Pneumococcal Disease in a Medium-Sized Community in the United States

To assess the importance of bacteremic pneumococcal disease among the population of one "average" American community, we studied all hospitalized patients who had Streptococcus pneumoniae isolated from blood, CSF, pleural fluid, or ascitic fluid during the years 1978 through 1981 in Huntington, WVa, and environs. Seventeen patients were children younger than 13 years, and 71 were adults. The case fatality rate from bacteremic pneumococcal disease among adults was 30%, and among children it was 6%. It was much higher (88%) in adults older than 50 years with extrapulmonary disease. Approximately four fifths of the typed isolates from adults or children were types included in the current vaccine. Eighty-nine percent of the adults who died of pneumococcal infection had been candidates for pneumococcal vaccine, but only one patient had received vaccine, just before becoming ill with pneumococcal disease. These data provide a basis for widespread use of pneumococcal vaccine in high-risk groups.