Pneumococcal disease

Infectious Disease

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Pneumococcal bacteria, Streptococcus pneumoniae, can cause a range of problems from ear infections to pneumonia (serious chest infections), as well as other life-threatening conditions such as meningitis (inflammation of the brain) and septicaemia (blood poisoning).

There are over 100 different types of pneumococcal bacteria, but vaccines have been produced to protect against only some of these types, the ones that cause the most disease.

In the UK, around 40,000 people a year are hospitalised with pneumococcal pneumonia. Even with the use of antibiotics, pneumonia still causes death in up to 20% of cases. Worldwide, pneumonia is the leading cause of death in children.

According to the World Health Organization, pneumonia killed over 740,000 children in 2019, and accounts for 14% of all deaths of children under 5 years old. Pneumonia can be caused by a number of different bacteria, viruses and fungi. However, it is estimated that at least two thirds of all cases of bacterial pneumonia are caused by Streptococcus pneumoniae bacteria.

Certain types of pneumococcus bacteria can also infect normally sterile areas of the body such as the blood and the brain. This is called invasive pneumococcal disease, and causes life-threatening diseases including septicaemia (severe blood poisoning) and meningitis (inflammation of the outer covering of the brain and spinal cord). Around 15% of children with pneumococcal meningitis die, and 25% will have severe, lasting effects, including loss of hearing, loss of sight, learning and language disabilities, or seizures.

Invasive pneumococcal disease particularly affects very young babies, elderly people and those with weakened immune systems. People with cochlear implants, cerebrospinal fluid (CSF) leaks, skull defects or fractures of the skull can sometimes get repeated infections. Pneumococcal disease can also cause ear infections (otitis media) and sinusitis.

 

These are the most serious symptoms of pneumococcal disease:

Pneumonia:

  • makes the lungs become inflamed and fill with fluid, so they do not work properly and not enough oxygen can get into the bloodstream.
  • Typical symptoms in children under five include fever, cough, pain in the chest and fast or difficult breathing.
  • Other symptoms can include headaches, fatigue, feeling sick or vomiting, wheezing, joint and muscle pain, and feeling confused and disorientated (particularly in elderly people).
  • Symptoms can appear very suddenly, or take several days to develop.

Meningitis:

  • is the inflammation of the outer covering of the brain and spinal cord.
  • is very difficult to spot in the early stages.
  • Early symptoms are usually fever, vomiting, headache and feeling unwell, just like in many mild illnesses (but in babies under 3 months old there may be no sign of fever).
  • Other symptoms include high-pitched screaming in babies, being difficult to wake, and tense or bulging soft spot on head.
  • When meningitis is caused by pneumococcal bacteria, the reddish-purple non-blanching rash usually does not appear. (A non-blanching rash does not disappear when pressed with a glass, which many people think of as a classic sign of meningitis.)
  • The disease progresses very quickly, and can kill in a matter of hours.

Septicaemia:

  • is a serious form of blood poisoning
  • produces a rash in most cases, which is typically non-blanching (but not always, especially in the early stages)
  • may cause joint and limb pain
  • causes shock
  • can lead to skin scarring or limb amputations

See the Meningitis Research Foundation website for more detailed information on the signs and symptoms of meningitis.

 

It is spread by water droplets coughed into the air by an infected person. The number of cases peaks in winter each year, because people tend to be in closer contact with each other for longer periods, and this spreads the disease more easily. It is also possible that common viral infections in winter make people more susceptible.

Some types of pneumococcal bacteria can be carried in the back of the throat without causing any symptoms.

 

For babies born in the UK after 1st January 2020, the pneumococcal conjugate vaccine (PCV) is given at 12 weeks, followed by a booster at 12-13 months. The  PCV used in the UK gives protection against 13 types of pneumococcal bacteria that cause pneumococcal disease and is given to babies in the UK. The brand name of the PCV used in the UK is Prevenar 13 (see the patient information leaflet).

The pneumococcal polysaccharide vaccine (PPV) gives protection against 23 types of pneumococcal bacteria that cause pneumococcal disease and is given to adults in the UK aged 65 years and over, or those who are at a greater risk of complications from pneumococcal disease due to other health conditions.  The brand name for the PPV used in the UK is Pneumovax 23 (see the patient information leaflet). 

 

 In the short film below, Dr Andrew Prendergast talks about pneumococcal disease and why it is important to vaccinate against the disease.

What is Pneumococcal Disease and why do we need a vaccine?

https://www.youtube.com/embed/Vaj3rmDNQEU?wmode=opaque&controls=&rel=0

Pneumococcal meningitis - Sam's story

Sam Willis had pneumococcal meningitis when he was 9 months old, before the vaccine was available. In this film, made when Sam was 11 years old, his father talks about the lasting effects of the disease and the impact on the whole family.

The lasting effects of pneumococcal meningitis

 

 

Before the introduction of childhood pneumococcal vaccination, one child in every 200 in the UK was admitted to hospital for pneumococcal pneumonia during the first five years of life. Read how pneumococcal disease affected one family before the introduction of the vaccine.

In 2006 the PCV was introduced into the UK schedule. It is estimated that in the first 11 years of the pneumococcal vaccine programme (2006-07 to 2016-17), the vaccine prevented nearly 40,000 cases of invasive pneumococcal disease, and about 2,000 deaths. The first vaccine, introduced in the UK in 2006, covered 7 types of pneumococcal bacteria and disease caused by these 7 types is almost never seen in young children today. In 2010 this vaccine was replaced by one covering 13 types. Disease caused by these further 6 types of pneumococcal bacteria is now very uncommon in babies and young children.

However there are many other types of pneumococcal bacteria that can cause infections, and it remains a major cause of serious disease. Every year there are 5,000-6,000 cases of invasive pneumococcal disease (meningitis and septicaemia), and around 40,000 hospitalisations due to pneumococcal pneumonia in children and adults.

 

Page last updated Friday, October 4, 2024