{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:50:28Z","timestamp":1783407028084,"version":"3.54.6"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"unspecified","delay-in-days":33,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>In August 2023, the Finnish Institute for Health and Welfare received reports of a potential cluster of pneumococcal pneumonia cases among shipyard employees in Turku, Finland. Considering a similar outbreak in the same shipyard in 2019, we initiated a case\u2013control study to investigate individual and environmental risk factors specific to this occupational setting in order to inform targeted prevention measures. In total, 14 hospitalized cases were identified from 19 August to 15 October 2023. <jats:italic>Streptococcus pneumoniae<\/jats:italic> serotypes 4 and 9\u00a0V were isolated from blood cultures of seven cases. Eleven cases and 67 controls working at the shipyard were included in the case\u2013control study. Compared with controls, cases were more likely to be living in an apartment\/studio or a hotel\/hostel, and less likely in a house or with family. Furthermore, cases were more likely to have a shorter duration of employment (&lt; 1\u00a0year) at the shipyard compared to controls. Control measures, including an information and a vaccination campaign, were implemented. We emphasize shipyard-wide hygiene improvements and recommend nationwide consideration of expanding pneumococcal vaccination eligibility to all shipyard construction employees as an occupational high-risk group.<\/jats:p>","DOI":"10.1017\/s0950268824001870","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T05:32:22Z","timestamp":1738560742000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Second reported outbreak of pneumococcal pneumonia among shipyard employees in Turku, Finland, August\u2013October 2023: a case\u2013control study"],"prefix":"10.1017","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5367-8403","authenticated-orcid":false,"given":"Wioleta","family":"Kitowska","sequence":"first","affiliation":[{"name":"European Centre for Disease Prevention and Control (ECDC)"},{"name":"Finnish Institute for Health and Welfare (THL)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8674-1525","authenticated-orcid":false,"given":"Ana Cristina","family":"Gonzalez-Perez","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control (ECDC)"},{"name":"Finnish Institute for Health and Welfare (THL)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3549-6686","authenticated-orcid":false,"given":"Joana","family":"Sequeira Neto","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control (ECDC)"},{"name":"Finnish Institute for Health and Welfare (THL)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1993-2532","authenticated-orcid":false,"given":"Mari","family":"Kanerva","sequence":"additional","affiliation":[{"name":"Infection Control Unit, The Wellbeing Services County of Southwest Finland (Varha)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Kaukavuori","sequence":"additional","affiliation":[{"name":"Meyer Turku"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6399-8846","authenticated-orcid":false,"given":"Irmeli","family":"Lindstr\u00f6m","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health (FIOH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Frilander","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health (FIOH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1819-518X","authenticated-orcid":false,"given":"Timoth\u00e9e","family":"Dub","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare (THL)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0330-7396","authenticated-orcid":false,"given":"Lotta","family":"Siira","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare (THL)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Pneumococcal Shipyard Outbreak Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"S0950268824001870_r23","unstructured":"[23] Robert Koch Institute (2024) Recommendations of the Standing Committee on Vaccination (STIKO). https:\/\/www.rki.de\/DE\/Content\/Kommissionen\/STIKO\/Empfehlungen\/Impfempfehlungen_node.html (accessed 9 Sep 2024)."},{"key":"S0950268824001870_r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2019.12.015"},{"key":"S0950268824001870_r2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11091495"},{"key":"S0950268824001870_r8","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2015.20.21.21138"},{"key":"S0950268824001870_r11","unstructured":"[11] Finlex (2024) Communicable Diseases Act 1227\/2016 Dec 21, 2016. https:\/\/www.finlex.fi\/en\/laki\/kaannokset\/2016\/en20161227 (accessed 29 May 2024)."},{"key":"S0950268824001870_r18","unstructured":"[18] Van Der Linden, M , Itzek, A. (2024) Post-pandemic IPD surge in Germany with strongly increased pcv13 serotype levels. In 13th Meeting of the International Society of Pneumonia & Pneumococcal Diseases, Cape Town, South Africa, p. 284. https:\/\/isppd.kenes.com\/abstract-publication\/ (accessed 12 May 2024)."},{"key":"S0950268824001870_r14","first-page":"1","article-title":"Naturally acquired human immunity to pneumococcus is dependent on antibody to protein antigens","volume":"13","author":"Wilson","year":"2017","journal-title":"PLoS Pathogens"},{"key":"S0950268824001870_r22","unstructured":"[22] Health and Safety Executive (HSE) (2024) Pneumonia Vaccination for Employees Exposed to Welding and Metal Fume (EIS44). https:\/\/www.hse.gov.uk\/pubns\/eis44.htm (accessed 9 Sep 2024)."},{"key":"S0950268824001870_r15","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00706-5"},{"key":"S0950268824001870_r4","unstructured":"[4] Finnish Institute for Health and Welfare (2024) Pneumococcal Vaccines. https:\/\/thl.fi\/en\/topics\/infectious-diseases-and-vaccinations\/vaccines-a-to-z\/pneumococcal-vaccines (accessed 10 Jun 2024)."},{"key":"S0950268824001870_r13","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-022-01848-6"},{"key":"S0950268824001870_r25","unstructured":"[25] Finnish Institute of Occupational Health (2024) The Finnish Institute of Occupational Health and Finnish Institute for Health and Welfare Recommend Pneumococcal Vaccination for Shipyard Workers Exposed to Metal Vapours. https:\/\/www.ttl.fi\/en\/topical\/news\/the-finnish-institute-of-occupational-health-and-finnish-institute-for-health-and-welfare-recommend (accessed 29 May 2024)."},{"key":"S0950268824001870_r16","unstructured":"[16] Cuypers, L , et al. (2024) Rapid increase of vaccine serotype 4 (GPSC162) invasive pneumococcal disease in young adults since 2020 in Belgium. In 13th Meeting of the International Society of Pneumonia & Pneumococcal Diseases, Cape Town, South Africa, p. 263. https:\/\/isppd.kenes.com\/abstract-publication\/ (accessed 12 May 2024)."},{"key":"S0950268824001870_r17","unstructured":"[17] Steens, A , et al. (2024) Increase in serotype 4 invasive pneumococcal disease in adults in the Netherlands, not due to an ongoing outbreak . In 13th Meeting of the International Society of Pneumonia & Pneumococcal Diseases, Cape Town, South Africa, p. 281. https:\/\/isppd.kenes.com\/abstract-publication\/ (accessed 12 May 2024)."},{"key":"S0950268824001870_r5","unstructured":"[5] European Centre for Disease Prevention and Control (2024) Vaccine Scheduler: Pneumococcal Disease: Recommended Vaccinations. https:\/\/vaccine-schedule.ecdc.europa.eu\/Scheduler\/ByDisease?SelectedDiseaseId=25&SelectedCountryIdByDisease=-1 (accessed 9 Sep 2024)."},{"key":"S0950268824001870_r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2021.102183"},{"key":"S0950268824001870_r1","unstructured":"[1] Centers for Disease Control and Prevention (2023) Pneumococcal Disease. https:\/\/www.cdc.gov\/pneumococcal\/index.html (accessed 21 Dec 2023)."},{"key":"S0950268824001870_r24","unstructured":"[24] Bundesministerium f\u00fcr Soziales, Gesundheit, Pflege und Konsumentenschutz (BMSGPK) (2024) Impfplan \u00d6sterreich 2023\/2024. https:\/\/www.sozialministerium.at\/Themen\/Gesundheit\/Impfen\/Impfplan-%C3%96sterreich.html (accessed 9 Sep 2024)."},{"key":"S0950268824001870_r10","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2019.24.49.1900681"},{"key":"S0950268824001870_r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2010.02.2268"},{"key":"S0950268824001870_r12","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2019-106175"},{"key":"S0950268824001870_r19","unstructured":"[19] Brueggemann, AB , et al. (2024) The IRIS Consortium investigates changes in pneumococcal serotypes causing invasive disease across the age spectrum. In 13th Meeting of the International Society of Pneumonia & Pneumococcal Diseases, Cape Town, South Africa, p. 676. https:\/\/isppd.kenes.com\/abstract-publication\/ (accessed 12 May 2024)."},{"key":"S0950268824001870_r21","unstructured":"[21] National Health Service for England (2024) Pneumococcal Vaccine. https:\/\/www.nhs.uk\/vaccinations\/pneumococcal-vaccine\/ (accessed 9 Sep 2024)."},{"key":"S0950268824001870_r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.10.046"},{"key":"S0950268824001870_r6","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.11.2000162"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268824001870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T14:45:32Z","timestamp":1759848332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268824001870\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":25,"alternative-id":["S0950268824001870"],"URL":"https:\/\/doi.org\/10.1017\/s0950268824001870","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e32"}}