Pneumococcal Disease

Pneumococcal infection is a major cause of morbidity and mortality worldwide. It is a bacterial infection that causes pneumonia, meningitis, bacteraemia and other life-threatening ailments. Serious pneumococcal infections are a global health problem, but they can be prevented with vaccination.


Pneumococcal Disease Causes and Risk Factors

Pneumococcal disease (PD) is caused by a bacterium called Streptococcus pneumonia, which is also known as pneumococcus. There are more than 90 serotypes of this bacterium. 

Pneumococcus can attack different parts of the body and cause serious infection of the following systems:
Lungs (pneumonia)
Blood (bacteraemia)
Coverings of the brain and spinal cord (meningitis)
Middle ear (acute otitis media)

It is common for people, especially children, to carry pneumococcus in their nose and throat. The bacteria can spread from person to person by:
Direct contact
Droplets from an infected person through coughing or sneezing
Articles contaminated with infected droplets

Not everyone exposed to the bacteria develops the disease. Some people become carriers, while others progress to develop the infection.

Although anyone can get pneumococcal disease, those at particularly high risk are infants, the elderly and individuals with chronic medical illnesses or weakened immune systems.

Pneumococcal Disease Signs and Symptoms 

Pneumococcal disease is most common in children under the age of two years and in adults aged 65 years and above. Within one to three days of infection, the following signs and symptoms may appear, and vary based on the systems affected.
Bacteraemia — high fever and non-specific signs of illness
Meningitis — fever, severe headache, vomiting, nausea, photophobia (avoidance of bright light owing to pain) and/or stiffness of the neck. Infants often have fever and non-specific signs of illness
Pneumonia — fever, chills, cough, chest pain and rapid breathing
Acute otitis media — ear pain and fever
Sinusitis — low-grade fever, runny nose and cough

Pneumococcal Disease Complications

Pneumococcal pneumonia may lead to lung abscess and pericarditis (inflammation of the sac surrounding the heart).
Pneumococcal meningitis may cause significant learning disabilities, speech delays, paralysis and even death.
Recurrent otitis media can cause hearing impairment.

Pneumococcal Disease Diagnosis 

For non-invasive pneumococcal disease, such as pneumonia or otitis media, a physical examination and X-rays are required. Invasive pneumococcal disease is diagnosed by isolating the bacteria from the blood, spinal fluid, lungs or other body fluids.

Pneumococcal Disease Treatment 

Prompt treatment with antibiotics, such as penicillin, is usually effective. However, in recent years, treatment has become more challenging with the emergence of strains resistant to antibiotics, particularly penicillin. In this case, a longer hospital stay, together with expensive alternative therapy, may be needed.

Pneumococcal Disease Vaccines

Vaccination is generally the safe, effective way to protect against pneumococcal disease. The two types of pneumococcal disease vaccines currently available are: 

Pneumococcal Polysaccharide Vaccine (PPSV23)

This protects against 23 pneumococcal serotypes. A single dose is recommended for: 
People aged 65 years and above
People aged two to 64 years with diabetes or chronic diseases of the heart, lungs, liver, and kidneys, as well as immunocompromised patients

Pneumococcal Conjugate Vaccine (PCV)

All infants should be given two doses of PCV13 (at ages three and five months), with a booster at 12 months. Children who fall behind should be given catch-up vaccination through to 59 months of age.

Refer to this table for the National Childhood Immunisation Schedule or ask your child’s doctor for more details. The vaccine may cause mild fever and some soreness around the site of injection, which usually lasts only a short time. 

Use of MediSave for Pneumococcal Disease Vaccinations

MediSave of up to $400 per year per account can be used to pay for pneumococcal disease vaccinations in children. MediSave can also be used to pay for pneumococcal vaccination with PPSV23 for those in a high-risk group as indicated above.

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