Pneumococcal Diseases

Introduction

Pneumococcal diseases are a worldwide public health problem. S. pneumonia is the leading cause of severe pneumonia in children under 5 years of age, causing over one (1) million deaths each year mainly in developing countries. In industrialized countries most infection occurs in the elderly

Causative agent:

Pneumococcal disease refers to a group of clinical conditions caused by the bacterium Steptococcus pneumonia. Invasive pneumococcal infections include pneumonia, meningitis and febrile bacteraemia. The common non-invasive conditions include otitis media, sinusitis and bronchitis.

Transmission:

Infection is acquired by direct person-to-person contact via respiratory droplets or oral contact or indirectly through articles freshly soiled with respiratory discharges.

Incubation period: Not well determined. May be as short as 1 – 3 days

Travelers with certain chronic conditions such as chronic renal failure, chronic liver disease, Diabetes mellitus, HIV/AIDS, immunosuppression after organ transplantation, asplenia or dysfunctional spleen and others are at increased risk of pneumococcal disease

Crowded settings or situations of close, prolonged contact with young children increase risk of contracting disease while traveling. Risk is more common in winter months and when respiratory viruses such as Influenza are circulating.

Sign & Symptoms

Sudden onset of fever (with chills or rigor and/or other systemic symptoms like myalgia, arthralgia, headache, and malaise), pleural pain, dyspnea, tachypnea, productive cough of rusty sputum,

Complication

Altered mental status and death

Treatment

Symptomatic treatment

Antibiotics: For severe pneumonia treat with Penicillin G or Erythromycin. For non-severe pneumonia, recommended antibiotics such as Ampicillin, Amoxycillin or Ciprofloxacin.

Prevention & Precautions

Vaccination as Prophylaxis

Type of vaccine: capsular Polysaccharides of the 23 valent pneumococcal vaccine

Number of doses: one (1) given s.c. or i.m.

Reimmunisation: After 6 years for high risk of fatal pneumococcal infections such as asplenic patient, after 3-5 years should be considered for patient of nephrotic syndrome, renal failure and transplant recipients

Contraindications: Adverse reaction to previous dose

Adverse reactions: Mild local reactions

Before departure: 2 weeks

Recommended for: Those at high risk (as mentioned above)

Special precautions: None

Last Reviewed : 26 April 2012
Writer : Dr. Norhayati bt. Rusli
Accreditor : Dr. Fatimah bt. Othman
Reviewer : Dr. Muhaini bt. Othman