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What is Pneumococcal Pneumonia?
Nov. 9, 2004 - Pneumococcal pneumonia
primarily causes illness in children younger than 2 years old and adults
65 years of age or older. The elderly are especially vulnerable to
getting seriously ill and dying from this disease. In addition, people
with certain medical conditions such as chronic heart, lung, or liver
diseases or sickle cell anemia are also at increased risk for getting
pneumococcal pneumonia as are people with HIV infection or AIDS or
people who have had organ transplants and are taking medicines that
lower their resistance to infection.
Pneumococcal pneumonia is an infection in the lungs
caused by bacteria called Streptococcus pneumoniae. S.
pneumoniae, also called pneumococcus, can infect the upper
respiratory tracts of adults and children and can spread to the blood,
lungs, middle ear, or nervous system. CDC estimates S. pneumoniae
causes 40,000 deaths and 500,000 cases of pneumonia annually in the
United States. The yearly incidence of pneumococcal pneumonia is twice
as high in African Americans than in whites and is responsible for 3,000
cases of meningitis (inflammation of spinal cord membranes), 50,000
cases of bacteremia (bacteria in the blood), and 7 million cases of
otitis media (inner ear infection)
[JAMA; 285:1729-1735, 2001].
According
to the World Health Organization, S. pneumoniae is the leading
cause of severe pneumonia worldwide in children younger than 5 years
old, causing more than 1 million deaths in children each year
[Pneumococcal Vaccines: WHO Position
Paper: Wkly Epidemiol Rec, Vol 74, 177-183, 1999].
How is
Pneumococcus Spread?
The noses and throats of up to 70 percent of
healthy people contain pneumococcus at any given time. It is spread from
person to person by coughing, sneezing, or close contact. Researchers
don't know why it suddenly invades the lungs and the bloodstream to
cause disease.
What are
the Symptoms of Pneumococcal Pneumonia?
Pneumococcal pneumonia may begin suddenly,
with a severe shaking chill usually followed by
-
High fever
-
Cough
-
Shortness of breath
-
Rapid breathing
-
Chest pains
There may be
other symptoms as well.
-
Nausea
-
Vomiting
-
Headache
-
Tiredness
-
Muscle aches
In an otherwise
healthy adult, pneumococcal pneumonia usually involves one or more parts
of the lungs, known as lobes. Thus, it is sometimes called lobar
pneumonia. The remainder of the respiratory system is comparatively not
affected. In contrast, infants, young children, and elderly people more
commonly develop a relatively mild infection in other parts of the
lungs, such as around the air vessels (bronchi) causing
bronchopneumonia.
How is
Pneumococcal Pneumonia Diagnosed?
A doctor or other health care provider
diagnoses pneumonia based on
-
Symptoms
-
Physical examination
-
Laboratory tests
-
Chest x-ray
Because a number
of bacteria, viruses, and other infectious agents can cause pneumonia,
if you have any of the symptoms, you should get diagnosed early and
start taking the right medicine if you have any of the symptoms. The
presence of S. pneumoniae in the blood, saliva, or lung fluid
helps lead to a diagnosis of pneumococcal pneumonia.
How is
Pneumococcal Pneumonia Treated?
Health care providers usually prescribe
antibiotics, such as penicillin, to treat this bacterial disease. The
symptoms of pneumococcal pneumonia usually subside within 12 to 36 hours
after treatment has begun. Bacteria such as S. pneumoniae,
however, are resisting and fighting off the powers of antibiotics to
destroy them. Such antibiotic resistance is increasing worldwide because
these medicines have been overused or misused. Therefore, if you are at
risk of getting pneumococcal pneumonia, you should talk with your doctor
about taking steps to prevent it.
Can
Pneumococcal Pneumonia be Prevented?
The pneumococcal vaccine is the only way to
prevent getting pneumococcal pneumonia. Vaccines are available for
children and adults.
The CDC National
Immunization Program (NIP) recommends that you get immunized against
pneumococcal pneumonia if you are in any of the following groups.
-
You are 65 years old or
older.
-
You have a serious
long-term health problem such as heart disease, sickle cell disease,
alcoholism, leaks of cerebrospinal fluid, lung disease (not
including asthma), diabetes, or liver cirrhosis.
-
Your resistance to
infection is lowered due to HIV infection or AIDS; lymphoma,
leukemia, or other cancers; cancer treatment with x-rays or drugs;
treatment with long-term steroids; bone marrow or organ transplant;
kidney failure; nephrotic (kidney) syndrome; damaged spleen or no
spleen.
-
You are an Alaskan-Native
or from certain Native-American populations.
In February
2000, the U.S. Food and Drug Administration approved a pneumococcal
vaccine for use in toddlers and children. It is the first pneumococcal
vaccine approved for children younger than 2 years old
[http://www.fda.gov/cber/inside/annrpt.htm,:
CBER Annual Report FY2000 Issued:01-08-01, Posted: 03-15-01, Updated:
04-10-01]. NIP recommends that all children ages 2
to 23 months old get this vaccine.
Does
Pneumococcal Pneumonia Cause Complications?
According to CDC, in 25 to 30 percent of
people with pneumococcal pneumonia, the bacteria invade the blood stream
from the lungs. This causes bacteremia, a very serious condition.
Pneumococcal pneumonia also can cause other lung problems and certain
heart problems.
What
Research is Going On?
The National Institute of Allergy and
Infectious Diseases (NIAID) supports research on more effective
prevention and treatment approaches to control pneumonia and its causes.
These include
-
Developing and licensing
vaccines and treatments for the disease-causing microbes (pathogens)
that cause pneumonia
-
Stimulating research on
the structure and function of these pathogens
-
Developing better and more
rapid diagnostic tools
-
Understanding the
long-term health impact respiratory pathogens have in various
populations
-
Examining the effect of
vaccines in high-risk populations
-
Determining how
pneumococcus becomes resistant to antibiotics
The recently
approved pneumococcal conjugate vaccine for children is partially the
result of crucial NIAID research in the early development of the
vaccine. This vaccine helps prevent pneumococcal diseases in babies and
toddlers and is the latest advance in developing vaccines against common
bacterial infections. This effort was led in large part by NIAID for
more than 30 years.
NIAID supports
studies to develop improved pneumococcal conjugate vaccines for children
worldwide. In one such study, NIAID researchers are working with The
Gambia Government and scientists from several international research
institutions to test a pneumococcal conjugate vaccine in The Gambia,
West Africa. Health care experts have consistently identified
pneumococcus as the most common cause of bacterial pneumonia in The
Gambia. In a pattern typical of many developing areas, infant and child
mortality rates in The Gambia are high, acute respiratory infections are
a leading cause of death, and pneumococcus is the most common cause of
these infections.
Where Can I
Get More Information About Pneumococcal Pneumonia and Pneumococcal
Vaccine?
For information on
pneumococcal vaccine
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