PNEUMOCOCCAL SEROTYPES - WHAT’S HAPPENING ACROSS CANADA?
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PNEUMOCOCCAL SEROTYPES - WHAT’S HAPPENING ACROSS CANADA? Focus on 2009 Gregory J. Tyrrell, PhD, FCCM, D(ABMM) Division of Medical Microbiology PowerPoint PPT Presentation


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PNEUMOCOCCAL SEROTYPES - WHAT’S HAPPENING ACROSS CANADA? Focus on 2009 Gregory J. Tyrrell, PhD, FCCM, D(ABMM) Division of Medical Microbiology Department of Laboratory Medicine and Pathology Public Health Laboratory - Alberta University of Alberta. CONFLICT OF INTEREST DISCLOSURE STATEMENT

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PNEUMOCOCCAL SEROTYPES - WHAT’S HAPPENING ACROSS CANADA? Focus on 2009 Gregory J. Tyrrell, PhD, FCCM, D(ABMM) Division of Medical Microbiology

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Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCAL SEROTYPES - WHAT’S HAPPENING ACROSS CANADA?

Focus on 2009

Gregory J. Tyrrell, PhD, FCCM, D(ABMM)

Division of Medical Microbiology

Department of Laboratory Medicine and Pathology

Public Health Laboratory - Alberta

University of Alberta


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

  • CONFLICT OF INTEREST DISCLOSURE STATEMENT

  • Clinical Research Funding:

  • Wyeth

  • Consultations (Advisory Boards)/Presentations:

  • Wyeth, GSK


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

Credit: PneumoACTION 2010 website.

PneumoACTION is a project of the International Vaccine Access Centerat Johns Hopkins Bloomberg School of Public Health


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

Pneumococcus

Polysaccharide Capsule


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

Streptococcus pneumoniae

Capsule major virulence factor

91 different capsule types (serotypes).

110F18B28A40PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

211A18C28F41PHiD10: 4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

311B18F2941FPCV13: 4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

411C19A3142

511D19B32A43

6A11F19C32F44

6B12A19F33A45

6C12B2033B46

7A12F2133C47A

7B1322A33D47F

7C1422F33F48

7F15A23A34

815B23B35A

9A15C23F35B

9L15F24A35C

9N16A24B35F

9V16F24F36

10A17A25A37

10B17F25F38

10C18A2739


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

Source: Clinical updates in Pediatric Infectious Diseases. Vol2(6): Feb 1999.


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PCV7

nonPCV7

INCIDENCE OF IPD IN ALBERTA CHILDREN 0-23 MO.

2000 –2007

86.26 / 100,000

Incidence / 100,000 in < 2 year age group

1.1 / 100,000

Tyrrell 2009. Vaccine. 27(27):3553-3560.


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

IPD CASES IN CANADA: ISOLATE SUBMISSION

NUMBERS BY CASE. 2000 –2009

Number of Cases


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

NUMBER OF ISOLATES SEROTYPED BY NCS

2000-2009 CANADA (EXCLUDING QUEBEC)

Number of Cases

Age


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

NUMBER OF CASES BY PROVINCE OR TERRITORY

2000-2009 13,896 CASES

NUMBER OF CASES BY PROVINCE OR TERRITORY

2008 AND 2009

2008

2009

Number of Cases

Number of Cases

Province of Territory

Province of Territory


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

ALL CASES COUNTED WERE FROM INVASIVEDISEASE ONLY.

Non-invasive cases excluded.

Ears, eyes, throats, urine, respiratory not counted.


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPED –

CANADA (EXCLUDING QUEBEC)

0-23 MONTHS Extra serotypes provided by PHiD10 and PCV13 only.

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

1 (10 & 13)

3 (13)

5 (10 & 13)

6A (13)

7F (10 & 13)

19A (13)

Number of Cases


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

CANADA (EXCLUDING QUEBEC)

0-23 MONTHS January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

WESTERN CANADA 0-23 MONTHS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

ONTARIO 0-23 MONTHS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

CANADA (EXCLUDING QUEBEC)

2-4 YEARS January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

WESTERN CANADA 2-4 YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

ONTARIO 2-4 YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES INCANADA (EXCLUDING QUEBEC)5-19 YEARS January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

WESTERN CANADA 5-19 YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

ONTARIO 5-19 YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES INCANADA (EXCLUDING QUEBEC)20-64 YEARS January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

WESTERN CANADA 20-64 YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

ONTARIO 20-64 YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES INCANADA (EXCLUDING QUEBEC)65+ YEARS January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

*

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

WESTERN CANADA 65+ YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

PNEUMOCOCCI SEROTYPES IN

ONTARIO 65+ YEARS

January 2009 to February 2010

PCV7: 4, 6B, 9V, 14, 18C, 19F, 23F

PHiD10:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F

PCV13:4, 6B, 9V, 14, 18C, 19F, 23F, 1, 5, 7F,3,6A, 19A

PCV7

PHiD10

PCV13

NVT

*PPV23

*

*

*

Number of Cases

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Serotype


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

SEROTYPE 5 OUTBREAK IN WESTERN CANADA


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

SEROTYPE 5 CASES BY AGE


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

CANADA 2009

PCV7

PHiD10

PCV13

Percent coverage

Based on invasive pneumococcal isolates

submitted to the NCS for serotyping.


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

WESTERN CANADA 2009 (BC, AB, SK, MN)

PCV7

PHiD10

PCV13

Percent coverage

Based on invasive pneumococcal isolates

submitted to the NCS for serotyping.


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

ONTARIO 2009

PCV7

PHiD10

PCV13

Percent coverage

Based on invasive pneumococcal isolates

submitted to the NCS for serotyping.


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

SUMMARY

1.Pneumococcal capsule main virulence factor

2.91 different capsule types (serotypes)

3.3 conjugate vaccines (7-valent, 10-valent, 13-valent)

4.Serotyping at NCS has doubled in the last couple of years

5.PCV7 introduced in Canada 2002

6.PCV7 cases have dropped in the 0-4 years group since this time

7.19A has increased in the 0-23 month age group in Canada

8.7F next in this age category

9.PCV13 coverage in Canada based on serotype of isolates submitted to the National Centre for Streptococcus:

0-23 = 61.3%

2-4 = 67.6%

5-19 = 69.7%

20-64 = 55.3%

65+ = 55.4%

10.Large serotype 5 outbreak in Western Canada


Pneumococcal serotypes what s happening across canada focus on 2009 gregory j tyrrell phd fccm dabmm division of

ACKNOWLEDGEMENTS

Members of the National Centre for Streptococcus involved in pneumococcal serotyping:

Marg Lovgren

Jocelyne Kakulphimp

Donna Hurteau

Karen Beyent

Connie Tsang

Also like to thank the Provincial Laboratories and Diagnostic Laboratories who

submitted invasive pneumococcal isolates for serotyping.

Continued support from Alberta Health and Wellness, the National Microbiology Laboratory and Wyeth.


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