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Emergence of pneumococcal 19A empyema in UK children
  1. Matthew F Thomas1,2,
  2. Carmen L Sheppard3,
  3. Malcolm Guiver4,
  4. Mary P E Slack3,
  5. Robert C George3,
  6. Russell Gorton5,
  7. James Y Paton6,
  8. Clare Simmister2,
  9. David Cliff7,
  10. Mohamed A Elemraid8,9,
  11. Julia E Clark9,
  12. Stephen P Rushton1,
  13. David Anthony Spencer2
  1. 1School of Biology, Newcastle University, Newcastle-Upon-Tyne, UK
  2. 2Department of Respiratory Paediatrics, Newcastle-Upon-Tyne Hospitals NHS Trust, Newcastle-Upon-Tyne, UK
  3. 3Respiratory and Systemic Infection Laboratory, Centre for Infections, Colindale, Health Protection Agency, London, UK
  4. 4Molecular Diagnostic Laboratory, Health Protection Agency North West, Manchester, UK
  5. 5Regional Epidemiology Unit, Health Protection Agency North East, Newcastle-Upon-Tyne, UK
  6. 6School of Medicine, University of Glasgow, Glasgow, UK
  7. 7Newcastle-Upon-Tyne Hospitals NHS Trust, Newcastle-Upon-Tyne, UK
  8. 8Institute of Cellular Medicine, Newcastle University, UK
  9. 9Department of Paediatric Infectious Disease and Immunology, Newcastle-Upon-Tyne Hospitals NHS Trust, Newcastle-Upon-Tyne, UK
  1. Correspondence to Dr David Anthony Spencer, Department of Respiratory Paediatrics, Great North Children's Hospital, Newcastle-Upon-Tyne NE1 4LP, Tyne & Wear, UK; David.Spencer2{at}


Introduction Invasive pneumococcal disease due to serotype 19A has become a major concern, particularly in the USA and Asia. We describe the characteristics of pneumococcal serotype 19A related empyema and changes in its incidence in the UK.

Methods Data from paediatric empyema patients between September 2006 and March 2011 were collected from 17 respiratory centres in the UK. Pneumococcal serotypes were identified as part of the Health Protection Agency enhanced paediatric empyema surveillance programme.

Results Four serotypes accounted for over 80% of 136 cases (Serotype 1 : 43%, 3 : 21%, 7 : 11% and 19A:10%). The incidence of empyema due to serotype 19A quadrupled from 0.48 (0.16–1.13) cases per million children in 2006/2007 to 2.02 (1.25–3.09) in 2010/2011. Severity of disease was significantly increased in children with 19A infection when compared to other serotypes.

Conclusions The incidence of empyema due to pneumococcal serotype 19A infection has increased significantly and is associated with substantial morbidity.

  • Epidemiology
  • Infectious Diseases
  • Respiratory
  • Immunisation
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