Pneumococcus

In general, the symptoms of pneumococcal infections are similar to those caused by influenza viruses, which include upper respiratory tract symptoms such as fever and cough. However, specific symptoms depend largely on the site of infection.

• Otitis media: fever and earache, possibly with discharge
• Pneumonia: fever, shortness of breath, chills, and productive cough
• Meningitis: fever, neck stiffness and delirium
• Bacteraemia and septicaemia: joint pain and chills. Other parts of the body may also be infected at the same time, which may result in pneumonia, meningitis, etc.

Pneumococcus can survive in organs along the human upper respiratory tract, such as the nose and throat. In fact, even healthy people can sometimes be carriers without showing any symptoms. Pneumococcus can spread through droplets while coughing and sneezing or through indirectly touching respiratory secretions. Children under the age of 5 and elderly over the age of 65 are at high risk in view of their weaker immunity and higher susceptibility to pneumococcal invasion.

Other high-risk individuals who are more susceptible to pneumococcal infections include people who have suffered from invasive pneumococcal infections in the past, people with low immunity (such as cancer patients, people infected with HIV, or those who have undergone splenectomy), patients with chronic diseases (such as diabetes or cardiovascular diseases), and people with cochlear implants.

To prevent pneumococcal infections, a safer and more effective method nowadays is be vaccinated with pneumococcal vaccines. Currently, 13-valent (for 13 serotypes) and 23-valent (for 23 serotypes) vaccines are more commonly available in the market. 

The Scientific Committee on Vaccine Preventable Diseases (SCVPD) of the Centre for Health Protection (CHP) recommends newborns should receive pneumococcal conjugate vaccines (PCV) under the Hong Kong Childhood Immunisation Programme (HKCIP). The standard regimen includes a primary series of 2 doses at 2 and 4 months and a booster dose at 12 months. A single dose of PCV13 catch-up vaccination should be provided to children who have not completed the primary series or received any booster dose of PCV13 between the age of 1 year and under 6 years.

For elderly 65 years of age and older without high-risk conditions*, SCVPD recommends either a single dose of PCV13 or a single dose of 23vPPV.

*High-risk conditions include:

a. History of invasive pneumococcal disease;

b. Immunocompromised states:

•  Asplenia, HIV /AIDS , primary immunodeficiency
•  Immunodeficiencies related to malignancies and transplantation
•  Immunodeficiencies related to use of immunosuppressive drugs / systemic steroid

c. Chronic disease

•  Chronic cardiac, pulmonary, liver or renal disease
•  Diabetes mellitus or cerebrospinal fluid leakage

d. With cochlear implants

(Essential hypertension per se is not considered as a high-risk condition)

Patients with high-risk conditions should consult their doctors before receiving pneumococcal vaccine.

In addition to being vaccinated with preventive vaccines, it is necessary to build up good body immunity. In particular, it is important to always maintain a balanced diet, engage in moderate exercise, and have adequate rest. Make sure to pay attention to personal hygiene and keep the environment clean. Remember to cover your nose and mouth when sneezing or coughing and wash your hands frequently.