Pneumococcal Disease

pneumococcal disease

Pneumococcal disease is caused by a bacterium known as Streptococcus pneumoniae, also called pneumococcus. Pneumococcus can cause a variety of infections, ranging from ear and sinus infections to bloodstream infections and pneumonia. Pneumonia is an infection of the lungs. The pneumococcus is one of the most common causes of severe pneumonia.

Pneumococcal pneumonia is the most common type of pneumococcal disease in adults. It occurs in about 175,000 Americans each year. An estimate from 2011 states that pneumococcal disease was responsible for 4 million illnesses, 445,000 hospitalizations, and 22,000 deaths each year. 

When the bacteria invade parts of the body that are normally free from germs, the illness is usually very severe, requiring hospitalization.

Symptoms

The most common serious form of pneumococcal disease is pneumococcal pneumonia. Symptoms of pneumococcal pneumonia include:

  • Fevers and chills
  • Coughing
  • Rapid breathing or difficulty breathing
  • Chest pain

Meningitis is the most severe type of invasive pneumococcal disease. Of children younger than 5 years old who get pneumococcal meningitis, about one out of 15 dies of the infection and others may have long-term problems, such as hearing loss or developmental delay. Signs of meningitis include:

  • fever
  • headache
  • stiff neck or neck pain,
  • difficulty with vision
  • change in mental status e.g., irritability, confusion

There are other types of pneumococcal disease including bacteremia, sepsis, and ear infections.

Information about these infections and complications that can arise from these conditions

Laboratory Testing

Pneumococcal infection is usually diagnosed by bacterial culture of the site of infection, e.g., blood culture or cerebral spinal fluid culture.

Transmission

Pneumococcal bacteria can be spread person to person through airborne droplets created when an infected person talks, coughs, or sneezes. Pneumococcal bacteria can be spread to hands after touching anything that has pneumococcal bacteria on it and then touching eyes, nose, or mouth.While anyone can get sick with pneumococcal disease, some people are at a greater risk for severe infection than others.

More information on who is at risk for pneumococcal disease

Vaccination

The best way to prevent pneumococcal disease is by getting vaccinated. Pneumococcal vaccines help protect against some of the 92 types of pneumococcal bacteria. There are two types of pneumococcal vaccines.

The 13-valent pneumococcal conjugate vaccine (PCV13) targets the 13 types associated with 61% of invasive disease in children younger than five years. It is also now given as a single dose to adults over 65 years.

The pneumococcal polysaccharide vaccine (PPV23) targets 23 of the most common serotypes of S. pneumoniae that account for 60-76% of the types that are associated with invasive disease. It is administered to persons ≥ 2 years of age who have any of several underlying medical conditions and also children age 2 to18 years with underlying medical conditions. PPV23 is given to everyone 65 years of age and older.

Pneumococcal Conjugate Vaccine (PCV13)

Pneumococcal Polysaccharide Vaccine (PPSV23)
Protects against 13 types of pneumococcal bacteria Protects against 23 types of pneumococcal bacteria.

One-time dose for adults age 19 years or older who have:

  • Cerebro-spinal fluid leaks
  •  Cochlear implants
  • Sickle cell disease or other red blood cell disorders
  • Had their spleen removed or were born without a spleen
  • Medical conditions that weaken the immune system such as HIV infection, chronic kidney disease, leukemia, lymphoma, Hodgkin’s disease, multiple myeloma, or some cancers
  • Had an organ transplant or are taking chemotherapy, long-term steroids, or radiation therapy.

Recommended for all adults age 65 years or older. Also recommended for adults age 19 through 64 years who have:

  • Chronic heart, kidney, lung, or liver disease, or who smoke cigarettes, or abuse alcohol
  • Diabetes
  • Cerebro-spinal fluid leaks
  • Cochlear implants
  • Sickle cell disease or other red blood cell disorders
  • Had their spleen removed or were born without a spleen
  • Medical conditions that weaken the immune system such as HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, or some cancers
  • Had an organ transplant or are taking chemotherapy, long-term steroids, or radiation therapy.
People who receive a PCV13 vaccination also need one or more PPSV23 vaccinations, but others are recommended the PPSV23 vaccine only. Not a yearly vaccination, but depending on age and medical conditions, some people may need 2 or 3 PPSV23 vaccinations in their lifetime.

More information on the pneumococcal vaccination

Additional information on the pneumococcal vaccination can be found from the Immunization Action Coalition

Treatment

Early diagnosis and treatment are very important for invasive pneumococcal infections. Antibiotics are used to treat invasive pneumococcal disease.

More information on the diagnosis and treatment of pneumococcal disease

Prevention

To prevent pneumococcal infection, care should be taken to observe the following:

  • Get immunized as appropriate. See that your children receive their full immunization series on time.
  • Take antibiotics only as direct by a health care provider; take the full course unless directed otherwise.
  • Get a flu vaccine every year because having the flu increases your chances of getting pneumococcal disease.
  • Cover your cough. Cover your mouth and nose with a tissue when you cough or sneeze.
  • Put your used tissue in the waste basket.
  • Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Use an alcohol-based hand rub if soap and water are not available.
  • Avoid close contact with people who are coughing.
  • Practice good hand hygiene.
  • Prophylactic (preventative) antibiotics are NOT recommended for contacts of patients with pneumococcal infection.