Pneumococcal Disease Increasing With Influenza Activity, CDC Says

Kate Traynor

BETHESDA, MD 25 November 2009—Cases of invasive pneumococcal disease are increasing, presumably as a result of H1N1 influenza activity, the Centers for Disease Control and Prevention (CDC) reported today.

"We're seeing an increase in serious pneumococcal infections around the country," said Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases.

Schuchat said the emerging situation is "worrisome."

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She said 58 cases of serious pneumococcal disease were reported last month in the Denver metropolitan area, which is nearly three times the average for that time of year. The spike in pneumococcal disease coincided with a surge in influenza activity in the area and is likely related to that surge, she said.

In contrast to typical influenza seasons, when pneumococcal disease primarily strikes the elderly, most of the Denver-area cases involved people 20–59 years of age, Schuchat said.

Colorado is 1 of 10 states that participate in a CDC surveillance program to track bacterial illnesses. Schuchat said other states in the network have also reported increased rates of pneumococcal disease this fall, and CDC believes the problem exists nationwide.

CDC believes that more widespread use of pneumococcal vaccines can protect patients against serious pneumococcal pneumonia, including secondary pneumonia infection in patients with influenza.

A November 16 communication from CDC's Health Alert network urged health care providers to administer pneumococcal polysaccharide vaccine to patients who are at risk for pneumococcal disease. This group includes people 65 years or older and those age 2–64 years with chronic conditions like diabetes, asthma, or heart disease.

But Schuchat said that only about 25% of people under age 65 for whom the vaccine is indicated ever receive it.

"I do strongly urge people to sort out whether you're in one of those high-risk groups and talk to your doctor or ask your pharmacist whether you can be vaccinated" against pneumococcal disease, Schuchat said.

She said CDC believes that the national supply of pneumococcal vaccine is sufficient to support the agency's efforts to boost vaccination rates.

This is in contrast to the amount of H1N1 influenza vaccine currently available in the United States. Schuchat said 7 million doses of H1N1 vaccine have become available since Friday, for a total of 21.2 million doses since vaccine distribution began—far short of initial projections.

But Schuchat said CDC believes December will be "a big month" for H1N1 vaccination.

"We're likely to see more places, including more doctors' offices, more clinics, able to offer the H1N1 vaccine," she said. "Several states are planning major activities after Thanksgiving to promote more vaccination, . . . so stay informed and look for them."