Pneumococcal disease refers to any infection caused by the bacterium Streptococcus pneumoniae, also known as pneumococcus. This bacterium lives in the nose and throat and can cause a range of infections, from mild illnesses like ear and sinus infections to serious conditions such as pneumonia and meningitis. Anyone can contract pneumococcal disease, but young children, the elderly, and people with compromised immunity are at higher risk.
There are around 90 different types of pneumococcus, although it is thought that only between eight and 10 of these are responsible for most cases of severe disease. The introduction of pneumococcal conjugate vaccines has greatly reduced the number of cases and deaths, but there are still millions of children who remain unvaccinated and vaccines do not protect against all strains.
The symptoms of pneumococcal disease vary depending on the part of the body that is infected.
Common symptoms include:
Other more serious symptoms include
Pneumococcal infections can lead to severe complications. In low and middle-income countries, fatality rates for children with severe infections like bacteraemia or meningitis can range from 20 to 50 per cent.
Individuals with sickle cell disease, certain immune deficiencies, or chronic renal disease, and those taking immunosuppressive drugs are at an increased risk for pneumococcal infection. Smoking also increases the risk of the disease.
Pneumococcal bacteria are transmitted through direct contact with respiratory secretions, such as saliva or mucus, from infected individuals. This can occur when an infected person coughs or sneezes, spreading droplets containing the bacteria. The risk of infection can vary by season, with higher rates during winter when people are more likely to be in close contact.
Pneumococcal disease is treated with antibiotics. However, some strains of pneumococcus have developed resistance to certain antibiotics and testing is used to determine the most effective treatment.
Vaccination is the most effective way to prevent pneumococcal disease. In the UK babies get their first dose at 16 weeks and a booster at a year old. Older adults also get a dose at the age of 65. Children and adults at a higher risk of the disease may also get an additional dose.
Simple infection control methods, such as covering your mouth and nose when you cough and sneeze and washing your hands regularly, particularly before preparing food, can also help prevent the spread of the disease.
Streptococcus pneumoniae has been causing disease and death for thousands of years but it was first isolated in France by Louis Pasteur in 1880 from the saliva of a patient with rabies. Researchers began developing a vaccine in South Africa in the 1920s but the first vaccine was not licenced until 1977. More advanced pneumococcal conjugate vaccines (PCV) were then developed and rolled out in the 2000s. They have since been expanded to protect against more strains of the disease.
A study in the Lancet estimated that in the 11 years after PCV was introduced into the UK schedule in 2006 it prevented around 40,000 cases of invasive pneumococcal disease, and about 2,000 deaths.
nhsinform.scot/pneumococcal-infections
vaccineknowledge.ox.ac.uk/pneumococcal-disease
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