Pneumococcal disease

Pneumococcal disease is an acute infection caused by the Streptococcus pneumoniae bacteria. It can cause a variety of severe illnesses including lung infection (pneumonia), infection around the brain (meningitis) and blood poisoning (septicaemia) with pneumonia being the most common in the Northern Territory (NT). 

The bacteria can also cause less severe but troubling illness such as sinus and ear infections.

How it is spread

Many healthy people carry the bacteria in their nose and throat, especially young children. The bacteria can be spread to others by direct oral contact such as kissing or contact with articles soiled with infected mouth or nose secretions. 

Occasionally the bacteria will cause an infection by invading the body or blood stream. It is uncommon to get infected from a person who is sick with pneumococcal disease.

Symptoms

The time between being infected with the bacteria and becoming sick is uncertain but may be as short as 1 to 3 days. 

The symptoms vary depending on which part of the body is affected but usually a fever will be present.

Pneumonia presents as shortness of breath, cough, fever, lack of energy and sometimes chest pain whereas meningitis can cause headache, stiff neck, nausea, vomiting and drowsiness. 

Who is at risk

Anyone can get pneumococcal disease, but some groups including young children, the elderly, any person with a weakened immune system or a chronic illness and those who smoke have a higher risk of getting sick with pneumococcal disease.  

Having a respiratory viral infection such as influenza may also increase the risk of being infected.

Treatment

Pneumococcal disease is treated with antibiotics under a doctor’s care.

Prevention

There are more than 90 different types of Streptococcus pneumoniae bacteria. There are conjugate and polysaccharide pneumococcal vaccines, each of which is used in different circumstances as described below. 

The vaccines work in slightly different ways and protect against a different number of the pneumococcal bacteria.

Conjugate vaccine (Prevenar 13®)

All children are offered this vaccine free at 6 weeks and at 4 and 6 months of age. Young children with medical conditions associated with an increased risk of invasive pneumococcal disease (IPD) and all Indigenous children receive a 4th dose at 18 months. 

Older children and adults with medical conditions associated with the highest increased risk of IPD are also recommended to receive a single dose of Prevenar 13® vaccine.

These medical conditions include:

  • asplenia or a spleen that doesn’t work properly
  • immune system deficiencies (from either disease or treatment)
  • cerebrospinal fluid leak
  • cochlear implants
  • intracranial shunts
  • severe kidney disease, especially those receiving dialysis.

People with these conditions will also require vaccination with the Pneumovax23® vaccine described in the next section.

Polysaccharide vaccine (Pneumovax 23®)

Adults 65 years and over and all Indigenous people 15 years and over in the NT are eligible to receive a free Pneumovax 23® vaccine.

The vaccine is also recommended for people from 4 years of age with conditions associated with an increased risk of IPD. 

In addition to those conditions described above where the Prevenar 13® vaccine is recommended this includes the following:

  • hazardous alcohol intake
  • chronic heart disease
  • chronic liver disease
  • chronic lung disease
  • diabetes
  • down syndrome
  • premature birth at <28 weeks gestation
  • tobacco smokers.

Additional doses of Pneumovax23® may be recommended in some circumstances.

Your doctor will be able to advise you further about which vaccine(s) you should receive, and whether any additional doses may be needed in the future.

Side effects of the vaccine

Serious side effects are rare. Up to 10% of children may have some redness at the injection site or develop a mild fever. 

In adults local redness and soreness at the injection site for the first couple of days is common.

How the disease can be controlled

Providing antibiotics or vaccinating people who have recently been in contact with a person infected with pneumococcal disease is not usually required (during outbreak situations vaccine may be administered to household contacts).  

Life style factors such as overcrowding contribute to chronic illnesses and should be addressed. 

Smoking and smoke exposure increase the risk of pneumococcal disease and should be avoided.  

Yearly influenza vaccination will reduce the risk of pneumococcal disease as it can be a complication that follows influenza.

Contact

For more information contact your nearest Centre for Disease Control.

Last updated: 27 June 2017