What We Do
Pneumococcal infections are a major cause of illness and death worldwide. They are monitored by Santé publique France.
Since pneumococcal infections are a major cause of morbidity and mortality, particularly among the most vulnerable populations (young children, older adults, and people with chronic diseases), they represent a public health challenge.
Santé publique France is responsible for the epidemiological surveillance and prevention of these infections.
Epidemiological surveillance of pneumococcal infections
To assess the impact of this vaccination, epidemiological surveillance of pneumococcal infections allows for the annual measurement of the number of invasive pneumococcal infections relative to the population (incidence rate). Surveillance also makes it possible to measure the proportion of these infections caused by strains covered or not covered by the vaccine in order to track the effect of vaccination on the circulation of pneumococcal strains.
This surveillance of pneumococcal infections in France relies primarily on two networks of hospital laboratories:
the Epibac network, coordinated by Santé publique France
the network of the National Pneumococcal Reference Center (CNRP) in association with the networks of the Regional Pneumococcal Observatories (ORP).
The Epibac network is a network of hospital microbiologists established in 1987 and coordinated by Santé publique France since 1999. It consists of more than 300 French hospital microbiology laboratories located throughout the country that volunteer each year to participate in the surveillance of invasive bacterial infections. Epibac collects data on the number of invasive infections caused by six bacteria, including pneumococcus.
The cases of invasive pneumococcal infections reported are defined by the isolation of pneumococcus in the blood (bacteremia and sepsis) or in the cerebrospinal fluid (meningitis). Since 2009, cases diagnosed by the detection of pneumococcal DNA via PCR in the blood or cerebrospinal fluid have been included.
For each case of invasive pneumococcal infection, the date of specimen collection, date of birth, and site of collection are recorded.
Epibac data enable the estimation and monitoring of trends in the number of cases and the incidence of invasive pneumococcal infections for the entire French population by age group.
Learn more: The Epibac network
The CNRP’s mission is to provide biological expertise and contribute to the surveillance of pneumococcal infections and their antibiotic resistance.
For the microbiological surveillance of pneumococci, the CNRP has been partnered since 2001 with a network of 23 ORPs spread across the entire metropolitan area, including both public and private laboratories (approximately 400 laboratories). This surveillance focuses in particular on strains isolated from invasive pneumococcal infections. The CNRP’s analysis of these strains includes determining the susceptibility of pneumococcal strains to the main antibiotics used, as well as identifying the serotypes of the strains. This microbiological surveillance is essential because it allows for monitoring the evolution of serotypic coverage of the various vaccines available or recommended in France, as well as the evolution of antibiotic resistance in pneumococcal strains.
Since 2001, the ORP-CNRP network has collected and studied annually all strains isolated from cerebrospinal fluid (meningitis) or blood (bacteremia or septicemia) in children aged 0 to 15 years, and, every other year, a systematic sample of one in six strains isolated from the blood of adults over 15 years of age.
Learn more:
Other surveillance networks or observatories exist. These include networks of hospital pediatricians and infectious disease specialists.
Surveillance networks for invasive pneumococcal infections in children of the Val-de-Marne Pediatric Clinical and Therapeutic Association (ACTIV)
The Observatory for Bacterial Meningitis in Newborns and Children has been coordinated by ACTIV on behalf of the Pediatric Infection Prevention Group (GPIP) since 2001. It includes nearly 250 pediatric departments. In 2011, it expanded its surveillance to include invasive pneumococcal infections in children. Its objective is to collect epidemiological data—such as vaccination status—as well as clinical, biological, and follow-up data for the cases included.
Learn more: Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV)
Surveys and studies have also been conducted in France and across Europe
SIIPA was established through a partnership between the CNRP, the ORPs, the French-Speaking Society of Infectious Diseases (Spilf), and Santé publique France. It is a prospective, descriptive, multicenter cohort study conducted in public and private acute-care hospitals across several regions. Its objective is to supplement laboratory data with clinical and epidemiological data, to estimate the incidence and trends of bacteremic pneumonia in adults based on risk factors, and to assess the impact of vaccination policy. Following the pilot phase conducted in hospitals and clinics in the Arc Alpin, Centre, and Provence ORPs between October 2012 and December 2013, this surveillance was expanded to include hospitals in Burgundy, Champagne-Ardenne, and Alsace.
Learn more: Presentation of the initial results of the pilot study
The European SpIDnet project was launched in 2012 in response to a call for proposals from the European Centre for Disease Prevention and Control (ECDC) to assess the impact of pneumococcal vaccination on invasive pneumococcal infections in Europe. Nine European Union member states, including France, coordinated by Epiconcept, participated in the first phase of the project from 2012 to 2014. Its objective was to establish and coordinate a multicenter surveillance system for invasive pneumococcal infections in children, in order to assess the impact of vaccination with 10- and 13-valent pneumococcal conjugate vaccines on invasive pneumococcal infections in Europe.
The initial results of this coordinated surveillance enabled an analysis of the efficacy of the 10- and 13-valent pneumococcal conjugate vaccines, which recently replaced the 7-valent conjugate vaccine in Europe, as well as an analysis of the impact of the use of these vaccines on the incidence of invasive pneumococcal infections in children. In 2014, the project was expanded to include surveillance in adults. In 2015, the project was extended to 10 EU Member States.
Santé publique France coordinates French participation by providing combined data from the ACTIV, SIIPA, Epibac, CNRP, and ORP surveillance networks.
Learn more: SpIDnet Study
A preventive initiative against pneumococcal infections
Santé publique France helps promote vaccination through various resources (website, promotional campaigns, brochures, etc.). We have created an informational website about the different vaccines available in France to provide reliable, scientifically validated answers to questions that the public and healthcare professionals may have on the subject.
A section dedicated to vaccination against pneumococcal infections is available in two separate sections: one for the general public and the other for healthcare professionals, to better support them in their practice.
Santé publique France also develops tools and documents specifically focused on the prevention of pneumococcal infections for healthcare professionals and the general public.
In addition, Santé publique France promotes preventive measures to protect against infections transmitted through direct and close contact, such as pneumococcal infection, including hand hygiene and wearing a mask if respiratory symptoms are present.
In relation to
Vaccination
thematic dossier
Contagious diseases most often affect children at a very young age. Because children are particularly vulnerable, they are a priority target for vaccination programs.
