Pneumococcal Disease: Are Your Children Protected?

Globally, more than 2 million people die of pneumococcal infections every year of which a million are children below 5 years.

Pneumococcal infections are caused by the bacteria, streptococcus pneumoniae, commonly referred to as pneumococcus. Middle-ear infections (or otitis media), sinusitis and bronchitis are non-invasive and less severe manifestations of pneumococcal infection, but are considerably more common. Meanwhile, meningitis (inflammation of the lining membrane of the spinal cord and brain) and bacteraemia (bacterial infection of the blood) are invasive, more sever and potentially life-threatening.

Children Most At Risk

Any child can be infected; however, infants from birth to 24 months are at highest risk, due to their low levels of circulating pneumococcal antibodies. Children with weakened immunity (either born with a faulty immune system or the immune system is compromised following infections like HIV/AIDS or a side-effect of medical treatment), infants and children who attend day care and, children with chronic diseases such as asthma and congenital heart diseases are also among those at highest risk of infection.

Spotting An Infection

Symptoms of the disease sometimes overlap, seem similar to the common cold and some symptoms are so subtle it can be difficult to spot altogether. If your child shows any combination of these symptoms, or if he is not getting better after 3-5 days see a doctor or paediatrician immediately.

Protecting Your Child Against Infection

1. Practice good hygiene at home and make sure your child’s day care centre does the same at their premises.
2. If your child is old enough, teach him about good hygiene practices at home, school and in public places (e.g. wash hands with soap and cover mouth and nose when sneezing).
3. Avoid close contact (i.e. kissing, hugging, or sharing the same eating utensils) with people who are sick.
4. Exclusively breastfeed your child for at least the first 6 months, improve your baby’s nutrition, and avoid air pollution (smoking, stove fires, car exhaust) where possible.
5. Get your child vaccinated against pneumococcal infection.

Prevention Through Vaccination

The most effective method for preventing pneumococcal infection is by vaccination. Currently two types of pneumococcal vaccines are in the market:

• Pneumococcal Conjugate Vaccine (PCV)
• Pneumococcal Polysaccharide Vaccine (PPSV23).

PCV is recommended for children in a series of four doses; one each at 2, 4 and 6 months and the last one between 12 to 15 months. PCV can be used in children from as young as 6 weeks, it induces improved immune memory and provides herd immunity. It also substantially decreases the rate of antibiotic-resistant invasive pneumococcal disease (IPD) in infants and young children. PPSV23 on the other hand, is can only be used in children older than 2 years. In any case, you should consult your doctor regarding which vaccine is best for your child.

What is ‘Herd Immunity’?

When a large portion of a community is immunised against an infectious disease, most members of the community, even those who are not vaccinated, are protected against that disease because there is little opportunity for an outbreak.

Even those who have been previously infected only enjoy a limited degree of immunity, which may not be sufficient to protect them from subsequent infections. This is why scheduled vaccination regimes against pneumococcal infection are highly recommended. It is also important to get an influenza vaccine every year because having the flu increases your chances of getting pneumococcal disease.

PCV is not available under the National Immunisation Programme (NIP), but nevertheless available in all public and private hospitals, and selected clinics nationwide. Ask your doctor for more details about the vaccine and get your child vaccinated today.

An educational contribution by Malaysian Paediatric Association.