prevnar failure due to pneumococcal carriage?

[peglem]

http://www.ncbi.nlm.nih.gov/pubmed/20384496

 

CONCLUSIONS: Serotype-specific hyporesponsiveness to PCV7 after pneumococcal carriage in infants is demonstrated for the first time. This phenomenon was common, lasted for at least several months, and was only partially overcome by the 12-month booster.

[kimballot]

Thanks, Peg - this is very interesting. Do you think this would explain why my son, who has had sinusitis since birth, may not have had a lasting response to 2 pneumovax injections? ... (though he had pneumovax and not the newer prevnar version)

Edited June 29, 2010 by kimballot

[peglem]

Thanks, Peg - this is very interesting. Do you think this would explain why my son, who has had sinusitis since birth, may not have had a lasting response to 2 pneumovax injections? ... (though he had pneumovax and not the newer prevnar version)

Yes, I think that's what its saying. So, does this mean kids who respond poorly to pneumovax/prevnar should be checked for pneumo carriage?

[Fixit]

pneumo carriage?

 

what is that/this?

[peglem]

pneumo carriage?

 

what is that/this?

It would be "carrying" the streptococcus pneumonia pathogen in your cells, without exhibiting an immune reaction that would demonstrate infection- like strep A carriers, but with a different pathogen.

[mama2alex]

This is really interesting. I wonder if this is why my son has had 6 bouts with pneumonia (almost 7 this spring, but he was already on antibiotics, so we nipped it). It might also explain why he was deficient on s. pneumo titers then had a borderline response on s. pneumo titers post-Pneumovax (just high enough for the insurance companies to deny monthly IVIG, but still low on a number of them). I'm adding this to my list of things to discuss with the DAN doc this Friday!

 

pneumo carriage?

 

what is that/this?

It would be "carrying" the streptococcus pneumonia pathogen in your cells, without exhibiting an immune reaction that would demonstrate infection- like strep A carriers, but with a different pathogen.

[Fixit]

pneumo carriage?

 

what is that/this?

It would be "carrying" the streptococcus pneumonia pathogen in your cells, without exhibiting an immune reaction that would demonstrate infection- like strep A carriers, but with a different pathogen.

 

so it is in the body....

would this be considered bad or good...

does it mean that you can't mount a response???

[peglem]

pneumo carriage?

 

what is that/this?

It would be "carrying" the streptococcus pneumonia pathogen in your cells, without exhibiting an immune reaction that would demonstrate infection- like strep A carriers, but with a different pathogen.

 

so it is in the body....

would this be considered bad or good...

does it mean that you can't mount a response???

Bad! And yes, for some reason the immune system isn't fighting the pathogen. It just occurred to me that the vaccine titer failure isn't because of the carriage- both the carriage and the poor titer response are because the immune system is not mounting a response to the pathogen.

[TessaKrista]

Peglem, how do we test for this? My son had prevnar, and still had pneumonia a few times. I found that odd. He has complained of a sore chest, but not now that he has been on azithromycin, though. What do you make of this? Instead of a strep test, is there a test for the pneumonia carrier thing?

[kimballot]

Peglem, how do we test for this? My son had prevnar, and still had pneumonia a few times. I found that odd. He has complained of a sore chest, but not now that he has been on azithromycin, though. What do you make of this? Instead of a strep test, is there a test for the pneumonia carrier thing?

 

Sweet cheeks mom -

They can test for it with an immune status blood test. The doc can order s. pneumoniae titers - I believe you want titers to 14 serotypes (I think 14 is all the serotypes - sometimes doctors order fewer than 14.)

 

Also - if your son had pneumonia - was it "walking pneumonia".... because that is usually mycoplasma, which is a whole other problem our kids deal with... so you should have your doc order mycoplasma titers as well.

 

If you've not done so yet, you should try to hook up with a PANDAS doc - even if you have to pay out of pocket for a phone consult. A PANDAS doc can at least get you going with some good bloodwork to figure out what is going on.

[kimballot]

[

Bad! And yes, for some reason the immune system isn't fighting the pathogen. It just occurred to me that the vaccine titer failure isn't because of the carriage- both the carriage and the poor titer response are because the immune system is not mounting a response to the pathogen.

 

Peglem - yes - that is what I have been thinking... that my son's chronic sinusitis is becaue he is not able to mount a response to s. pneumoniae- even with vaccination. That is why Dr. B is recommending IVIG. I think the carriage just shows that the ANTIGEN is present... but the low titers show a lack of ANTIBODIES.

 

It is my understanding that s. pneumoniae is NORMALLY found in the sinuses, but is kept in check by the antibodies... low antibodies result in sinus infections.

 

Is that your understanding as well?

[kim]

All this really says to me is that the vaccine didn't work as well at prompting the immune system to respond, if the child was already carrying the bacteria at the time the vaccine was given. Is the reduced response in this case a good or bad thing? It would appear that the body has recognized the bacteria in some way, even tho it wasn't infectous and the immune response was lessened? If that's the case, it's interesting. One thing that occurs to me tho, is that the vaccine does not act in the body in a natural way (the way the immune system would respond during natural infection) so what conclusions can be drawn from this in relationship to carriage and infection where a vaccine isn't involved, I wouldn't even have a guess.

 

We all carry bugs that can cause problems IF they become invasive and the immune system is overwhelmed for what ever reason.

 

What really concerns me about this, is the fact that the PCV 7 appears to have increased the incidence of a nasty strain of S. pneumoniae, 19A, (and others) which is highly antibiotic resistant

 

http://www.naturalnews.com/023241_pneumoni...ia_disease.html

 

In 2004-2005, researchers at the University of Iowa found that 35% of penicillin-resistant infections were caused by 19A. The year before, 19A caused only 2%.

 

Bacteria have the ability to "share" their characteristics. We don't want antibiotic resistant strains to circulate. I'm assuming more infections with this strain=more carriage, too. Now, they have developed a vaccine that contains 19A. What happens if the same principle applies? Will people who were "carriers", mount a lesser immune response? Would that pose a problem? They didn't say if any of the children in the study that Peg posted, went on to develope "infectious" disease at a higher rate in the kids where the lessened immune response was noted.

 

Just a few quick thoughts