Pneumococcal Disease

Pneumococcal [noo-muh-KOK-uhl] disease is a name for any infection caused by bacteria called Streptococcus pneumoniae, or pneumococcus. Pneumococcal infections can range from ear and sinus infections to pneumonia and bloodstream infections. Some of these infections can be life threatening, especially when the bacteria invade parts of the body that are normally sterile, like the lining of the brain and spinal cord.

Anyone can get pneumococcal disease, but some people are at increased risk. Being of a certain age or having certain medical conditions can increase a person’s odds for infection. Children at increased risk for pneumococcal disease include:

  • Those younger than 2 years old
  • Chronic heart, lung, or kidney disease
  • Cerebrospinal fluid (CSF) leak – a health problem where fluid surrounding and protecting the brain and spinal cord leaks
  • Cochlear implant (a small electronic device that is surgically implanted to help people with severe hearing loss be able to hear)
  • Diabetes
  • HIV infection, cancer, solid organ transplant, or another condition or taking medicine that weakens the immune system
  • Nephrotic syndrome (a kidney disorder)
  • Sickle cell disease, a damaged spleen, or no spleen

Adults 65 years or older are also at increased risk for pneumococcal disease. All adults who smoke and / or have chronic obstructive lung disease, emphysema, and asthma, are at risk of getting infected regardless of their age. Other medical conditions which predispose to pneumococcal disease include:

  • Alcoholism
  • Chronic heart, lung, kidney, or liver disease
  • Cochlear implant
  • CSF leak after a head or spine injury, for instance
  • Diabetes
  • HIV infection, cancer, solid organ transplant, or another condition or taking medicine that weakens the immune system
  • Nephrotic syndrome
  • Sickle cell disease, a damaged spleen, or no spleen

Human hosts spread pneumococcal bacteria to others through direct contact with respiratory secretions, like saliva or mucus. Many people, especially children, have the bacteria in their nose or throat at one time or another without being ill. This is “carriage”.

Pneumococcal disease is a spectrum that includes many different types of infections. Symptoms depend on the part of the body that is infected. Most pneumococcal infections are mild. However, some can be deadly or result in long-term problems if the bacteria colonise your blood. This may lead to loss of limb(s), kidney failure, damage to vital organs such as the brain, lungs, or heart.

Vaccines are the best way to prevent against pneumococcal disease. Here in Malaysia, there are 2 kinds of vaccines available:

  • Pneumococcal conjugate vaccines (PCV-10 and PCV-13)
  • Pneumococcal polysaccharide vaccine (PPSV-23)

The PCV-10 vaccine (Synflorix) protects against 10 serotypes of the bacteria (covering serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F and 23F) and has been implemented as part of the mandatory National Immunisation Programme for Malaysian children since November 2020.

Here at Dr. Tan & Partners we have PCV-13 vaccine (Prevnar) which covers an additional three serotypes (19A, 6A, and 3) in addition to PPSV-23 vaccine (Pneumovax) which protects against 23 serotypes. Kindly make an appointment with one of our Doctors to find out which vaccine is suitable for you. It is also important to get an influenza vaccine every year because having the flu increases the likelihood of getting pneumococcal disease.


National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases (2022) Pneumococcal Disease, www.cdc.gov/pneumococcal, accessed 5th January 2023.

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