDC estimates IPD causes 3,000 cases of meningitis, 60,000 cases of bacteremia and more than 125,000 hospitalizations for pneumonia – as well as 10,000 – 15,000 deaths – annually. Using the average IPD incidence from the Centers for Disease Control and Prevention (CDC) and the county population estimates, there should be approximately 2,100 IPD cases a year in the county. However, data received from the IPD special surveillance project was less than half of this number. Making IPD officially reportable would help us accurately assess the impact of IPD on our community.
“The increasing resistance to antibiotics poses a serious public health concern,” said Elizabeth Bancroft, M.D., S.M., director of the county’s Hospital Infection, Bloodborne Pathogen and Antimicrobial Resistance team. “With increased physician reporting, we will be better able to track emerging antibiotic resistance trends in the county and distribute the information so that physicians can prescribe effective antibiotic treatments. From 1996 to 1999, we saw a significant increase in penicillin resistance in IPD, fortunately, this trend has leveled off for the past couple of years.”
Dr. Fielding emphasizes the importance of prevention for pneumococcal disease. “As influenza and pneumonia season approaches, the importance of vaccination should be emphasized to prevent unnecessary morbidity and mortality from these diseases,” he said. “This is the single most important measure that an individual can take to protect themselves from pneumococcal disease.”
The polysaccharide pneumococcal vaccine is recommended for all persons over 65 years of age and for all persons older than 2 years of age who are at high risk for getting invasive pneumococcal disease (those suffering from immunosuppression, diabetes, history of cancer).
In February 2000, the Food and Drug Administration approved the use of a vaccine (Prevnar) to protect children under the age of five years from pneumococcal disease. The CDC Advisory Committee on Immunization Practices recommended the vaccination of all children up to 24 month of age in June of the same year. After the introduction of Prevnar, data for the county is already indicating a noticeable decrease of IPD in children. Mandatory reporting by physicians, laboratories, hospital infection control practitioners, and other healthcare professionals will enhance the department’s ability to evaluate the impact of these vaccines.
More information on pneumococcal disease in the county may be found at: http://lapublichealth.org/acd/pneumo.htm.
Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control and community and family health. Public Health comprises more than 3,800 employees and has an annual budget exceeding $465 million.