Pneumococcal disease

This page explains more about the disease, the incidence rate and the associated vaccine.

The disease 

• Caused by a germ (a bacterium called Streptococcus pneumoniae).

• There are about 90 strains of this bacterium, but only a limited number cause serious disease in the UK.

• Not a very infectious disease, even within families.

• The germ is present in the nose and throat of many people without causing a problem.

• Most common in young children and older adults.

• It is not known how long the disease takes to appear after contact with an infected person.

• Causes a variety of problems:

  • meningiitis - inflammation of the lining of the brain

  • septicaemia - blood poisoning

  • pneumonia

  • ear infections

• Symptoms depend on the problem.

• It is difficult to be precise about the number of cases, especially of pneumonia, because tests are not always done to find out which germ has caused the pneumonia. The average number of reported cases in children younger than five years old is about 700 per year. However, it is estimated that the actual number is probably about three times this.

• Treatment is with antibiotics, but increasingly the germs are resistant to the standard antibiotics.

• In spite of treatment, one in ten to twenty of those with meningitis will die and about three times as many are left with lasting disabilities.

• Each year in England and Wales, there about an estimated 40 deaths in children between one month and five years old.

The vaccine

• The vaccine used routinely in children is made from the sugar coat of a number of strains of pneumococcus, which cause most of the serious disease in children in the UK. To this has been attached a small amount of something similar to diphtheria toxoid. The amount is not enough to replace diphtheria vaccine.

• Because of this way of making it, it is called a conjugate vaccine. This is the same technique that is used to produce both the successful Hib and meningococcal C vaccines.

• There has been a similar, but not as effective, vaccine (plain polysaccharide vaccine) in use in the UK for 20 years. This is mainly given to the elderly.

• A conjugate vaccine has been part of the routine USA programme since 2000. Since its introduction there, there has been a 94 per cent reduction in serious disease in children under five years of age.

• It has been used in the UK since 2001 for children with conditions which put them at higher risk of catching the infection and of being seriously affected by it (eg heart disease).

• In September 2006, it became part of the UK's routine immunisation schedule.

• In a few children it may cause a mild fever and soreness at the site of injection. More serious side effects are rare.

• The original vaccine, which gave protection against seven strains of the germ, has been very effective.

• However, with time, some of the strains not covered by the vaccine have become more common.

• In 2010, a vaccine against 13 strains was introduced. This will cause a further reduction in disease.

• Continued monitoring will look out for increases in other strains.