Pneumococcal disease is an infection caused by a bacteria called Streptococcus pneumoniae also known as pneumococcus. Pneumococcus can cause pneumonia (lung infection), meningitis ( infection of the lining of the brain and spine), blood infections (bacteremia) and middle ear infections (otitis media). In severe cases, it can cause fatality. It can be prevented via vaccination.
Some people carry the pneumococcus bacteria in their nose and throat but they may no exhibit any symptoms and are just carriers. It is spread via respiratory droplets when the infected person sneeze or cough and also via close contact with articles contaminated respiratory secretions.
Pneumococcal disease is more common in children under 2 years old and those older than 65 years old. Immuno-compromised patients , smokers and asthmatic patients are also at increased risk of infection.
Symptoms of pneumococcal disease
Symptoms usually occur within 3 days of infection. The symptoms depend on the system affected.
1. Pneumococcal pneumonia will present with fever, cough, chest pain and shortness of breath. Complications include formation of lung abscess and spread of infection to the pericardium of heart resulting in pericarditis.
2. Pneumococcal meningitis will present with fever, stiff neck, severe headache, nausea & vomiting, confusion, disorientation and photophobia (visual sensitive to light). This sis a serious infection with possible complications affecting learning , speech, paralysis and even death.
3. Pneumococcal bacteremia ( blood infection) will present with high fever, multiple joint pain, chills, confusion and non specific signs.
4. Pneumococcal otitis media ( middle ear infection) will present with fever, irritability, painful ear, red swollen tympanic membrane. Recurrent infection can cause deafness.
5. Pneumococcal sinusitis will present with prolonged low grade fever associated with runny nose and cough.
Diagnosis is made via physical examination, laboratory tests in isolating the bacteria, chest x-ray and lumbar puncture for cases of meningitis.
Treatment is infusion of antibiotics.
Prevention of pneumococcal is made possible with vaccination. there are two vaccines available : pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23).
There are about 90 types of pneumococcal bacterial. PCV13 protects against 13 types and PPSV23 protects against 23 types. Both protects against meningitis infection and bacteremia. PCV13 also protects against pneumococcal pneumonia. Most people who get the vaccine develop protection to most or all of these types within 2-3 weeks post vaccination.
PCV 13 is incorporated into childhood vaccinations for infants and children under 2 years old. A series of 4 doses at the ages stated below:
1 dose of PCV13 is recommended for all adults above 65 years of age who have not previously received the vaccine. A dose of PPSV23 should be given 6 to 12 months later.
For those who had PPSV23 vaccine before, one dose of PCV13 should be given at least one year after receiving the most recent dose of PPSV23.
Patients (children 6-18 years old and adults from 19-64 years old) with risk factors should get one dose of PCV13 if not previously vaccinated before. The risk factors include chronic medical conditions like heart disease, kidney failure, chronic lung disease, diabetes , chronic liver disease, immuno-compromised ( HIV and cancer patients), patients without a spleen and those with sickle cell disease.
PPSV23 is recommended those age 2-64 who are at risk of pneumococcal disease and those above 65 years old. Risk factors include chronic medical conditions like heart disease, chronic lung disease, diabetes , chronic liver disease, immuno-compromised ( HIV and cancer patients), patients without a spleen and those with sickle cell disease.
People age 2-64 years old with above chronic health conditions may be recommended to receive a second dose, five years after their first dose.Those who had a dose of PPSV23 at age 65 years or older should also get a booster of PPSV23 5 years after the first dose.