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Pneumococcal infection - including symptoms, treatment and prevention

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae, also known as pneumococcus (plural ‘pneumococci’). Pneumococci are commonly found in the upper respiratory tract of healthy people throughout the world.

There are many different types (serotypes) of pneumococci. Serotype refers to groups of microorganisms that are extremely closely related, but can be distinguished by having slightly different antigens (a foreign substance which causes the body to produce antibodies) or causing the body to produce slightly different antibodies.

Although anyone can get pneumococcal disease, it tends to occur in the elderly or in people with serious underlying medical conditions. The following groups are at higher risk:

  • children under 2 years of age
  • children in group childcare
  • Aboriginal and Torres Strait Islander people.

Pneumococcal pneumonia is a serious infection of the lungs which can be fatal, especially in the elderly or infants. Outbreaks of pneumococcal pneumonia are rare. When an outbreak does occur, it is usually in adults living in crowded, substandard conditions.

Invasive pneumococcal infection is a notifiable condition1

How pneumococcal infection is spread

Pneumococcal infection is spread when an infected person talks, coughs or sneezes small droplets containing infectious agents into the air. The droplets in the air may be breathed in by those nearby. Infection may be spread by contact with hands, tissues and other articles soiled by infected nose and throat discharges. Pneumococcal infections are more common during the winter and may be triggered by viral infections.

Signs and symptoms

Infections usually involve the:

  • lungs
  • middle ear
  • sinuses
  • bloodstream
  • meninges, which are the lining of the brain and spinal cord (causing meningitis).

Pneumococcal pneumonia

Symptoms of pneumococcal pneumonia may include:

  • fever
  • chills and shaking
  • chest pain when breathing in or out
  • shortness of breath
  • cough
  • blood-stained or ‘rusty’ sputum (phlegm)
  • drowsiness (excessive sleepiness) or confusion are common symptoms in the elderly.

Pneumococcal meningitis

People with pneumococcal meningitis often have:

  • high fever
  • headache
  • stiff neck
  • nausea and vomiting
  • photophobia (discomfort when looking at light).

The classic symptoms may be difficult to detect in infants and the child may only appear to be inactive, irritable, feeding poorly and may be vomiting.

Diagnosis

Pneumococcal infection is diagnosed by microscopic examination and growth of the bacteria from blood, sputum or other specimens. PCR (polymerase chain reaction) testing in a pathology laboratory is sometimes used.

Incubation period

(time between becoming infected and developing symptoms)

Usually 3 to 4 days, but can vary from 1 to 10 days.

Infectious period

(time during which an infected person can infect others)

Effective antibiotic therapy makes people non-infectious within 24 hours. There is no need to give antibiotics to contacts who are not sick. A contact is any person who has been close enough to an infected person to be at risk of having acquired the infection from that person.

Treatment

Effective antibiotic therapy is available.

Prevention

  • Exclusion from work or school is not necessary. The person can return when he or she feels well. It is not necessary to give antibiotics to contacts in school or childcare centres if they are not sick.
  • There are vaccines available to prevent Streptococcus pneumoniae infection. These vaccines protect against the most common serotypes that cause infection. There is no vaccine available to protect against all of the known serotypes, so vaccination will not provide complete protection. Immunisation is routinely given to all children through the National Immunisation Program. The first dose of pneumococcal vaccine, in combination with other vaccines, is now recommended to be given at 6 weeks of age. Vaccination is recommended for people at an increased risk of getting pneumococcal disease. See the Pneumococcal vaccines page for more information.

Useful links


1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.

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