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Pneumococcal Disease

 


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Class
Bacterial Infection
Description
Pneumococcal disease is the term used to describe a variety of conditions caused by the bacterium Streptococcus pneumoniae or the pneumococcus. Older people over 75 and very young children under 5 are most at risk. The pneumococcus is responsible for disabling and potentially life-threatening diseases, such as meningitis, septicaemia (blood poisoning), and invasive pneumonia which together are known as Invasive Pneumococcal Disease (IPD). It is also the leading cause of common, non-invasive childhood illnesses such as otitis media, sinusitis and common chest infections.
Symptoms
There are three major serious, invasive conditions caused by pneumococcal infection: meningitis, invasive pneumonia and septicaemia (blood poisoning). They are all caused by infection with the same bacteria but have different symptoms. It is important to note that not everyone will develop the symptoms below and that they can appear in any order. A number of less serious conditions are also caused by pneumococcal infections.
Pneumococcal meningitis : (infection of the covering of the brain or spinal cord) in babies and young children can cause fever, vomiting, refusal to feed, a high-pitched or moaning cry and irritability. Babies may also develop a tense or bulging fontanelle (the soft spot on the top of the baby's head), blotchy or pale skin, rapid breathing, a floppy body or stiffness with jerky movements. Older children and adults may experience a severe headache, stiff neck and aversion to bright lights as well as fever and vomiting. Approximately one in five children who contract pneumococcal meningitis will die and 50% of survivors will be left with permanent disabilities including deafness, blindness or cerebral palsy. For more information see the Meningitis condition page in the A-Z and the Meningitis Research Foundation (www.meningitis.org).

Invasive pneumonia : (infection of the lungs) starts suddenly with shivering fits, fever, pains in the chest and coughing. The cough is dry at first, but within days the person starts to cough up phlegm. The phlegm is usually yellow or bloodstained. Breathing is typically fast and shallow. The infected person may gasp for air and may even go bluish around the lips and nails due to the lack of air. It hurts to breathe in deeply or cough. Approximately 1 in 200 children in the UK are admitted to hospital before the age of five as a result of pneumococcal pneumonia

Pneumococcal septicaemia : (blood poisoning): usually begins with fever and chills. Excessive sweating may occur. The heart rate and respiratory rate rise in association with high fever. The affected individual will feel very ill with profound feelings of weakness. As the condition evolves the person may begin to feel very cold and clammy. The skin becomes very pale and the person may exhibit tiny spots on the skin, which do not blanch when a glass tumbler is applied to the skin.

The pneumococcus also causes a number of less serious, non-invasive conditions which still burden the NHS and families affected. These include otitis media (infection of the middle ear), sinusitis (infection of the sinuses) and common chest infections. By the age of 3, most children will have suffered at least one incidence of otits media and half of them will get another infection by the time they are 5. The pneumococcus causes the more frequent and severe cases of otitis media.

The bacterium, Streptococcus pneumoniae or the pneumococcus is the source of these diseases. The pneumococcus is an encapsulated, gram positive bacterium of which 90 strains have been identified, however, a limited number are responsible for causing the majority of the disease and only 8-10 are responsible for approximately 80% of the disease in the UK in children under 5.
Treatment
The most effective form of treatment is prevention. Many of the early stage symptoms of the conditions caused by IPD are easily mistaken for less serious conditions such as flu. The longer these diseases remain undiagnosed, the more life threatening they become. Childhood vaccination, now available in the UK, is very effective against pneumococcal disease. (See Childhood Vaccines.) An effective vaccination programme is the only sensible solution to a problem which has not improved in years despite new antibiotics and advances in treatment. In addition to children, the elderly are at a greater risk of contracting the infection. In the case of non vaccinated children or the elderly, treatment options for infections are through the use of various antibiotics. Unfortunately, rising levels of resistance by bacteria to antibiotics mean that they are sometimes not effective as they once were. If you are 65 and over you should be routinely offered pneumococcal polysaccharide vaccine to protect against pneumococcal disease on the NHS.
Did You Know?
The greatest incidence of the disease is in young children or the elderly.

It is estimated that 50 children under the age of five die each year from serious pneumococcal disease.

In adults, the increased risk of pneumococcal disease begins in those aged over 45 and rises sharply in those over 75, particularly if they are already ill, have no spleen or have a weakened immune system; for example, if they are having treatment for cancer.

It is thought that there are more than 18,000 hospitalised cases of pneumococcal pneumonia each year in the UK in people aged 65 and over.
Sanofi Pasteur MSD
This material has been produced by MedicineChest with funding from Sanofi Pasteur MSD. Sanofi Pasteur MSD has reviewed this article for accuracy. Editorial control remains with MedicineChest.


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