Common Childhood Conditions: What You Need To Know About Pneumococcal Disease

One of the most serious conditions a child can develop when they are less than five years old is pneumococcal disease. It can lead to meningitis and pneumonia, as well as permanent hearing loss, mental, speech or movement disability.

Dr Chan Si Min, head and consultant, division of paediatric infectious diseases at National University Hospital shares all you need to know about this life-threatening disease.

What causes pneumococcal disease?
Pneumococcal disease is a bacterial infection caused by Streptococcus pneumoniae. It is spread when an infected person sneezes or coughs.

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When a person is infected, the bacteria can spread two ways. If it is spread from the nose and throat to the ears or sinuses, it causes milder disease. However when it spreads to the blood, lungs or brain, it causes severe disease. Serious invasive pneumococcal disease (IPD) is most common in young children under two. Older children who are older than five and adults are less susceptible to IPD. In Singapore, the estimated incidence of IPD is approximately 15 per 100 000 children under five years old.

Certain medical conditions may predispose to a higher risk of IPD; children with a defective immune system (e.g. absence of spleen, sickle cell disease, cancer, post-organ transplant, chemotherapy, long term oral steroid treatment). Children with certain specific medical conditions (e.g. cochlear implants, cerebrospinal fluid leaks, chronic renal failure) also have higher incidence of IPD.

What are the symptoms?
Symptoms of illness depend on which part of the body is affected. Pneumococcal pneumonia is the most common serious form of the illness and can cause fever, cough, difficulty in breathing, and chest pain. It is results in complications like fluid or pus in the lungs, it can be more difficult to treat.

Pneumococcal meningitis affects the fluid covering the brain and spinal cord and it can cause fever, severe headache, vomiting, dislike of bright lights, stiff neck, and drowsiness or confusion. In young babies, poor eating and drinking, irritability and lethargy may occur.

Blood infection (bacteraemia) causes fever, chills and lethargy. Pneumococcus is also a major cause of ear infections (acute otitis media) which causes fever, ear pain, and a swollen red ear drum.

Can it be treated?
Pneumococcal disease is treated with antibiotics. Severe disease usually requires hospital admission for intravenous antibiotics.

What are some preventive measures parents can take?
Certain types of pneumococcal vaccines protects against the 13 types of pneumococcal bacteria that cause most of the severe illnesses (there are more than 90 types in total).

Preventing pneumococcal disease through vaccination is important to prevent serious illness, and with time, as the bacteria may become resistant to currently available antibiotics, it becomes harder to treat severe infections.

Dr Chan Si Min is the head and consultant from the Division of Paediatric Infectious Diseases, National University Hospital. She has trained and practised in paediatrics, neonatology, and paediatric infectious diseases in London and has conducted research into the management of critically ill children treated for Influenza A H1N1.

To learn more about other common childhood conditions, click here

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