Pneumococcal Disease : Part 2

by CDC

(Page 2 of 2)

How serious is pneumococcal disease?

Pneumococcal disease is a very serious illness in young children. Pneumococcal infections are now the most common cause of invasive bacterial infection in U. S. children. In the United States it is estimated that pneumococcal infections cause 200 deaths, 700 cases of meningitis, 17,000 cases of bacteremia, 4.9 million cases of otitis media (ear infections) annually in children under 5 years of age.

Meningitis is the most severe type of pneumococcal disease. Of children under 5 years with pneumococcal meningitis, about 5% will die of their infection and others may have long-term problems such as 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. Nearly all children with ear infections recover, although children with recurrent infections can suffer hearing loss.

How is pneumococcal disease spread?

The bacteria is spread through contact between persons who are ill or who carry the bacteria in their throat. 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.

How is pneumococcal disease treated/cured?

Pneumococcal disease is treated with antibiotics. Over the last decade, many pneumococci have become resistant to some of the antibiotics used to treat pneumococcal infections; high levels of resistance to penicillin are common.

Can pneumococcal disease in children be prevented?

The FDA recently licensed a new vaccine for the prevention of pneumococcal disease in children. The new pneumococcal vaccine, Prevnar® (manufactured by Wyeth-Lederle Vaccines), is a vaccine in which the serotypes are conjugated (or linked) to a protein. This new pneumococcal conjugate vaccine has been shown to be highly effective in preventing invasive pneumococcal disease in preventing invasive pneumococcal disease (such as young children. In a study of the new vaccine among 37,000 infants in California, the vaccine was over 90% effective in preventing invasive disease among the children studied. The children who received the new vaccine also had 7% fewer episodes of otitis media and a 20% decrease in the number of tympanostomy tubes (ear tubes) placed. The vaccine was also shown to decrease the number of episodes of pneumonia.

Prevnar® is indicated for use in infants and toddlers. The vaccine should be given to all infants < 24 months of age at 2, 4, and 6 months of age, followed by a booster dose at 12-15 months of age. Children who are unvaccinated and are 7 to 11 months of age should be given a total of 3 doses (2 months apart) and children age 12 to 23 months should be given a total of 2 doses at least two months apart. Most children who are 24 months of age or older only need one dose of the vaccine.

The Advisory Committee on Immunization Practices also recommends the new pneumococcal childhood vaccine be given to children age 24 to 59 months at highest risk of infection, including those with certain illness (sickle cell anemia, HIV infection, chronic lung or heart disease). Vaccine should be considered for other children through 59 months of age with a priority for those at higher risk which includes Alaska Natives, American Indians, or African Americans and those children who attend out of home day care for more than 4 hours per week and all children aged 24-35 months.

The recently licensed pneumococcal conjugate vaccine, Prevnar®, is the first pneumococcal vaccine that can be used in children under the age of 2 years. However, pneumococcal vaccines for the prevention of disease among children and adults who are 2 years and older have been in use since 1977. Pneumovax® and Pnu-Immune® are 23-valent polysaccharide vaccines that are currently recommended for use in all adults who are > 65 years of age 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 condition.

Campaigns for judicious use of antibiotics may also slow or reverse emerging drug resistance found among pneumococcal infection.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.