Pneumococcal bacterial infection: What it is and how to prevent related diseases

Invasive Pneumococcal diseases (IPDs) IPD is associated with high mortality in children under five years of age, resulting in 14 percent of deaths in India.
pneumonia, meningitis and other IPDs are often fatal and associated with high mortality in children.
pneumonia, meningitis and other IPDs are often fatal and associated with high mortality in children.
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Children under five years of age, especially those aged two years or under, face a high risk of pneumococcal disease, which is caused by infection of a bacteria -- Streptococcus pneumoniae, also known as pneumococcus. This bacterial infection can lead to a range of disease conditions, including pneumonia, meningitis (inflammation of the tissues surrounding the brain and spinal cord), or blood infections, collectively known as Invasive Pneumococcal Disease (IPD).

IPD is associated with high mortality in children under five years of age, resulting in 14 percent of deaths in India. The latest available study published by UNICEF estimates that 0.105 million deaths in children under five years of age in India are caused by pneumococci. The World Health Organization (WHO) states that India accounts for 36 percent of the total burden of clinical pneumonia in the WHO South East Asia region.

IPDs are also found in adults. In 2018, the incidence of pneumococcal disease in India was 31.3 percent for adults aged 60 and older, 22.7 percent for adults aged 44–60, and 13.9 percent for adults aged 18–44. 

Children under 5, especially those under 2, are at the highest risk of developing and dying from pneumococcal disease. Other risk factors include compromised immune systems, malnutrition, poverty, air pollution, and exposure to indoor smoke. 

The overall mortality rate for pneumococcal pneumonia in India is 14–30%, and can reach up to 47% in severe cases. The mortality rate for invasive pneumococcal disease (IPD) is 20–50%, which is high for developing countries. 

Another major risk that is emerging now in countries like India is the antibiotic resistance to certain strains of the bacteria. This makes it very difficult to treat the disease once infected.

A strain means nothing but a genetic or structural variant or subtype of a microorganism -- the bacteria. Since these are very dynamic, researchers always explore a wide coverage such strains while developing vaccines.

Vaccination

Taking the higher risk factors of post infection treatments, medical experts increasingly stresses the need of prevention through vaccination.

According to Dr. Vijay Yewale, Pediatrician, Yewale Hospital in Mumbai, immunization offers an important protective solution for parents to fight off pneumococcal-related diseases such as pneumonia and meningitis, especially among children.

"Considering the challenges in diagnosing and treating such diseases, there is a clear need for advanced vaccines with a wider representation of relevant pneumococcal bacteria strains. This in turn helps provide broader protection against pneumococcal disease amongst children,” Yewale says.

The pneumococcal conjugate vaccines (PCV) are available in India. These shots are part of the government’s national immunization program to reduce childhood mortality in the country. However, it is important to consult a doctor to ensure that vaccinations are administered at the correct time.

In addition government programmes, there certain health charities working in the field PCVs. The Indian unit of John Snow, Inc. (JSI), a health care consulting and research organisation dedicated to improving health conditions of individual and communities, especially the underserved, works in this area in the country. This organisation supports the national and state governments to monitor the implementation of the vaccine and ensure that children receive it.

How do the shots help  

Vaccination can protect against some of these infections and can prevent complications in children. It helps address pneumococcal bacterial infections, including pneumonia and meningitis, for which children under two years of age are most at risk.

Latest technologies, broader coverage of strains

One of the latest technologies, which was recently made available in India by the US drugs and vaccines maker Abbott is a 14 strains shot -- PneumoShield 14. This offers a much broader protection than current pneumococcal vaccines in India.

This Pneumococcal Conjugate Vaccine is advised for children over 6 weeks of age.

A conjugate vaccine is a distinct type of vaccine that combines a part of the bacteria with a protein to make it work better. This helps the immune system recognise and fight off the bacteria more effectively, making it stronger against certain infections, which can result in severe diseases, especially among children.

According to Abbott, the new technology (PCV-14) vaccine protects against five more strains than the PCV 10, and two more strains than the PCV 13 vaccines that are currently used in India. The recommended immunisation schedule for PneumoShield 14, which is administered via intramuscular injections, is at 6, 10, and 14 weeks.

"This innovation offers broader protection potential against 14 pneumococcal strains in circulation, which cause the majority of pneumococcal-related diseases in India," says Abbott India's Managing Director Swati Dalal.

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