About Pneumococcal Disease

By Ann Douglas

Ann Douglas Brings Mommy Know-how Tour To Indigo Yorkdale

Canadian parenting author offers real-world advice to make sense of baby's health care and immunization needs Who: Ann Douglas, leading authority on parenting and award-winning author of 27 must-have books, including The Mother of All Pregnancy Books; The Mother of All Baby Books; The Mother of All Toddler Books and The Mother of All Parenting Books. What: Canada's foremost parenting writer and mother of four children will help educate parents about baby health care and the importance of immunizing their children in support of National Immunization Awareness Week (April 24 to April 30). The discussion will be followed by a Question and Answer period. When: Tuesday, April 26, 2005 11:00 a.m. Where: Indigo - Yorkdale Yorkdale Shopping Centre 3401 Dufferin Street, Unit 29 Note: Ann Douglas will also be available to sign copies of her books Ottawa parents can meet Ann at the Chapters store at Pinecres on Thursday, April 28 at 11 am. Click here for more information.

Pneumococcal disease is a growing threat to children¹s health worldwide, resulting in more than 1.2 million deaths each year in children under five in developing countries. In Canada there are approximately half a million cases of pneumococcal disease annually. Conditions arising from pneumococcal disease include meningitis, bacteremia related to bacterial infection of the blood, pneumonia, and inflammation of the middle ear associated with acute otitis media. Furthermore, rapidly emerging antibiotic-resistant strains of the disease have made treatment of pneumococcal infections increasingly difficult. As a result, the need for an effective vaccine has grown more urgent each day.

What Is Pneumococcal Disease?

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Pneumococcal disease describes a group of illnesses caused by the bacterium Streptococcus (S.) pneumoniae, also known as pneumococcus. This bacterial pathogen, which affects both children and adults, is a major cause of morbidity and mortality worldwide. Because there are 90 different serotypes of S. pneumoniae, development of effective vaccines has proven to be more challenging than in other disease areas.

After pneumococcus colonizes in the upper respiratory tract, it can then cause several different types of severe, invasive pneumococcal diseases (IPDs), defined as any infection in which S. pneumoniae is isolated from the blood or other normally sterile site. IPDs include bacteremia (bacterial infection of the blood) and meningitis (bacterial infection of the membrane of the spinal cord or brain).

When pneumococcus spreads from the nasopharynx to the upper and lower respiratory tract, non-invasive pneumococcal diseases can result, including bacterial pneumonia (inflammation of the lung), acute otitis media (inflammation of the middle ear) and sinusitis (infection of the sinuses). If untreated or resistant to treatment, pneumococcal disease can lead to hearing loss, learning disabilities, speech delays, paralysis and sometimes death.

Increased Childhood Risk

Several factors increase a child¹s risk of contracting a pneumococcal infection. In a recent Canadian study, 23 per cent of all invasive infections occurred in children with an underlying medical condition. Infants from birth to 24 months are at highest risk, due to their low levels of circulating pneumococcal antibodies. Weakened immune status, e.g., from sickle cell disease or HIV, also greatly increases the risk of infection. Since as many as 50 per cent of preschool children are carriers of pneumococcus, children who attend daycare are much more likely to become infected due to their increased exposure to the bacteria in the daycare setting. In all countries in which pneumococcal disease has been studied, findings show that younger children have a greater chance of contracting invasive pneumococcal disease.

Between 1991 and 1998, in a study involving eleven paediatric centres across Canada, there were over 1,500 cases of invasive pneumcoccal infection. Approximately 60 per cent of cases occurred before two years of age. Significant medical conditions were present in approximately 23 per cent of cases.

Transmission

Pneumococcus is commonly found in the nose and throat of healthy children and adults, with as many as four different serotypes carried at once. While not all individuals will get sick from pneumococcus, anyone in whom the bacteria have colonized is a carrier, and can potentially infect others through airborne particles, such as those in sneezes or coughs.

The colonization of pneumococci in young children is very common, since children lack type-specific serum antibodies to fight the bacteria prior to colonization. Children are, therefore, both major carriers and victims of pneumococcal disease.

Symptoms

The symptoms of pneumococcal disease vary by illness:

Bacteremia symptoms may include high fever associated with other nonspecific signs of illness.

Meningitis symptoms include fever, severe headache, nausea, vomiting, stiff neck and photophobia (avoidance of light due to pain) in older children, while in infants, fever and non-specific signs of illness are more frequent symptoms.

Pneumonia symptoms include sudden shaking, chills, cough, fever and chest congestion.

Acute otitis media symptoms may include earache, fever and muffled hearing. In infants and young children, frequent tugging at the ear may signal acute otitis media.

Sinusitis symptoms include low-grade fever, runny nose and cough.

Invasive pneumococcal disease is diagnosed when the organism is cultured from blood or from normally sterile extrapulmonary sites. In contrast, tympanocentisis (ear fluid culture) and x-ray are used to diagnose non-invasive diseases, including otitis media and pneumococcal pneumonia.

Antibiotic Resistance: A Growing Threat

In the past, pneumococcal disease could be treated effectively with antibiotics, particularly penicillin. In the last 20 years, however, there has been an alarming increase in S. pneumoniae strains that are resistant to penicillin and other antibiotics. A Canadian study recently found that resistance to antibiotics in adults increased from two per cent in 1998 to 15 per cent in 2001. Children infected with drug-resistant strains may experience prolonged illness and therefore require treatment with expensive alternative antibiotics and hospitalization.

1. Peters, T.R., Edwards, K.M. The pneumococcal protein conjugate vaccines. J Pediatr 2000; 137 (3):416-30.

2 Gold, R. Meningococcal and Pneumococcal Disease. Paediatrics and Child Health. Novembre 2002; 7 (9). Accès à : http://www.pulsus.com/Paeds/07_09/gold_ed.htm

3 Scheifele et al. Invasive Pneumococcal Infections in Canadian Children, 1991-1998: Implications for New Vaccination Strategies. Clinical Infectious Diseases (2000:31:850).

4 Scheifele et al. Invasive Pneumococcal Infections in Canadian Children, 1991-1998: Implications for New Vaccination Strategies. Clinical Infectious Diseases 2000:31:850.

5 Canadian Bacterial Surveillance Network, http://microbiology.mtsinai.on.ca/research/cbsn.shtml

 

About Ann Douglas

Ann Douglas is an award-winning journalist and the author of 27 books, including The Mother of All Pregnancy Books; The Mother of All Baby Books; The Mother of All Toddler Books; The Mother of All Parenting Books; and The Mother of All Pregnancy Organizers.

A parent educator and mother of four, Ann is also the co-author (with John R. Sussman, M.D.) of two other highly popular pregnancy books: The Unofficial Guide to Having a Baby and Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss.

Ann is currently serving as the honorary Chair of the National Healthy Mothers Healthy Babies 9-Month Club and is a member of the expert advisory group for Invest in Kids.

Known for her lively anecdotes and real-world advice, Ann is a regular contributor to WebMD.com, PregnancyandBaby.com, and Spree Living. She makes frequent appearances on both radio and television and is regularly quoted in such publications as Parenting, Parents, Fit Pregnancy, American Baby, and Working Mother.

A much sought after speaker who is equally comfortable leading small-group workshops or delivering keynote addresses, Ann is widely recognized for her ability to both entertain and inspire her audiences and to speak to the issues that are of greatest concern to parents today. Ann's recent speaking appearances include the The Learning Annex in Toronto; the Vancouver Wellness Show; the Vancouver Baby Fair; the Michigan International Women's Show; the Childbirth and Postpartum Professionals Association (CAPPA) Canada's Conference; the City of Toronto's Middle Year's Child Care Conference; and an appearance at a recent parenting conference hosted by the York Region District School Board.

Ann is a past president of the Periodical Writers Association of Canada (PWAC) and teaches writing courses through Trent University. She mentors emerging and established authors through PWAC's mentorship program as well as through her own private author coaching business, Author Incubator.

Ann lives in Peterborough, Ontario, with her husband and four children.