Understanding Pneumococcal Disease and Vaccines

Pneumococcal disease is an infection caused by the bacteria Streptococcus pneumoniae. There are over 100 different types, or strains, of Streptococcus pneumoniae (S. pneumoniae).

Although pneumococcal infection can be mild, it can also cause serious and even deadly diseases. Serious infections in the blood, lungs, and the lining of the brain and spinal cord can result in hospitalization, lifelong disability, and even death.

What Are the Symptoms of Pneumococcal Disease?

Pneumococcal disease can include many different types of infections. Symptoms depend on the part of the body that is infected.

Mild infections:

• Sinusitis (a sinus infection): Stuffy or runny nose, headache, loss of sense of smell, and facial pain or pressure
• Otitis media (middle ear infection): Ear pain, a red, swollen eardrum, fever, and sleepiness

Serious infections:

• Pneumonia (a lung infection): Fever, chills, cough, rapid breathing or difficulty breathing, and chest pain
• Bacteremia (blood infection): Fever, chills, and low alertness
• Meningitis (infection of the lining of the brain and spinal cord): Stiff neck, fever, headache, sensitivity to light, confusion, and low appetite, poor drinking, or vomiting in babies

Who Is Most at Risk for Pneumococcal Disease?

Pneumococcal disease is a major public health problem worldwide. Age, medical conditions, and other factors can increase someone’s risk for pneumococcal disease and severe infections.

People at increased risk for pneumococcal disease include:

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• Children younger than 5 years of age
• Adults 65 years or older
• People with a weakened immune system (like sickle cell disease)

Some children are at higher risk than others. Experts do not know why, but children of certain racial and ethnic groups also have increased rates of pneumococcal disease, including:

• African American
• Alaska Native
• American Indian

Also, young children attending childcare are at increased risk for serious pneumococcal infection.

How Does Pneumococcal Disease Spread?

Pneumococcal disease is contagious. People spread S. penumoniae bacteria to someone else through droplets of saliva and/or mucus when they:

• Cough
• Sneeze
• Touch each other, share objects, or kiss

Many healthy people, especially children, have the bacteria in their nose or throat at one time or another without being ill. This is called carriage. Illness develops when the bacteria spread and cause infection in the body.

How Is Pneumococcal Disease Diagnosed?

The diagnosis is made by finding S. penumoniae in the blood, infected fluid, or phlegm. Isolating and growing the bacteria in a laboratory helps identify the specific type of bacteria causing the infection. Knowing the cause helps doctors choose the right treatment.

If doctors suspect serious pneumococcal disease, like meningitis or bacteremia, they will collect samples or cerebrospinal fluid (the fluid that surrounds the brain and spinal cord) or blood.

How is Pneumococcal Disease Treated?

Antibiotics are used to treat pneumococcal disease. Treatment may start with a broad-spectrum antibiotic, which works against a wide range of bacteria. After testing, and once more information is known about the specific strain of bacteria, a more targeted antibiotic may be selected.

For mild infections, your doctor may recommend fluids, pain relievers, and rest.

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What Complications Can Pneumococcal Disease Cause?

Even with antibiotic treatment, pneumococcal disease can be deadly. About 1 in 12 children who get pneumococcal meningitis die of the infection. Pneumococcal kills about 1 in 20 who get the disease.

Those who survive may have long-term problems, such as:

• Inflammation of the outer lining of the heart
• Respiratory failure
• Loss of limbs
• Brain damage
• Organ failure
• Infection around the lungs and in the chest cavity
• Septic shock

Vaccination is the best way to prevent pneumococcal disease. It gives your immune system a head start against a potentially deadly infection.

What Types of Pneumococcal Vaccines Are Available?

There are two main types of pneumococcal vaccines. Both are made from polysaccharides (sugars) surrounding the bacteria.

• Polysaccharide vaccine (PPSV)
• Pneumococcal conjugate vaccines (PCVs)

PPSV was the first type of vaccine created and contains polysaccharides as its antigen (substance that induces an immune response in the body). It activates only part of the immune system, which means that protection is short-lived. PPSV vaccines don’t work in children younger than 2 years of age.

PCVs, or conjugate vaccines, contain polysaccharides and a carrier protein. This helps to activate more of the immune system for longer-lasting, more robust protection. PCVs do provide protection to children younger than 2 years of age.

While currently available vaccines are effective, scientists are constantly looking for ways to update and improve them. The types of pneumococcal bacteria known to cause serious disease are increasing. Scientists are working to develop a vaccine that can provide a wider range of long-lasting protection against the most serious pneumococcal diseases.