International Circumpolar Surveillance of invasive bacterial diseases, 20002006
Abstract number: O361
Zulz T., Bruce M.G., Parks D., Tam T., Stenz F., Nystedt A., Lovell O., Parkinson A.J.
Background: The International Circumpolar Surveillance (ICS) system conducts population-based surveillance of invasive bacterial diseases in Greenland (GN), Northern Canada (N Can), Northern Sweden (N Swe), Norway (Nor) and in the U.S. Arctic (Alaska [AK]).
Methods: Isolates from patients with invasive diseases caused by Haemophilus influenzae (Hi), Neisseria meningitidis (Nm), Group A Streptococcus (GAS), and Group B Streptococcus (GBS) were forwarded to reference laboratories in AK (20002006), N Can (20002006), GN (20012006), Nor (20052006) and N Swe (20032005) for confirmation and serotyping. Norway did not provide data for GAS and GBS. Clinical and demographic information were collected using standardised surveillance forms.
Results: The total numbers of reported cases were 249 Hi, 128 Nm, 289 GAS, and 215 GBS. Crude annualised rates of invasive disease per 100,000 population varied by country and organism (Table 1). AK Native and N Can Aboriginal people had higher rates of disease [(AK Native: Hi=5.7/100,000, GAS=11.5/100,000), (N Can Aboriginal: Hi=11.5/100,000, GAS=10.2/100,000)] than non-Aboriginals [(AK non-Native: Hi=1.2/100,000, GAS=3/100,000), (N Can non-Aboriginals: Hi=1.1/100,000, GAS=1.1/100,000)]. Of the 221 Hi cases that were serotyped, 37 (17%) were Hib [AK 22 cases (rate 0.5), N Can 13 cases (rate 1.4), Nor 2 cases (rate 0.04] and age ranged from <1 to 69 years; Hib disease occurred in persons <2 years of age in AK (41%) and N Can (77%). Fifty-one (23%) Hi cases were serotype a (Hia) [AK 13 cases (rate 0.29), N Can 38 cases (rate 4.15)]. Non-typeable Hi comprised 37% of serotyped cases in AK, 26% in N Can and 63% in Nor. Age distribution of Hi cases differed between countries; 49% of AK cases and 89% of Nor cases were >40 years compared with 13% in N Can (p < 0.001, p < 0.000).
Conclusion: Aboriginal peoples of AK and N Can have higher rates of invasive bacterial disease caused by Hi and GAS than non-aboriginals. Overall rates of Nm disease are higher in GN than AK, N Can, N Swe and Nor. Cases of invasive Hib disease continue to occur in children <2 years of age in the North American Arctic. Hi cases are more likely to occur in older persons in AK and Nor and young children in N Can; age distribution differences warrant further study.
Table 1: Rates* of Invasive Disease, ICS Data, 20002006
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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