Pebody R G, Hellenbrand W, D'Ancona F, Ruutu P
Health Protection Agency, London, United Kingdom.
Euro Surveill. 2006 Sep;11(9):171-8.
Pneumococcal disease (Pnc) is responsible for invasive pneumococcal disease (IPD)--mainly meningitis and septicaemia--and is an infection of public health importance in Europe. Following the licensure of an effective conjugate vaccine (PCV) in Europe, several European countries, including France, Germany, the Netherlands, Norway, Spain and the United Kingdom, are introducing universal Pnc childhood immunisation programmes. As part of a European Union (EU) funded project on pneumococcal disease (Pnc-EURO), a questionnaire was distributed in late 2003 to each of the current 25 European Union member states as well as Norway and Switzerland to get a clearer picture of national surveillance for invasive pneumococcal disease (IPD) in Europe. All respondents were contacted in 2006 and asked to provide an update to the questionnaire. Twenty two of the 27 countries targeted completed and returned the questionnaire. Four of the 22 responding countries have no reporting requirement for IPD. Eighteen countries reported a total of 27 national surveillance systems. Case definitions employed in these systems differed. Fourteen of the 18 countries reported collection of IPD strains to a single reference lab for serotyping and in 12 countries to a single laboratory for susceptibility testing. Thirteen countries undertook laboratory quality assurance. Information on age and sex were widely collected, but only 11/27 systems collected information on pneumococcal polysaccharide vaccine status, while 5/27 systems collected information on pneumococcal conjugate vaccine status. The incidence of IPD reported in each of the 18 countries ranged from 0.4 to 20/100,000 in the general population, with a total of 23,470 IPD cases reported over a 12 month period. Surveillance for IPD in Europe is very heterogeneous. Several countries lack surveillance systems. Large differences in reported disease incidence may reflect both true differences, and also variations in patient and healthcare factors, including surveillance. If IPD surveillance in Europe can be strengthened, countries will be able to make informed decisions regarding the introduction of new pneumococcal vaccines and also to monitor and compare the impact and effectiveness of new programmes.
肺炎球菌疾病（Pnc）可引发侵袭性肺炎球菌疾病（IPD）——主要是脑膜炎和败血症——并且在欧洲是具有公共卫生重要性的一种感染。在欧洲一种有效的结合疫苗（PCV）获得许可后，包括法国、德国、荷兰、挪威、西班牙和英国在内的几个欧洲国家正在推行针对儿童的肺炎球菌疾病普遍免疫规划。作为欧盟资助的肺炎球菌疾病项目（Pnc-EURO）的一部分，2003年末向当时的25个欧盟成员国以及挪威和瑞士分发了一份调查问卷，以便更清楚地了解欧洲侵袭性肺炎球菌疾病（IPD）的国家监测情况。2006年与所有受访者取得联系，并要求他们提供调查问卷的最新情况。目标涉及的27个国家中有22个完成并返还了调查问卷。22个回复国家中有4个对IPD没有报告要求。18个国家报告共有27个国家监测系统。这些系统采用的病例定义各不相同。18个国家中有14个报告将IPD菌株收集到一个单一的参考实验室进行血清分型，12个国家将其收集到一个单一实验室进行药敏试验。13个国家开展了实验室质量保证工作。广泛收集了年龄和性别的信息，但只有11/27个系统收集了肺炎球菌多糖疫苗接种状况的信息，而5/27个系统收集了肺炎球菌结合疫苗接种状况的信息。18个国家中每个国家报告的IPD发病率在普通人群中为0.4至20/10万，在12个月期间共报告了23470例IPD病例。欧洲对IPD的监测差异很大。几个国家缺乏监测系统。报告的疾病发病率存在很大差异，这可能既反映了实际差异，也反映了患者和医疗保健因素（包括监测）的差异。如果欧洲能够加强对IPD的监测，各国将能够就是否引入新的肺炎球菌疫苗做出明智决策，并且能够监测和比较新规划的影响和效果。
