What is pneumococcal diseases?
Pneumococcal disease is a bacterial disease caused by Pneumococcus (Streptococcus pneumoniae) that can cause serious infections in children and adults:2
- Meningitis (infection in the brain)
- Bacteremia (infection in blood)
- Pneumonia (lung infection)
- Otitis media (infection inside ear cavity)
The World Health Organization (WHO) says that pneumococcal disease is the world’s number 1 vaccine-preventable cause of death among infants and children younger than 5 years of age.
Pneumococci colonize the upper respiratory tract and then can spread to multiple sites throughout the body causing two types of pneumococcal diseases.2,9
- Non-invasive pneumococcal diseases, including:
- Bacterial pneumonia
- Acute otitis media
- Acute sinusitis.
- Invasive pneumococcal diseases are caused when pneumococci invade the blood stream. They include:
- Bacteremia and sepsis
- Meningitis
Out of these, four types of infections can have serious consequences; they include Meningitis (infection in the brain), bacteremia/sepsis (infection in blood), Pneumonia (lung infection) and Otitis media (infection inside ear cavity).8 The diseases can cause serious symptoms like brain damage, lifelong disability or death.10
Bacteria- different strains:
Streptococcus pneumoniae are a group of bacteria with over 90 known strains (serotypes). Most S. pneumoniae serotypes have been shown to cause disease, but only a minority of serotypes produce the majority of pneumococcal infections.8
Pneumococci are common inhabitants of the respiratory tract and may be isolated from the nasopharynx of 5-70% of adults, depending on the population and setting. Only 5-10% of adults without children are carriers. In schools and orphanages, 25-50% of students and residents may be carriers. On military installations, as many as 50-60% of service personnel may be carriers. The duration of carriage varies and is generally longer in children than adults. In addition, the relationship of carriage to the development of natural immunity is poorly understood.8
How can the disease spread?
- Pneumococcal infections are easily spread when people are in close contact, especially through sneezing, coughing and kissing children.11
- Many healthy people may carry the bacteria in their nose and throat even when they are not sick themselves. They may then spread the disease to children, putting them at risk of developing serious infections.11
- Children could also get infected by putting their hands in their mouths, after coming into contact with the bacteria.11
- The disease can also be spread when children touch an infected object such as a cup, toothbrush, toy or book.11
Serious complications:
- Pneumococcal disease can be serious, especially for infants and young children.8
- Infections caused by pneumococcal disease can be fatal, and can cause lifelong damage to the brain, the ears and to major organs, despite being treated with antibiotics.10
- Pneumonia causes nearly 1 in 5 deaths among children under the age of five worldwide – more than 2 million children die each year.12
- Pneumococcal meningitis is fatal in about 1 out of 10 children younger than 5 years and others may have long-term problems such as hearing loss or developmental delay.13
- About 1 out of 100 children with bacteremia dies of the disease.13
Prevalence- Worldwide and KSA:
In 2008, the overall incidence of invasive pneumococcal disease in the United States was 14.5 cases per 100,000 population. Surveillance data suggests that the use of pneumococcal conjugate vaccine has had a major impact on the incidence of invasive disease among young children. The overall incidence of invasive disease among children younger than 5 years of age decreased from approximately 99 cases per 100,000 population during 1998-1999 to 21 cases per 100,000 population in 2008. The reductions in incidence resulted from a 99% decrease in disease.8
The Arabian Peninsula, including KSA, is a region with a considerable burden of IPD. A study conducted in the period 1999–2003 to calculate IPD morbidity and mortality among the population of children aged ≤5 years in Central and Western regions of KSA, estimated an annual incidence of IPD ranged from 24.4 to 53.5 per 100,000.2