Further Product Information

CONTENTS

Summary
Epidemiology and burden of pneumococcal infection
Pathophysiology
Risk factors
Symptoms
Diagnosis
Disease management
Disease prevention
Socioeconomics
Key points
References

SUMMARY

Streptococcus pneumoniae (commonly referred to as the pneumococcus) imposes a significant but avoidable burden of illness and death. Following the successful introduction of vaccines against Haemophilus influenzae type B and meningococcus type C, the pneumococcus has re-emerged as one of the most important causes of serious childhood bacterial infection in the developed world. Pneumococcal infections are also a cause of substantial illness and mortality amongst the elderly, in individuals with chronic disease and in those with compromised immune systems. Pneumococci colonise the nasopharyngeal epithelium in healthy individuals, often without causing any symptoms. In susceptible individuals, however, pneumococci may spread to different body sites to cause a variety of diseases, ranging from upper (acute otitis media and sinusitis) and lower respiratory tract infections (pneumonia) to severe systemic infections, potentially resulting in meningitis, bacteraemic pneumonia, bacteraemia and sepsis. Asymptomatic carriage of pneumococci in the nasopharynx is particularly common in young children; this population is thus a major reservoir for the spread of pneumococcal infection. Indeed, virtually all children are carriers of pneumococci at some stage during childhood. The most common clinical presentation of pneumococcal infection encountered in primary care is that of acute otitis media in childhood. However, in terms of mortality and morbidity, invasive pneumococcal disease (IPD comprises meningitis, bacteraemia and septicaemia, pneumonia) is of greater clinical significance and sequelae from IPD can be severe - survivors of pneumococcal meningitis often suffer long-term severe disability, with its attendant personal and social costs. Although management of acute infections is with antibiotics, this has become increasingly complicated in recent years by the emergence of multidrug-resistant strains. Consequently, this has prompted a shift in focus away from antimicrobial therapy towards preventative measures and the development of new pneumococcal conjugate vaccines suitable for use in infants and children.