Seasons greetings! It’s been an eventful year for pneumococcal disease prevention around the world. Recently, the U.S. and Canada reported phenomenal health impact of routine childhood pneumococcal immunization; it virtually eliminated serious pneumococcal disease in children – plus it protected nonvaccinated children and adults as well. Earlier this year, The Gambia pneumococcal vaccine trial demonstrated the potential of pneumococcal vaccines in protecting the world’s most vulnerable children from dying of pneumococcal disease. Regional and local pneumococcal surveillence networks are in place to provide sound local disease burden data to aid decision makers about pneumococcal vaccine introduction. As the scientific evidence continues to build, the interest of countries, donors and industry also continues to gain momentum. You can learn more about these collaborative work to prevent pneumococcal disease worldwide in our progress report early next year.

Orin Levine Executive Director

Finance chiefs from the Group of Seven leading industrial nations pledged $1 billion to pharmaceutical companies that develop vaccines against diseases mostly afflicting developing nations, including pneumococcal disease. The proposed pilot Advance Market Commitment (AMC) plan stipulates that donor countries will secure funding if/when a vaccine is developed. After a pilot project is tested, the AMC plan will be considered for ratification at the next G7 meeting in Washington D.C. in April 2006.

CMAJ – November 8, 2005. A recent report in the Canadian Medical Association Journal summarized trends in pneumococcal disease incidence from 1998 to 2004 based on prospective population-based surveillance data from the Calgary Area Streptococcus pneumoniae Epidemiology Research (CASPER) team. The PCV7 vaccine was licensed in Canada in 2001. In 2002, the National Advisory Committee on Immunization recommended routine vaccination of all unvaccinated healthy children up to 59 months of age with a 4-dose schedule. Similar to trends in the U.S., the introduction of universal PCV7 immunization for infants in the Calgary region led to a prompt and large decline in the incidence of invasive pneumococcal infection among children under 2 years of age. Indirect herd immunity effects of PCV7 were similar in Canada compared to the U.S., with an associated decline in the incidence of PCV7 serotype invasive S. pneumoniae infection among adults older than 65 years of age. Kellner et al, Can. Med. Ass. Journal. 2005 Nov; 173 (10): 1150-1151.

Meningitis Research Foundation, London – November 24-25, 2005. Nearly 300 international scientists, clinicians, vaccine manufacturers and technical agencies attended the two-day conference hosted by Meningitis Research Foundation. The second day of the conference had a particularly strong developing world focus. Dr. Thomas Cherian of WHO chaired a session entitled “Control of pneumococcal disease: ensuring equitable access to life-saving vaccines”. In this session, PneumoADIP's Communications Director, Hans Kvist, spoke about PneumoADIP’s mission and strategies. Dr. Richard Adegbola from The Gambia, Dr. Andrew Pollard from Nepal, and Dr. Anthony Scott from Kenya, spoke about pneumococcal disease surveillance projects and vaccine trials in Africa and Asia.

PneumoADIP and Meningitis Research Foundation Media Outreach. In conjunction with the international conference, PneumoADIP and Meningitis Research Foundation coordinated media outreach efforts in the UK. Based on this outreach, BBC World Service Radio devoted an entire program of their Health Matters series to meningitis - focusing on the difficulty of diagnosing meningitis and on news from the Meningitis Research Foundation's conference on the development of pneumococcal vaccines. The BBC interviewed Dr. Richard Adegbola, Dr. Anthony Scott and Dr. Thomas Cherian for the program. Health Matters was broadcast twice on December 5th and 6th. The full program was also available all week on the World Service website.

NetSPEAR Conference, Kenya – Nov 15-16, 2005. The Network for Surveillance of Pneumococcal Diseases in East African Region (NetSPEAR) held its 3rd Annual NetSPEAR Meeting in Kilifi, Kenya. Over 70 researchers, clinicians and public health professionals convened during this two-day meeting to present surveillance sites reports and the latest developments in vaccine research and financing. Dr. Wamae Maranga, NetSPEAR Manager, presented key achievements in 2005: reinforcement of laboratory and diagnostic practice via WHO training, advances in communication on pneumococcal disease through participation in both print and visual media, provision of increased educational information for clinicians and scientists dealing with pneumococcal disease, improved training on pneumococcal disease data management and surveillance. Over the next year, work will continue with 12 government hospitals in Kenya, Uganda, Tanzania and Ethiopia that are already contributing meningitis surveillance data. For more information about NetSPEAR, please visit: http://www.netspear.org

NetSPEAR and PneumoADIP Outreach to Kenyan Press. In conjunction with the 3rd Annual Meeting, NetSPEAR and its partners organized a press conference with Kenyan broadcast and print journalists. In an interview with Kenyan newspaper, Nation Media, PneumoADIP’s Executive Director, Orin Levine, discussed recent progress and challenges in pneumococcal disease control and prevention in the November 24, 2005 issue.

Switzerland – December 6, 2005 . In its press release, Novartis announced its merger agreement with California-based vaccine manufacturer, Chiron Corporation. According to industry surveys, the global vaccine market is expected to experience accelerated growth, more than doubling in sales over the next five years, from an estimated $9.6 billion in 2004 to over $20 billion in 2009. Novartis joins other multi-national pharmaceutical companies and emerging vaccine manufacturers in this burgeoning global vaccine market.

Evaluating Efficacy of Novel Diagnostics. A randomized clinical trial conducted in Utrecht, The Netherlands assessed the impact of rapid detection of viral and atypical bacterial pathogens by Real-Time Polymerase Chain Reaction in patients with lower respiratory tract infection, including S. pneumoniae. Results revealed that real-time PCR was highly sensitive, and increased the diagnostic yield from 21% to 43%, compared to conventional diagnostic tests. However, despite this increase, however, rapid diagnosis did not significantly influence clinical management of patients and did not reduce additional diagnostic procedures, antibiotic use, antibiotic costs, or the overall duration of hospital stay. Oosterheert et al, Clin. Infect. Dis. 2005 Nov; 41(10): 1438-1444.

Demographic Trends in Antibacterial Resistance. The Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin (PROTEKT) is a longitudinal surveillance which includes 120 centers in over 30 countries. Initiated in 1999, the PROTEKT study aims to monitor antimicrobial resistance in common respiratory bacterial from patients with community-acquired respiratory tract infections (RTIs). Recent results from this study report the impact of demographic variables on antibacterial susceptibility of S. pneumoniae isolates collected from 1999-2000. While demographic factors had a significant impact on antimicrobial resistance of pneumococci, telithromycin remained highly active across all demographic groups studied in 25 different countries. Hoban et al, Intl. J. Infect. Dis. 2005 Sep; 9(5): 262-273.

Advances in Non-Invasive Diagnostics. A prospective study was conducted to evaluate the impact of rapid urine antigen tests on the etiology diagnosis of community acquired pneumoniae (CAP). S. pneumoniae polysaccharide capsular and C polysaccharide antigens were detected using the counterimmunoelectrophoresis (CIE) and the immunochromatographic test (ICT) from Binax. The sensitivity of diagnosis based on urine samples concentrated by selective ultrafiltration, as well as unconcentrated samples was assessed. Results indicate an increase in diagnostic yield using both CIE and ICT methods, and a greater increase with concentrated urine samples. These findings may contribute to the development of better strategies for early diagnosis and improved treatment of S. pneumoniae infections. Andreo et al, Resp. Med. 2005 Oct (In Press).

American Society for Tropical Medicine and Health
Dec 11-15, 2005
Washington, DC
http://www.astmh.org/

Interscience Conference on Antimicrobial Agents and Chemotherapy
Dec 16-19, 2005
Washington, DC
http://www.icaac.org/

5th International Symposium on Pneumococci and Pneumococcal Disease
April 2-6, 2006
Alice Springs, Australia
http://www.isppd5.com/