Nasopharyngeal Carriage and Transmission of Streptococcus pneumoniae in American Indian Households after a Decade of Pneumococcal Conjugate Vaccine Use

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Mosser, Jonathan F. ; Grant, Lindsay R. ; Millar, Eugene V. ; Weatherholtz, Robert C. ; Jackson, Delois M. ; Beall, Bernard ; Craig, Mariddie J. ; Reid, Raymond ; Santosham, Mathuram ; O'Brien, Katherine L.
• Description:
  Background ; Young children played a major role in pneumococcal nasopharyngeal carriage, acquisition, and transmission in the era before pneumococcal conjugate vaccine (PCV) use. Few studies document pneumococcal household dynamics in the routine-PCV7 era. ; Methods ; We investigated age-specific acquisition, household introduction, carriage clearance, and intra-household transmission in a prospective, longitudinal, observational cohort study of pneumococcal nasopharyngeal carriage in 300 American Indian households comprising 1,072 participants between March 2006 and March 2008. ; Results ; Pneumococcal acquisition rates were 2–6 times higher in children than adults. More household introductions of new pneumococcal strains were attributable to children <9 years than adults ≥17 years (p<0.001), and older children (2–8 years) than younger children (<2 years) (p<0.008). Compared to children <2 years, carriage clearance was more rapid in older children (2–4 years, HRclearance 1.53 95% CI: 1.22, 1.91; 5–8 years, HRclearance 1.71 1.36, 2.15) and adults (HRclearance 1.75 1.16, 2.64). Exposure to serotype-specific carriage in older children (2–8 years) most consistently increased the odds of subsequently acquiring that serotype for other household members. ; Conclusions ; In this community with a high burden of pneumococcal colonization and disease and routine PCV7 use, children (particularly older children 2–8 years) drive intra-household pneumococcal transmission: first, by acquiring, introducing, and harboring pneumococcus within the household, and then by transmitting acquired serotypes more efficiently than household members of other ages.
• Subjects:
  • Adult
  • Carrier State
  • Child
  • Child, Preschool
  • Family Characteristics
  • Female
  • Humans
  • Indians, North American
  • Logistic Models
  • Male
  More +
• Source:
  PLoS One. 2014; 9(1).
• Document Type:
  Journal Article
• Funding:
  U26IHS300013/03/PHS HHS/United States ; Canadian Institutes of Health Research/Canada ; Wellcome Trust/United Kingdom
• Volume:
  9
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/27980/cdc_27980_DS1.pdf
• File Type:
  [PDF - 257.34 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d770894647c5c28be9877127afed83f6d01661da3f11ed0980399c48c437a7b9