Public Health

What is pneumococcal disease? Pneumococcal disease is a leading cause of serious illness in children and adults throughout the world. The disease is caused by a common bacterium, the pneumococcus, which can attack different parts of the body. When pneumococcal bacteria invade the lungs, they cause pneumonia; when they invade the bloodstream, they cause bacteremia; and when they invade the covering of the brain, they cause meningitis. Streptococcus pneumoniae is the most common cause of pneumonia in the world and the most common cause of acute otitis media in children. Currently there are 84 known pneumococcal types, but only a few types account for most of the invasive disease.

Who gets pneumococcal disease and how is it spread? Pneumococci are commonly found in the upper respiratory tract, but generally people have a high resistance to disease. Resistance may be lowered by a number of risk factors including: age extremes (the very young and the very old); some viral upper respiratory tract infections, especially influenza; immunoglobulin deficiency; Hodgkin`s disease; splenic dysfunction (including sickle-cell anemia); asplenia; chronic cardiovascular or pulmonary disease; diabetes; alcoholism; cirrhosis; kidney disease; recent organ transplantation; AIDS; smoking; living in crowded conditions (institutions, barracks, and ships). Pneumococcal pneumonia occurs most often during the coldest months of the year when respiratory infections are common. The bacteria can be spread from person to person through respiratory droplet spread or indirectly through contact with articles soiled with respiratory discharges.

What are the symptoms of pneumococcal disease and when do they start? Symptoms of pneumonia caused by Streptococcus pneumoniae are: a sudden onset of chills, fever, chest pain, difficulty breathing, and a cough producing `rusty` sputum. In the elderly symptoms may be more subtle; a chest x-ray may provide the first evidence of pneumonia. In infants, vomiting and convulsions may be the first indication of infection. S. pneumoniae is the third leading cause of bacterial meningitis in the United States, most cases are in children under five years of age. Meningitis can develop from untreated middle ear or sinus infections, pneumonia, or bacteremia. Bacterial meningitis is seen as an acute onset of high fever, headache, vomiting, drowsiness, and stiff neck. Illness progresses rapidly causing loss of consciousness and possibly death. Symptoms may appear in one to three days from infection. People with normal immune systems may develop antibodies specific to each type of pneumococci which, in general, persist for life.

Is pneumococcal disease serious? Yes it can be. Streptococcus pneumoniae causes much illness and death in the United States each year. About 5 of every lOO persons who get pneumococcal pneumonia, about 20 out of every lOO persons who get bacteremia, and about 30 out of every lOO who get meningitis die of these infections.

What is the treatment for pneumococcal disease? Antibiotics are used to treat pneumococcal disease, in which penicillin is the drug of choice. If the patient is allergic to penicillin, vancomycin, erythromycin, clindamycin, and a number of other drugs are effective. Some types of pneumococci are resistant to penicillin and other drugs commonly used to treat infection.

Is there a vaccine for pneumococcal disease? Yes. There are two types of pneumococcal vaccine: the pneumococcal conjugate vaccine is routinely recommended for children under two years of age and for children between 24-59 months who have not been vaccinated or are considered high risk for the disease, and the pneumococcal polysaccharide vaccine which is also given to anyone over two years old who are at high risk of the disease and to any adult 65 years and older.

(Note: The photo above is only a representation of a child with an IV; not the disease.)

Wyoming Department of Health
2300 Capitol Ave.
Cheyenne WY 82002
(307) 777-7172

(Photo courtesy of wwwetch.com)