Pneumococcal disease

About pneumococcal disease

Pneumococcal disease refers to a range of illnesses that affect various parts of the body and are caused by infection with the bacterium Streptococcus pneumoniae, commonly known as pneumococcus.

Illnesses range from mild infections, such as ear infection, to pneumonia and life-threatening infections of the bloodstream and central nervous system, such as meningitis.

Immunisation can substantially reduce the risk of infection, especially in young children.

Pneumococcal disease is deadly

Pneumococcal disease is a leading cause of serious illness and death among Australian children under 2 years of age and persons over 85 years of age. The rates are highest among Aboriginal and Torres Strait Islander children, especially in central Australia.

Pneumococcal disease is also an important cause of pneumonia in adults 70 years of age or over. Older people are especially at risk of death from this disease.

It is estimated to kill around one million people worldwide every year.

While pneumococcal disease can occur at any time, infections seem to be more common during winter and spring. Young children, older people and people with impaired immune systems are among the most susceptible.

Pneumococcal infections

Streptococcus pneumoniae can cause a range of illnesses, depending on which part of the body is infected. These include:

• sinusitis – infection of the sinuses (air-filled cavities in the face). Symptoms include aching face, blocked nose, yellow-green nasal mucus and headache
• otitis media – middle ear infection. Symptoms include painful ear, hearing loss, high temperature, nausea and vomiting
• bacteraemia – bacteria invade the blood. Symptoms include fever, headache and muscular aches and pains. This is a very serious condition
• septic arthritis – joint infection. Symptoms include joint pain, swelling and reduced mobility of the joint
• osteomyelitis – bone infection. Symptoms include bone pain, reduced mobility of the affected part and fever
• pneumonia – lung inflammation. Symptoms include fever, cough, chest pains and breathing problems, such as shortness of breath
• meningitis – inflammation of the membranes (meninges) that enclose the brain and spinal cord. Symptoms may include high fever, headache, stiff neck, nausea and vomiting, and sometimes coma. Pneumococcal meningitis is extremely serious and has a high death rate.

Risk of pneumococcal disease

Certain groups are at increased risk of infection, including:

• children aged under 2 years
• children under 5 years with underlying medical conditions predisposing them to invasive pneumococcal disease
• Aboriginal and Torres Strait Islander children, especially in central Australia
• Aboriginal and Torres Strait Islander people
• people aged 70 years and over
• people with weakened immune systems
• people with chronic diseases such as diabetes, lung disease, cancer or kidney disease
• people who have impaired spleen function or have had their spleen removed
• people who smoke tobacco.

Spread of pneumococcal disease

Many people carry Streptococcus pneumoniae bacteria in their nose and throat. The bacteria are transferred to another person through droplets of saliva or mucus, such as when a ‘carrier’ sneezes, coughs, shares toys or kisses someone.

Most of the time, this doesn’t cause any illness. However, vulnerable people may develop pneumococcal disease. The immune system is unable to keep the bacteria in check, which then multiply out of control and spread to other areas of the body.

Diagnosis of pneumococcal disease

Since other types of bacteria can cause similar infections, it is important to test specifically for the presence of Streptococcus pneumoniae.

Depending on the symptoms, pneumococcal disease is diagnosed using a number of tests, including:

• physical examination
• chest x-ray
• phlegm test
• blood test
• urine test
• cerebrospinal fluid (CSF) test by lumbar puncture.

Treatment for pneumococcal disease

Treatment options include:

• antibiotics such as penicillin
• pain-relieving medication
• plenty of fluids
• rest
• hospital admission in severe cases – for example, meningitis.

Immunisation for pneumococcal disease

There are more than 95 different recognised strains of Streptococcus pneumoniae and no single vaccine can protect against all of them. However, pneumococcal vaccines are available to help prevent infection with the most common strains.

Immunisation can greatly lower the risk of infection in young children, especially those under 2 years of age.

In Victoria, pneumococcal vaccine is free of charge under the National Immunisation Program for:

Infants and young children

• Routine schedule
  • All infants at 2, 4, and 12 months of age
• Extra dose at 6 months for:
  • All Aboriginal and Torres Strait Islander infants
  • Infants born before 28 weeks
  • Medically at-risk infants
• Catch-up vaccination
  • Available for children under 5 years of age
  • The number of recommended doses depends on the child’s age and health

Children aged 12 months to less than 18 years

• Newly diagnosed medical risk condition may be eligible for funded dose

Adults

Pneumococcal vaccine is funded under the National Immunisation Program for:

• Aboriginal and Torres Strait Islander people aged 50 years and over
• All adults aged 70 years and over

Adults with certain medical risk conditions

Some medical conditions put people at higher risk of pneumococcal disease and extra pneumococcal vaccines are recommended and funded under the National Immunisation Program. However, some health conditions recommended for pneumococcal vaccination are not eligible for free vaccines. Check with your doctor about eligibility and costs.

Where to get help

• Your GP (doctor)
• Your local council immunisation service
• Nurse-on-Call Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Your local community health centre
• Immunisation Program, Department of Health, Victorian Government Email: immunisation@health.vic.gov.au
• National Immunisation Hotline Tel. 1800 671 811
• The emergency department of your nearest hospital