Pneumococcal Disease: Causes, Symptoms, Transmission, Treatment, and Prevention

Pneumococcal disease is caused by a bacterium Streptococcus pneumoniae that can attack different parts of the body. When these bacteria invade the lungs, they can cause pneumonia; when they invade the bloodstream, they can cause sepsis; and when they invade the lining of the brain, they can cause meningitis. These serious conditions often require hospitalization and can lead to death.

Anyone can contract pneumococcal disease, but some groups are at increased risk, including:

• Children under 2 years of age
• Adults over 65 years of age
• Children and adults with certain medical conditions, including chronic heart disease, lung disease, kidney or liver disease, diabetes, or conditions that weaken the immune system, such as HIV and certain types of cancer

Transmission

Pneumococcal disease spreads from person to person through contact with fluids such as saliva or mucus from an infected person. Many people, especially children, can carry this bacterium in their nose or throat without showing symptoms, but they can transmit the disease to others during this time.

Symptoms

People with pneumococcal disease may experience a combination of high fever, chills, cough, shortness of breath, chest pain, stiff neck, disorientation, and light sensitivity. Specific symptoms of pneumococcal infection depend on the part of the body affected (lungs, brain or spinal cord, or blood). Often, people can have multiple types of pneumococcal infections at the same time.

Pneumococcal bacteria cause infections such as:

• Otitis (ear infection): symptoms include ear pain, a swollen eardrum, fever, and drowsiness
• Sinusitis (sinus infection): symptoms include nasal congestion and headache
• Pneumonia (lung infection): symptoms include cough with secretions (thick mucus) and difficulty breathing

In rarer cases, when the bacteria invade other parts of the body, severe infections can occur, such as:

• Meningitis (infection of the lining of the brain and spinal cord): symptoms include stiff neck, fever and headache, light sensitivity, or confusion
• Sepsis (bloodstream infection): symptoms include fever, chills, and decreased alertness
• Pneumonia with sepsis: symptoms include fever, chills, cough, rapid breathing or difficulty breathing, and chest pain

Diagnosis

To diagnose pneumococcal disease, a doctor will analyze symptoms and perform a physical exam.

Depending on the severity of symptoms and the area of the body affected, the doctor may recommend other tests such as:

• chest X-ray – indicates the presence of pneumonia, fluid in the pleural cavity, or pockets of pus called empyema.
• laboratory tests: testing cerebrospinal fluid via lumbar puncture can detect meningitis. The doctor may also want to test the person's sputum, plus fluid from the lungs, joints, bones, around the heart, or fluid from an abscess.

Treatment

Antibiotics can be used to treat pneumococcal disease. However, in nearly a third of cases, pneumococcal bacteria can be resistant to treatment with one or more antibiotics.

Treatment may begin with a broad-spectrum antibiotic, which acts against a wide range of bacteria.

Prevention

Vaccination is the best way to protect yourself against pneumococcal disease. Pneumococcal vaccination is recommended for:

• children under 2 years of age
• adults over 65 years of age
• children, adolescents, and adults aged 19 to 64 with certain medical conditions or other risk factors

The vaccine stimulates the body to produce antibodies against the pneumococcal bacterium (pneumococcal germ). Two types of pneumococcal vaccines are authorized:

• Pneumococcal conjugate vaccine – administered to babies in three doses starting at 2 months of age and is part of the mandatory vaccination schedule proposed by the Ministry of Health. The vaccine is effective against 13 types of pneumococcal bacteria, which are considered the most dangerous. It is also recommended for adults over 19 who have certain medical conditions and for all people over 65.
• Pneumococcal polysaccharide vaccine – protects against 23 strains of pneumococcal bacteria, but it is recommended for children starting at 2 years of age, as well as for all adults, especially those over 65.

Vaccination is not indicated if you have had a severe allergic reaction (anaphylactic reaction) to a previous dose of the vaccine or to any of its components. If you are unwell and have a fever, vaccination should be postponed until you have recovered.

The pneumococcal vaccine can sometimes cause mild side effects: redness or swelling at the injection site, headache, fatigue, or muscle pain. Severe allergic reactions are rare.

Yes, the pneumococcal vaccine can be administered at the same time as the flu vaccine.

References
https://www.nfid.org/infectious-diseases/pneumococcal/
https://www.medicalnewstoday.com/articles/323463#treatment
https://www.catena.ro/totul-despre-infectia-cu-pneumococ-streptococcus-pneumoniae
https://www.hse.ie/eng/health/immunisation/pubinfo/adult/pneumo/ppvrom.pdf
https://www.health.ny.gov/diseases/communicable/pneumococcal/fact_sheet.htm
https://www.health.gov.on.ca/en/pro/programs/immunization/docs/hcp_fact_sheets_pneumococcal_disease.pdf