JEDDAH, 2 April 2008 — Pneumococcal disease is a leading cause of serious illness in children and adults throughout the world. The disease is caused by a common bacterium, the pneumococcus, which can attack different parts of the body. When bacteria invade the lungs, they cause the most common form of community-acquired bacterial pneumonia.
When bacteria invade the bloodstream, they cause bacteremia and when they invade the covering of the brain, they cause meningitis. Pneumococci may also cause otitis media (middle ear infection) and sinusitis. Currently, there are more than 90 known pneumococcal types. The 10 most common types account for some 62 percent of invasive disease worldwide.
Giving an overview of the spread of pneumococcal disease, Dr. Tarek Baghdady, former head of the pediatric department at Dr. Erfan Hospital, told a workshop in Jeddah last week that penumococcal disease had emerged as No. 1 cause for vaccine-preventable death in children under five.
The workshop, organized by Wyeth, a pharmaceutical company, aimed to spread awareness about pneumococcal diseases like meningitis (inflammation in the brain), bacteremia (infection of the blood) and pneumonia (infection of the lung) and their impact on the local community. The event also focused on the role of vaccines and the benefits of prevention instead of cure.
Quoting a World Health Organization study, he said over one million children die every year of pneumococcal diseases across the world. Children under two years and elderly people over 65 years are at higher risk.
Studies in Saudi Arabia, Bahrain, the UAE and Oman have shown that invasive pneumococcal disease in children under five years ranges from 60 to 112 per 100,000, which is higher than many Western countries. According to Dr. Baghdady, anyone can get pneumococcal disease. But some groups are at particularly high risk for pneumococcal disease or its complications.
These groups include persons aged 65 and older — individuals with weak immune systems due to cancer, leukemia, Hodgkin’s disease or human immunodeficiency virus (HIV), or persons with sickle cell disease or without a functioning spleen, or individuals who have a chronic illness such as lung, heart, and kidney disease, diabetes and alcoholism, or persons living in special environments or communities, and residents of chronic or long-term care facilities.
The disease is spread from person to person by droplets in the air (for example, when someone sneezes and coughs). This bacterium is found in the nose and throat of healthy children and sometimes adults.
The symptoms are different for different diseases. Bacteremia may include fever with other nonspecific signs of illness. Meningitis may include fever, severe headache, vomiting, sleepiness, irritability, seizures and stiff neck. Pneumonia may include cough, fever, shortness of breath and chest pain. Acute otitis media (AOM) may include earache, fever, vomiting and temporary hearing loss. Acute sinusitis may include fever, runny nose and cough.
Invasive pneumococcal disease is diagnosed through blood tests. Noninvasive pneumococcal disease is diagnosed through blood tests, physical examinations and x-rays.
Dr. Baghdady said that pneumococcal disease was mainly treated with antibiotics like penicillin. However, the types of pneumococcus bacterium that can resist antibiotics are increasing worldwide. These antibiotic-resistant types complicate treatment decisions, cause treatment failures and increase the cost of medical care.
“The best way to protect against pneumococcal disease is through vaccination,” Dr. Baghdady said, adding that infants and toddlers need the most protection and the vaccine to protect them against invasive pneumococcal disease.
