Invasive Pneumococcal Disease

Invasive Pneumococcal DiseasePhoto source: CDC


Pneumococcal disease is an illness that is caused by the pneumococcal bacteria. Anyone can get pneumococcal disease, but it is most common in children under age 5 (especially under age 2), adults over age 65 and in people living with certain medical conditions or other risk factors. Pneumococcal bacteria can cause infections of the ears, sinuses and lungs. It can also cause invasive pneumococcal disease (IPD). IPD is a type of serious infection that includes septicemia (an infection of the blood) and meningitis (an infection of the lining that covers the brain). It can lead to permanent brain damage, hearing loss or death. Each year, approximately 3,000 cases of IPD are reported in Canada.


Symptoms

Many people who have pneumococcal bacteria in their nose and throat will not show any symptoms. In some cases, pneumococcal bacteria can cause local (contained) infections, such as:

  • ear infections, which can lead to sore ear(s) and fever.
  • sinus infections, which can lead to cough, runny or stuffy nose, headache, sore throat, and facial pain or pressure.
  • lung infections, which can lead to coughing up thick mucus and difficulty breathing, chest pain and fever/chills.

It usually takes 1 to 3 days for symptoms to appear after the pneumococcal bacteria enter someone's body. In rarer cases, the bacteria can invade other parts of the body–like the brain or the spinal cord. When this happens, IPD can develop. The symptoms depend upon what part(s) of the body is (are) affected. But typically, symptoms may include:

  • fever
  • stiff neck
  • headache
  • photophobia (eyes being more sensitive to light)
  • vomiting
  • fussiness (crying)
  • loss of appetite
  • coughing
  • confusion

In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting. If you or your children develop the symptoms of IPD, see your health care provider immediately.


Causes

Pneumococcal bacteria are very common. These bacteria can spread very easily through infected mucus or saliva. A person is capable of transmitting disease to others if the bacteria are present in secretions from the nose and mouth. You may come in contact with infected mucus or saliva through:

  • close contact with an infected person
  • coughs and sneezes from an infected person
  • touching objects that were recently exposed to an infected person's mucus or saliva then rubbing your eyes or nose. These objects could include shared utensils, cups, tissues and toys.

Transmission stops when the bacteria disappear from the nose and mouth. This usually happens within 24 hours of starting an appropriate antibiotic treatment.


Risk Factors

In Canada, IPD is more common in the winter and spring. Pneumococcal infections may occur following a viral infection like influenza (flu). IPD is most common in the very young (those under age 5 – especially those under age 2) and the elderly (those over age 65).

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

  • 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.

Your risk for getting IPD can also be higher due to factors that are part of your environment or lifestyle. For example, people who are exposed to cigarette smoking or who are homeless are more at risk of getting IPD.


Treatment

Only your health care provider can diagnose IPD. See your doctor right away if you think you have IPD since early treatment is most effective. People with pneumococcal infections need to take antibiotics to get better.


Prevention

Bacteria like the pneumococcal bacteria can become resistant to the antibiotics normally used to treat infections. When this happens, it is harder to treat the infection. For this reason, prevention is very important. Vaccines can prevent IPD caused by many types of the pneumococcal bacteria. Manitoba offers pneumococcal vaccines through Manitoba’s Recommended Routine Immunization Program to infants, young children, and older adults. Pneumococcal vaccines are also offered free-of-charge to those who are at high risk for IPD. For further information on pneumococcal vaccines available in Manitoba and eligibility, refer to Manitoba’s Eligibility Criteria for Publicly Funded Immunizations.

It is also important to receive the seasonal flu vaccine every year and ensure you are up-to-date with all other recommended immunizations, especially if you are in a high-risk group. You can receive the pneumococcal vaccine together with the flu vaccine.

Other preventive steps include practicing good hand hygiene, covering your nose and mouth when you cough or sneeze, and avoiding sharing of personal items such as water bottles, lipstick, or cigarettes.


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