Aavitsland P, Frøholm L O, Høiby E A, Lystad A
Avdeling for samfunnsmedisin, Statens Institutt for Folkehelse, Oslo.
Tidsskr Nor Laegeforen. 1994 Sep 30;114(23):2711-4.
We surveyed 472 cases of culture-confirmed systemic pneumococcal disease that were reported to the Norwegian Notification System for Infectious Diseases during a 12-month period in 1992-93. The clinicians in charge of the patients filled in a questionnaire providing information on underlying disease and outcome for 461 (98%) of the patients. Eight of these patients were splenectomized; all of them more than ten years before. Four died, two survived but had serious sequelae, and two survived without obvious sequelae upon discharge from hospital. Using a rough estimate of the prevalence of unvaccinated splenectomized persons in Norway, we estimate that this group, compared to the normal population, has a relative risk of 25 of developing systemic pneumococcal disease and a relative risk of 75 of dying from pneumococcal disease. The serotype of the pneumococcal strain that caused the disease was determined for seven of the eight patients. All serotypes were represented in the 23-valent pneumococcal polysaccharide vaccine. We strongly recommend that doctors trace and vaccinate splenectomized individuals.
我们对1992 - 1993年12个月期间向挪威传染病报告系统报告的472例经培养确诊的全身性肺炎球菌病病例进行了调查。负责这些患者的临床医生为其中461例（98%）患者填写了一份问卷，提供了关于基础疾病和转归的信息。这些患者中有8例接受了脾切除术，均为十多年前进行的。其中4例死亡，2例存活但有严重后遗症，2例出院时存活且无明显后遗症。根据对挪威未接种疫苗的脾切除者患病率的粗略估计，我们推测该群体与正常人群相比，发生全身性肺炎球菌病的相对风险为25，死于肺炎球菌病的相对风险为75。对8例患者中的7例确定了引起疾病的肺炎球菌菌株的血清型。所有血清型均在23价肺炎球菌多糖疫苗中有所涵盖。我们强烈建议医生追踪并为脾切除者接种疫苗。
