Pneumococcal disease in a medium-sized community in the United States

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Abstract
To assess the importance of bacteremic pneumococcal disease among the population of an average American community, all hospitalized patients who had Streptococcus pneumoniae isolated from blood, CSF, pleural fluid or ascitic fluid during 1978-1981 in Huntington, West Virginia, and environs were studied. Seventeen patients were younger than 13 yr; 71 were adults. The case fatality rate from bacteremic pneumococcal disease among adults was 30%; among children it was 6%. It was much higher (88%) in adults > 50 yr with extrapulmonary disease. Approximately 4/5 of the typed isolates from adults or children were types included in the current vaccine; 89% of the adults who died of pneumococcal infection had been candidates for pneumococcal vaccine, but only 1 patient had received vaccine, just before becoming ill with pneumococcal disease. These data provide a basis for widespread use of pneumococcal vaccine in high-risk groups.