STREPTOCOCCUS PNEUMONIAE, INVASIVE DISEASE (ISP, Pneumococcal Infection)
What is pneumococcal disease?
Pneumococcal disease is a term given to a group of infections that are caused by the bacteria Streptococcus pneumoniae, also known as pneumococcus. The most common types of pneumococcal infections include middle ear infections, sinus infections, lung infections (pneumonia), blood stream infections (bacteremia), and meningitis. Some of these infections are considered to be “invasive”. Invasive disease means that germs invade parts of the body that are normally free from germs. For example, pneumococcal bacteria can invade the bloodstream, causing bacteremia, and/or tissues and fluids surrounding the brain and spinal cord, causing meningitis. When this happens, disease is usually very severe, causing hospitalization or even death.
What are the symptoms?
The signs and symptoms of pneumococcal disease can vary widely depending on the part of the body that is infected. Stiff neck, fever, headache, photophobia (eyes being more sensitive to light), and/or confusion are common signs and symptoms of pneumococcal meningitis. People with pneumococcal bacteremia often develop fever, chills, and/or low alertness.
How soon do the symptoms appear?
The time that symptoms may appear varies by type of infection and can be as short as 1-3 days.
Which children are most likely to get pneumococcal disease?
Young children are much more likely than older children and young adults to get pneumococcal disease. Children under 2 years of age, children in group child care, and children who have certain illnesses (for example, sickle cell disease, HIV infection, chronic heart or lung conditions) are at higher risk than other children to get pneumococcal disease. In addition, pneumococcal disease is more common among children of certain racial or ethnic groups, such as Alaska Natives, American Indians living in certain communities, and African-Americans, than among other groups.
How common is pneumococcal disease?
Each year in the United States, pneumococcus causes more than 4,800 cases of blood stream infections (bacteremia), meningitis, or other invasive disease in children younger than 5 years of age. Children under 2 years of age average more than 1 middle ear infection each year, many of which are caused by pneumococcus. Pneumococcus is the most common cause of bacteremia, pneumonia, meningitis, and otitis media (middle ear infections) in young children.
How serious is pneumococcal disease?
Invasive pneumococcal disease may be a very serious illness in young children. Meningitis is the most severe type of pneumococcal disease. Of children younger than 5 years of age with pneumococcal meningitis, about 5% will die of their infection and others may have long-term problems such as blindness or hearing loss. Many children with pneumococcal pneumonia or blood stream infections will be ill enough to be hospitalized. About 1% of children with blood stream infections or pneumonia with a blood stream infection will die of their illness. Sinus infections and ear infections are usually mild and are much more common than serious forms of pneumococcal disease. Some children, however, develop recurrent ear infections and may need tympanostomy tubes (ear tubes).
How is pneumococcal disease spread?
The bacteria that cause pneumococcal disease are spread through contact with persons who are ill or healthy persons who carry the bacteria in the back of the nose. Transmission is mostly through the spread of respiratory droplets from the nose or mouth of a person with a pneumococcal infection. It is common for people, especially children, to carry the bacteria in their throats without being ill from it.
What is the treatment for pneumococcal disease?
Antibiotics are used to treat pneumococcal disease.
Who needs to be vaccinated with pneumococcal vaccines?
The pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) protects against 13 types of pneumococci (the bacteria that cause pneumococcal disease). It is recommended for use in infants and young children. The vaccine should be given to all infants at 2, 4, and 6 months of age, followed by a booster dose at 12 through 15 months of age. Previously unvaccinated, healthy children 24 months through 4 years of age only need to receive one dose of this vaccine. Additional doses of PCV13 may be recommended, depending on the child’s age and health status. For more information, please consult the CDC’s Advisory Committee on Immunization Practice’s recommendations or your child’s healthcare provider.
The pneumococcal polysaccharide vaccine (PPSV), Pneumovax®, is a 23-valent polysaccharide vaccine that is currently recommended for use in all adults who are 65 years and older and for persons who are 2 years and older and at high risk for disease such as persons with sickle cell disease, HIV infection, or other immunocompromising conditions. It is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma and adults living in nursing homes or long-term care facilities.
Should people who have been in contact with a person with a diagnosed case of meningococcal disease be treated?
No prophylactic treatment is recommended for contacts of cases of invasive pneumococcal infections. Individuals who may have come into contact with respiratory sections of infected individuals should seek early medical care if they develop cough, chills, fever and other nonspecific symptoms within a few days after contact with a case. Quarantine of contacts is not warranted.
Is there a vaccine to prevent pneumococcal disease?
Yes, there are different vaccinations that can help prevent many types of the pneumococcal bacteria. The pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) protects against 13 types of pneumococci (the bacteria that cause pneumococcal disease). It is recommended for use in infants and young children. The vaccine should be given to all infants at 2, 4, and 6 months of age, followed by a booster dose at 12 through 15 months of age. Previously unvaccinated, healthy children 24 months through 4 years of age only need to receive one dose of this vaccine. Additional doses of PCV13 may be recommended, depending on the child’s age and health status. For more information, please consult the CDC’s Advisory Committee on Immunization Practice’s recommendations or your child’s healthcare provider.
The pneumococcal polysaccharide vaccine (PPSV), Pneumovax®, is a 23-valent polysaccharide vaccine that is currently recommended for use in all adults who are 65 years and older and for persons who are 2 years and older and at high risk for disease such as persons with sickle cell disease, HIV infection, or other immunocompromising conditions. It is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma and adults living in nursing homes or long-term care facilities.
***Contact your health care provider or local health department if you have additional questions about Pneumococcal Disease or vaccine availability***
Cuyahoga County Board of Health 216 201-2000
This fact sheet was adapted from the Ohio Department of Health’s Infectional Control Disease Manual (ICDM accessed at: http://www.odh.ohio.gov/pdf/IDCM/strppneu.pdf) and information from the Centers for Disease Control and Prevention (accessed at: https://www.cdc.gov/pneumococcal/index.html).