Streptococcus pneumoniae

 

Pneumococcal disease is the collective term for the group of clinical conditions caused by the bacterium Streptococcus pneumoniae.(1)

Transmission

  • Transmission occurs via airborne droplets.
  • Also spread through oral and direct person to person contact.
  • Bacteria can be spread by asymptomatic carriers.(1)

Epidemiology

  • Pneumococcal infections are a worldwide health problem.
  • There are many healthy, asymptomatic carriers of the bacteria.(1)
  • In developing countries pneumococcal pneumonia is estimated to cause approx. 1 million deaths every year in children under 5 years.(2)
  • In industrialised countries, most pneumococcal disease occurs in the elderly.(1)

Clinical Aspects

  • Incubation – short 1-3 days.

Risk of severe illness

Pneumococcal disease is a major cause of morbidity and mortality in high risk groups:

  • elderly
  • very young
  • impaired immunity
  • asplenic or non functioning spleen.

Signs Symptoms

Depends on organ system affected.

Organism may spread locally:

  • otitis media, sinusitis, bronchitis.
  • May affect the lungs:
    • pneumonia.
  • Cause systemic infections:
    • bacteraemia, meningitis.(3)

Diagnosis

  • Culture of Streptococcus pneumoniae from infected sites.

Treatment

  • Treated with antibiotics – primarily penicillin, cephalosporins and macrolides.
  • Antibiotic resistance is a serious and rapidly increasing problem worldwide.(2)

Advice to travellers

  • Travel itself does not increase the risk of acquiring pneumococcal infection, however optimal health care facilities may be limited during travel should disease occur.
  • Increasing resistance to antibiotics underlines the importance of vaccination.

When to consider vaccination

  • Vaccination should be considered for travellers within the UK risk groups or with chronic underlying disease, who have not previously received vaccination.(1)

Vaccination

Information also about pneumococcal disease and vaccination available in DH Green Book. This book is produced by the JCVI (Joint Committee for Vaccines and Immunisations). Their guidance may vary slightly from that of the manufacturers but should be followed by UK practitioners.(3)

Available vaccines for protection against pneumococcal disease