BACKGROUND: Invasive pneumococcal disease (IPD) is caused by Streptococcus pneumoniae and mostly presents as pneumonia, sepsis or meningitis. A notable portion of IPD cases is vaccine preventable and the pneumococcal conjugate vaccine (PCV) was introduced into the routine childhood immunization programs in many countries during the last decades. OBJECTIVES: Before PCV introduction in the Czech Republic in 2010, a national surveillance system for IPD was implemented in 2008 and further improved in 2011. In this study, we describe the new surveillance system for the first time and measure its sensitivity between 2010 and 2013 using the capture-recapture method. Furthermore, we describe the recent epidemiological trend of IPD, taking sensitivity estimates into account. RESULTS AND CONCLUSIONS: Between 2010 and 2013 the estimated sensitivity of the overall IPD surveillance increased from 81% to 99%. The sensitivity of individual reporting sources increased from 72% to 87% for the laboratory system and from 31% to 89% for the epidemiological notification system. Crucial for this improvement was the introduction of quarterly report reminders in 2011. Due to positive source dependency, the presented sensitivity estimates are most probably overestimated and reflect the upper limit of reporting completeness. Stratification showed variation in sensitivity of reporting particularly according to region. An effect of the PVC vaccination in the Czech Republic is visible in the incidence of IPD in target age groups (<5 y). This influence was not evident in the total IPD incidence and may interfere with increasing sensitivity of reporting. In 2013, an increase in the IPD incidence was observed. This finding requires further observation and a detailed vaccine impact analysis is needed to assess the current immunization strategy.

National Institute of Public Health ECDC Stockholm Sweden

National Institute of Public Health Prague Czech Republic

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Donkor ES (2013) Understanding the pneumococcus: transmission and evolution. Front Cell Infect Microbiol 3: 7 10.3389/fcimb.2013.00007 PubMed DOI PMC

Randle E, Ninis N, Inwald D (2011) Invasive pneumococcal disease. Arch Dis Child Educ Pract Ed 96: 183–190. 10.1136/adc.2010.191718 PubMed DOI

ECDC (2012) Surveillance of invasive pneumococcal disease in Europe, 2010. European Centre for Disease Prevention and Control.

Song JY, Nahm MH, Moseley MA (2013) Clinical implications of pneumococcal serotypes: invasive disease potential, clinical presentations, and antibiotic resistance. J Korean Med Sci 28: 4–15. 10.3346/jkms.2013.28.1.4 PubMed DOI PMC

Hanquet G, Perrocheau A, Kissling E, Bruhl DL, Tarrago D, Stuart J, et al. (2010) Surveillance of invasive pneumococcal disease in 30 EU countries: Towards a European system? Vaccine 28: 3920–3928. 10.1016/j.vaccine.2010.03.069 PubMed DOI

Isaacman DJ, McIntosh ED, Reinert RR (2010) Burden of invasive pneumococcal disease and serotype distribution among Streptococcus pneumoniae isolates in young children in Europe: impact of the 7-valent pneumococcal conjugate vaccine and considerations for future conjugate vaccines. Int J Infect Dis 14: e197–209. 10.1016/j.ijid.2009.05.010 PubMed DOI

Motlova J, Benes C, Kriz P (2009) Incidence of invasive pneumococcal disease in the Czech Republic and serotype coverage by vaccines, 1997–2006. Epidemiol Infect 137: 562–569. 10.1017/S0950268808001301 PubMed DOI

Pebody RG, Hellenbrand W, D'Ancona F, Ruutu P (2006) Pneumococcal disease surveillance in Europe. Euro Surveill 11: 171–178. PubMed

ECDC (2013) Surveillance of invasive bacterial diseases in Europe, 2011. European Centre for Disease Prevention and Control;

Hanquet G, Lernout T, Vergison A, Verhaegen J, Kissling E, Tuerlinckx D, et al. (2011) Impact of conjugate 7-valent vaccination in Belgium: addressing methodological challenges. Vaccine 29: 2856–2864. 10.1016/j.vaccine.2011.02.016 PubMed DOI

Savulescu C, Hanquet G, SpIDnet-group. Impact of higher-valency conjugate vaccines on invasive pneumococcal disease: preliminary results of a European multicentre project; 2014; Dublin, Ireland.

Brenner H (1995) Use and limitations of the capture-recapture method in disease monitoring with two dependent sources. Epidemiology 6: 42–48. PubMed

Tilling K (2001) Capture-recapture methods—useful or misleading? Int J Epidemiol 30: 12–14. PubMed

Hook EB, Regal RR (1992) The value of capture-recapture methods even for apparent exhaustive surveys. The need for adjustment for source of ascertainment intersection in attempted complete prevalence studies. Am J Epidemiol 135: 1060–1067. PubMed

Tilling K, Sterne JAC (1999) Capture-recapture models including covariate effects. Am J Epidemiol 149: 392–400. PubMed

Farrington CP (2002) Interval estimation for Poisson capture-recapture models in epidemiology. Stat Med 21: 3079–3092. PubMed

R_Core_Team (2013) R: A language and Environment for Statistical Computing.

Sekar CC, Deming WE (1949) On a Method of Estimating Birth and Death Rates and the Extent of Registration. Journal of the American Statistical Association 44: 101–115.

German RR, Lee LM, Horan JM, Milstein RL, Pertowski CA, Waller MN, et al. (2001) Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR Recomm Rep 50: 1–35; quiz CE31-37. PubMed

Gjini A, Stuart JM, George RC, Nichols T, Heyderman RS (2004) Capture-recapture analysis and pneumococcal meningitis estimates in England. Emerg Infect Dis 10: 87–93. PubMed

Howitz MF, Samuelsson S, Molbak K (2008) Declining incidence of meningococcal disease in Denmark, confirmed by a capture-recapture analysis for 1994 and 2002. Epidemiol Infect 136: 1088–1095. PubMed PMC

Schrauder A, Claus H, Elias J, Vogel U, Haas W, Hellenbrand W (2007) Capture-recapture analysis to estimate the incidence of invasive meningococcal disease in Germany, 2003. Epidemiol Infect 135: 657–664. PubMed PMC

Declich S, Carter AO (1994) Public health surveillance: historical origins, methods and evaluation. Bull World Health Organ 72: 285–304. PubMed PMC

Evaluation of the Completeness and Timeliness of the Infant Pertussis Surveillance System in the Czech Republic in 2015, 2017 and 2019

Impact of pneumococcal conjugate vaccine on invasive pneumococcal disease in children under 5 years of age in the Czech Republic

Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination

Surveillance of pneumococcal diseases in Central and Eastern Europe