BROWARD COUNTY HEALTH DEPARTMENT

 

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The Facts on Pneumococcal Disease

 

Text Box: Penicillin used to be the first line of defense against pneumococcal disease. Overuse of antibiotics has induced many drug-resistant strains of S. pneumoniae. More than half of all pneumococcal infections in the United States are resistant to penicillin and other drugs. What is pneumococcal disease?  Pneumococcal disease is cause by Streptococcus pneumoniae, a bacterial pathogen that affects infants, children, and adults.  The bacteria cause sinus and middle ear infections, meningitis, pneumonia, and invasive infections of the blood.  S. pneumoniae is the most common cause of bacterial meningitis in infants and children in the United States.  There are 83 different types of these bacteria, but 23 types account for 90% of pneumococcal infections.  Strains of drug-resistant S. pneumoniae have emerged in recent years, making treatment much more difficult.  Pneumococcal disease causes more than 40,000 annual deaths.  Together with influenza infection, it is the 6th leading cause of death in the United States.                   

 

Who gets pneumococcal disease?  All children and adults are susceptible, but children younger than 2 years of age and adults 65 years of age or older are at increased risk.  Persons with sickle cell disease and those whose spleen has been removed surgically are a highest risk because they have difficulty removing S. pneumoniae from the bloodstream.  Each year in the United States, pneumococcal disease is responsible for an estimated 7 million cases of middle ear infection; 500,000 cases of pneumonia; 50,000 cases of life-threatening blood-borne infection; 3,000 cases of meningitis.

 

How is the disease spread?  By droplet spread (sneezing), by direct oral contact, or indirectly via articles soiled with discharges from the nose or mouth of infected persons.  Person-to- person spread commonly occurs, but illness among casual contacts is frequent.  Persons with susceptible strains of S. pneumoniae become noninfectious within 24-48 hours after penicillin treatment begins.

 

What are the symptoms of pneumococcal disease?  Fever, vomiting, and seizures may be the first symptoms in infants and young children.  Fever, ear pain, or sinus congestion occur in older children and adults.  Shaking chills, fever, chest pain, productive cough, and rapid or labored breathing may suddenly appear.

 

When do symptoms appear?  Usually within 1 to 3 days after exposure.

 

How is pneumococcal disease diagnosed?  Cultures from blood, spinal fluid, or pus confirm the diagnosis.

 

What is the treatment?  Cases of blood-borne infection or bacterial meningitis possibly or proven to be caused by S. pneumoniae should receive combination therapy with vancomycin and cefotaxime or ceftriaxone.  Middle ear infections and sinusitis usually are treated with oral amoxicillin.

 

How can pneumococcal disease be prevented?  Pneumococcal vaccine protects against 23 strains of S. pneumoniae that cause 90% of the illness.  Anyone aged 65 years or older should receive the vaccine.  Anyone whose spleen has been removed surgically also should receive the vaccine.  Persons aged 2-64 years with immune deficiency, heart, lung, or liver disease, diabetes mellitus, alcoholism, spinal fluid leaks, or sickle cell disease should receive the vaccine.  It is not effective in children younger than 2 years of age.

 

 

For further information, contact the Broward County Health Department at 954/467-4865.

 

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