Pneumococcal infections are acute infections that are caused by the bacteria known as streptococcus pneumoniae. There are over 90 different strains of streptococcus pneumoniae, but it is thought that most infections are caused by 10 strains.
Types of pneumococcal infection
Pneumococcal infections are usually one of two types; non-invasive pneumococcal infections, which occur outside the major organs or the blood, and tend to be less serious, and invasive pneumococcal infections, which occur inside a major organ, or in the blood, and tend to be more serious.
Non-invasive pneumococcal infections
Non-invasive pneumococcal infections include middle ear infection (otitis media), infection of the sinuses (sinusitis), and infection of the airways (bronchitis).
Non-invasive pneumococcal infections are thought to be quite common, although it’s hard to estimate the exact number of cases that occur each year. This is because infections usually clear up within a few days, so people don’t usually have to visit their doctor.
Invasive pneumococcal infections
Invasive pneumococcal infections include pneumonia (lung infection), meningitis (infection of the brain), and infection of the blood (sepsis).
Invasive pneumococcal infections are less common than the non-invasive variety, but they can place a considerable strain on health services. Cases of invasive pneumococcal infection usually peak in the winter, during December and January in Europe.
Meningitis is a medical emergency that requires immediate treatment in an intensive care unit (ICU). However, it’s much rarer than pneumonia.
Vaccinations
There are two vaccinations that are used for the most common strains of pneumococcal infections. They are the pneumococcal conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine (PPV). The pneumococcal conjugate vaccine which all children under the age of two ought to receive as part of their childhood vaccination programme. The pneumococcal polysaccharide vaccine (PPV) is recommended for all adults over 65 years of age. This is also recommended for those who are over two years of age and in a high risk group for developing a pneumococcal infection, such as people with diabetes or heart disease.
See the causes section for more information about who is recommended to receive a PPV vaccine.
Trends in pneumococcal infections
Since the introduction of the PCV and the PPV, the number of cases of invasive pneumococcal infection has fallen by at least 50%.
However, there is concern about the number of streptococcus pneumoniae that have developed a resistance to antibiotics. These types of bacteria are known as drug-resistant streptococcus pneumoniae (DRSP).
In some countries (e.g. England and Wales) it is estimated that about 4% of streptococcus pneumoniae are resistant to drugs. Infections that are caused by DRSPs can be much more challenging to treat.
Doctors may be reluctant to prescribe antibiotics for cases of mild non-invasive infection because each time an antibiotic is used the chances of the bacteria developing a resistance to it are increased.
Symptoms of pneumococcal infections
If you have a pneumococcal infection, your symptoms will depend on the type of infection that you have. Some common symptoms include fever, chills, sweat, aches and pains, headache, and a general sense of feeling unwell.
Who is at risk from pneumococcal infections?
People who are most at risk of developing pneumococcal infections are:
- children under two years of age,
- adults over 65 years of age,
- those with a weakened immune system, and
- those with certain chronic health conditions, such as diabetes, or heart disease.
Causes of pneumococcal infections
streptococcus pneumoniae bacteria live in the throat and are spread through coughing, sneezing, and close contact.
For most people, the bacteria do not cause a problem because their immune system prevents it from moving from their throat to other parts of their body.
However, in those with a weakened immune system, either due to their age, or general health, the bacteria can move from the throat to other parts of the body, such as the lungs, the blood, or the brain. If this happens, a more serious infection can develop.
Risk factors
Those who are particularly at risk from pneumococcal infections are listed below.
- Children under two years of age.
- Adults who are over 65 years of age.
- People who have a weakened immune system due to a health condition such as HIV, or AIDS.
- People who are receiving medical treatment that is known to weaken the immune system, such as chemotherapy, or steroids.
- People who have a history of spleen disease, or dysfunction (the spleen is a organ that filters the blood).
- People with a chronic respiratory disease, such as chronic obstructive pulmonary disease (COPD).
- People with chronic heart disease.
- People with chronic kidney disease.
- People with chronic liver disease.
- People with diabetes who need to take insulin.
- People who wear a type of hearing aid that is known as a cochlear implant (people who use these devices have a slightly higher risk of developing meningitis. However, the reasons for this are still unclear).
- People who have spinal damage, as a result of an accident, or medical treatment, which has resulted in their cerebrospinal fluid (CSF) leaking from its normal position (CSF is a clear fluid that surrounds the brain and spine).
Contact your doctor if you are in one of these risk groups and you have not yet received a vaccination for pneumococcal infection.
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