Do you know about pneumococcal disease?

Pneumococcal disease is the name of any infection caused by bacteria called Streptococcus pneumoniae or also known as pneumococcus. Some of the infections caused by these bacteria are:

- Pneumonia (lung infection)

- Meningitis (infection of lining of brain)

- Otitis media (middle ear infection)

- Bacteraemia (infection in blood)

Pneumococcus is the leading cause of death from pneumonia globally

The World Health Organization (WHO) estimates that pneumococcus is responsible for over 300,000 mortalities in children under 5 years old worldwide annually. Children who have chronic diseases or have conditions or medications that weakens their immune system are at increased risk for developing pneumococcal disease.

Pneumococcus spreads through direct contact with respiratory secretions such as saliva or mucous.

The symptoms of the illness depend on the part of body infected by pneumococcus.

Pneumonia

Symptoms of pneumonia may include fever, cough, rapid breathing, and chest tightness. In some cases of pneumonia, complications may occur which include abnormal fluid collection around the lungs and chest cavity, and inflammation of the heart lining.

Meningitis

A child who develops meningitis may demonstrate fever, seizures, confusion, headache, or have a stiff neck. In young babies, they may have poor feeding and poor alertness. If left untreated, there is risk of death from the infection or long-term problems such as hearing loss or permanent developmental delay.

Otitis media

Middle ear infection presents with pain in the ear and fever. On inspecting the eardrums, they can be seen to be red and swollen. Ear infections are generally mild but the person may have repeated ear infections.

Bacteraemia

Infection in the bloodstream, or also known as bacteraemia or sepsis, is the body’s extreme response to an infection. The child may demonstrate fever, low blood pressure, high heart rate, confusion, difficulty breathing, and cold clammy skin. Sepsis may progress to damage the other organs such as the heart, brain, lungs, and kidneys.

Treatment will depend on the part of the body involved in the infection. The mainstay of treatment includes antibiotic therapy and supportive care, and keeping a close eye for any complications.

Uncomplicated pneumonia are typically treated as outpatient basis. However, some children with pneumonia develop breathing difficulties requiring hospital admission and oxygen therapy. A few progress into respiratory failure needing ICU care, with higher risk of mortality or long term complications. Thus it is important to recognise the early signs of worsening pneumonia and to seek medical attention before the condition deteriorates.

Meningitis and bacteraemia are less commonly seen compared to pneumonia and otitis media, but are serious conditions associated with high risk of permanent complications. These conditions usually require a prolonged course of antibiotics which may extend to several weeks.

Vaccination against pneumococcus is available and has been added into the national immunisation programme since 2020. Since its implementation, the acceptance rate for the vaccine has been encouraging, standing at 95% for the first dose of the vaccine. It is also reported that the incidence of pneumococcal disease has decreased since the vaccine was included in the immunisation programme.

In summary, pneumococcal disease is a potentially dangerous condition which may cause significant impact to the child depending on the manifestation. Antibiotics are key to the successful treatment of pneumococcal disease. Vaccination toward pneumococcus is essential to prevent the occurrence of pneumococcal disease in children.