Regional workshop on Invasive Bacterial Disease (IBD) surveillance, New Delhi, India, 20 December 2022
Overview
The Invasive bacterial disease includes surveillance for Haemophilus influenzae type b (Hib), Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis and Group B streptococcus.
The bacteria Streptococcus pneumoniae (pneumococcus) is the most frequent cause of severe pneumonia and pneumonia-related deaths worldwide. Pneumococci frequently and asymptomatically colonize the human nasopharynx, particularly in children, but can spread contiguously to cause otitis media and sinusitis, be aspirated to cause pneumonia or invade normally sterile sites to cause sepsis or meningitis.
Among the countries of the WHO South-East Asia Region, Sri Lanka and Myanmar are second to India in pneumococcal disease burden. Pneumococcal vaccines are either polysaccharide or conjugate vaccines. Polysaccharide vaccines are recommended in some developed countries to prevent pneumonia in older persons and persons with underlying medical conditions. The available pneumococcal conjugate vaccines (PCVs) are effective in preventing pneumococcal diseases in children due to vaccine serotypes. Overall rates of invasive pneumococcal disease remain reduced after conjugate vaccine introduction.
The bacteria Haemophilus influenzae type b (Hib) was the leading cause of non-epidemic bacterial meningitis worldwide in children prior to the introduction of Hib vaccine. H. influenzae can asymptomatically colonize the human nasopharynx, particularly in children. The bacteria can cause pneumonia, and more rarely, it can cause invasive disease, predominantly meningitis and pneumonia, but also epiglottitis, septic arthritis and others.
Neisseria meningitidis (Nm) is a gram-negative bacterium that usually resides harmlessly in the human pharynx. Under certain conditions, asymptomatic carriage can progress to invasive meningococcal disease (IMD), resulting in meningitis, fulminant septicaemia, or both. Neisseria meningitidis can also rarely cause arthritis, myocarditis, pericarditis, invasive pneumonia, necrotizing fasciitis and endophthalmitis.
Group B streptococcus has 10 serotypes, with 1a, 1b, II, III, IV and V causing most disease. Conjugate and protein vaccines designed to protect against group B streptococcal disease in mothers and babies are in clinical development.
Invasive bacterial diseases (IBD) have a higher burden in children under 5 years in low and middle-income countries such as India and other Southeast Asian countries. Maintaining case-based, active surveillance with laboratory confirmation remains a critical component of the global agenda in public health.
