PNEUMOCOCCAL

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What is it

Pneumococcal disease is a bacterial infection that has different subtypes depending on where in the body the infection is occurring. The disease can be less serious when it infects the sinuses or ears, but can be more severe when other parts of the body are infected.1

One serious form of the disease is an infection of the lungs, also known as pneumonia.1 Pneumonia is the most common form of pneumococcal disease in adults,1 and it can put some people at risk for hospitalization and possibly death.1

When the bacteria are more invasive, it can lead to an infection of the blood (bacteremia) and fluid and tissues surrounding the brain and spinal cord (meningitis), which could result in brain damage or even death.2 This is referred to as invasive pneumococcal disease (IPD). Among annual cases of IPD, most occur in those under the age of 5 or those above the age of 65.2

Who is at risk

Pneumococcal disease can occur at any age, but IPD most commonly affects those under the age of 5 (and especially those under the age of 2) and those over the age of 65.3

You may also be at high risk for IPD if you:3

  • have a cochlear implant
  • have a weakened immune system or are immune suppressed
  • have chronic organ disease (such as kidney, liver, lung or heart disease)
  • have certain other chronic conditions (such as diabetes or asthma)
  • have a non-functioning or missing spleen
  • are exposed to cigarette smoking
  • are homeless

What are the symptoms

When a pneumococcal infection occurs in the nose or throat, individuals generally do not show any signs or symptoms.4 However, some infections of the respiratory tract can lead to local infections (infections that do not cross into the blood or other parts of the body) and result in the development of symptoms. This includes ear infections (otitis media) where infected individuals will likely experience sore ear(s) and a fever, sinus infections (sinusitis), which can lead to congestion and headaches, and pneumonia, which can cause shortness of breath and coughing up thick mucus.4

When IPD occurs (blood or brain and spinal cord are infected), symptoms of headache, vomiting, stiff neck, and fever are the most common to occur.4 A high fever is generally the first sign to occur in children with IPD.4

How is it spread

Pneumococcal disease is caused by various strains of pneumococcal bacteria, some of which infect more often than others.5

Many people carry the bacteria in their nose and throat without experiencing any symptoms or complications.5 However, other susceptible individuals can be at risk for further infection if exposed

Pneumococcal bacteria are easily spread from person-to-person through contact with respiratory tract fluids such as mucus and saliva.5 This can occur when you when you come into contact with respiratory droplets in the air (such as when an infected individual coughs or sneezes), objects that have been in contaminated with an infected person’s respiratory tract fluids (such as utensils, cups, and tissues), or when you are in direct contact with infected individuals and their respiratory fluids.5

How is it prevented

Preventing pneumococcal disease is very important for several reasons. First, bacteria, including pneumococcal bacteria, are capable of developing resistance to the antibiotics we use to treat infections. Therefore, preventing infections will limit the use of antibiotics, thus minimizing resistance and allowing antibiotics to continue being effective.2 Second, there can be significant risks, such as hospitalization and death, associated with infections, especially IPD, and therefore it is important to prevent the disease from occurring in the first place.1
Pneumococcal disease is vaccine-preventable. There are different pneumococcal vaccines available, and in Canada they are recommended based on age and risk factors.6, 7, 8

It is also important to know that individuals can be at a higher risk for pneumococcal disease if they have been infected with the flu virus.6 Therefore, it is also important to prevent the flu, which can be done through a yearly vaccine (see “influenza” for more information).

How is it treated

It is important that individuals experiencing any of the symptoms of pneumococcal disease visit a healthcare provider right away, as they can diagnose the disease based on an assessment of symptoms and laboratory test results.

Once diagnosed, pneumococcal disease is treated with antibiotics.9 However, severe infections can cause permanent damage even with antibiotics, making prevention especially important.9

Medical advice is recommended for the onset of symptoms. For further information regarding Pneumococcal and immunization, please speak with your healthcare provider.

REFERENCES

  1. Centers for Disease Control and Prevention. About Pneumococcal. Fast Facts. (2015) https://www.cdc.gov/pneumococcal/about/facts.html
  2. Public Health Agency of Canada. Invasive Pneumococcal Disease. (2014) http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie-eng.php
  3. Public Health Agency of Canada. Invasive Pneumococcal Disease Risks. (2014) http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie/risks-risques-eng.php
  4. Public Health Agency of Canada. Invasive Pneumococcal Disease Symptoms. (2014) http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie/symptoms-symptomes-eng.php
  5. Public Health Agency of Canada. Invasive Pneumococcal Disease Causes. (2014) http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie/causes-eng.php
  6. Public Health Agency of Canada. Invasive Pneumococcal Disease Prevention. (2014) http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie/prevention-eng.php
  7. Pfizer Prevnar13 Product Monograph. (2015) https://pdf.hres.ca/dpd_pm/00033084.PDF
  8. Merck Pneumovax 23 Product Monograph. (2016) https://pdf.hres.ca/dpd_pm/00035855.PDF
  9. [Public Health Agency of Canada. Invasive Pneumococcal Disease Treatment. (2014) http://www.phac-aspc.gc.ca/im/vpd-mev/pneumococcal-pneumococcie/treatment-traitement-eng.php