Pneumococcal Pneumonia, NIAID Fact Sheet: NIAID
Article title: Pneumococcal Pneumonia, NIAID Fact Sheet: NIAID
Conditions: Pneumonia, Pneumococcal Pneumonia
Source: NIAID
August 2001
Pneumococcal Pneumonia
What is Pneumonia?
Pneumonia is a lung disease that can be caused
by a variety of viruses, bacteria, and sometimes fungi. The U.S. Centers
for Diseases Control and Prevention (CDC) estimate nearly 90,000 people in
the United States died from one of several kinds of pneumonia in 1999. In
the United States, pneumonia is the fifth leading cause of death
[Natl Vital Stat Report 47 (25), 10/5/1999]. Rates of
infection are three-times higher in African Americans than in whites and
are 5- to 10-times higher in Native-American adults and 10-times higher in
Native-American children [
J Infect Dis;170:368-76,
1994].
On an international scale, acute respiratory
infection ranks as the third most frequent cause of death among children
less than 5 years old and was responsible for approximately 3.5 million
deaths in 1998.
What is Pneumococcal Pneumonia?
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].
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.
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?
In about 30
percent of people with pneumococcal pneumonia, the bacteria invade the
blood stream from the lungs [
http://www.cdc.gov/nip/publications/pink/pneumo2.pdf
pp. 249-263]. This causes bacteremia, a very serious 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
NIAID is a component of the National Institutes of Health
(NIH). NIAID supports basic and applied research to prevent, diagnose, and
treat infectious and immune-mediated illnesses, including HIV/AIDS and
other sexually transmitted diseases, tuberculosis, malaria, autoimmune
disorders, asthma and allergies.
Prepared by:
Office of
Communications and Public Liaison
National Institute of Allergy and
Infectious Diseases
National Institutes of Health
Bethesda, MD 20892
Public Health Service
U.S. Department of Health and Human
Services
» Next page: Pneumonia among Children in Developing Countries: DBMD
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