National case definition: Invasive Pneumococcal Disease

Invasive pneumococcal disease

Date of last revision/review: May 2008

National notification

Only confirmed cases of disease should be notified.

Type of surveillance

Routine case-by-case notification to the federal level

Enhanced case-by-case notification to International Circumpolar Surveillance in participating Northern regions

Enhanced active case-by-case notification by paediatric tertiary care hospitals involved in the Immunization Monitoring Program, Active (IMPACT)

Case classification

Confirmed case

  • Clinical evidence of invasive disease (see Clinical evidence section) with laboratory confirmation of infection:
    • isolation of Streptococcus pneumoniae from a normally sterile site (excluding the middle ear and pleural cavity)
  • or
    • demonstration of S. pneumoniae DNA from a normally sterile site (excluding the middle ear and pleural cavity)

Probable case

  • Clinical evidence of invasive disease with no other apparent cause and with non-confirmatory laboratory evidence:
    • demonstration of S. pneumoniae antigen from a normally sterile site (excluding the middle ear and pleural cavity)

Laboratory comments

Sputum and bronchial lavages are not considered sterile specimens.

Demonstration of S. pneumoniae DNA or antigen does not permit determination of serotype. Serotyping is carried out in a reference laboratory and is important for monitoring changes in disease epidemiology, including the impact of vaccination programs and serotype replacement.

Clinical Evidence

Clinical illness associated with invasive disease manifests itself mainly as pneumonia with bacteremia, bacteremia without a known site of infection, and meningitis. Pneumonia without bacteremia is not notifiable.

ICD code(s)

  • 6.1 ICD-10 code(s)
  • A40.3 Septicaemia due to S. pneumoniae
  • B95.3 pneumoniae as the cause of diseases classified elsewhere, e.g.:
    • I30.1 Infective pericarditis
    • K65.0 Acute peritonitis
    • M00.8 Arthritis and polyarthritis due to other specified bacterial agents
    • O85 Puerperal sepsis
    • P23.6 Congenital pneumonia due to other bacterial agents
  • G00.1 Meningitis due to S. pneumoniae
  • J13 Pneumonia due to S. pneumoniae
  • M00.1 Pneumococcal arthritis and polyarthritis
  • ICD-9/ICD-9CM code(s)
  • 038.2 Septicaemia due to S. pneumoniae
  • 041.2 S. S. pneumoniae of unspecified site and as the cause of diseases classified elsewhere, e.g.:
    • 420.9 Infective pericarditis
    • 711.0 Pyogenic arthritis
  • 567.1 Pneumococcal peritonitis
  • 320.1 Meningitis due to S. pneumoniae
  • 481 Pneumonia due to S. pneumoniae
  • 711.0 Pneumococcal arthritis and polyarthritis

Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

References

Laboratory Centre for Disease Control. Preventing pneumococcal disease: a Canadian consensus conference. CCDR 1999;25:25-35.

Previous case definitions

Case definitions for diseases under national surveillance. CCDR 2000;26(S3).

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