Who is at risk?
Pneumococcal infections can occur at any time of the year and not just during the winter.
All age groups are at risk. However, infants under the age of two years are more likely to suffer from pneumococcal infections compared to other children1,2.
Children with poorly functioning immune systems or with other certain underlying medical conditions are more prone to the effects of pneumococcal infection but the vast majority of disease will actually occur in otherwise healthy youngsters3.
The presence of the pneumo bug in the back of the nose or throat is very common. For example, a study in the UK published in 2005 showed that almost all families with young children carried it at any one time during the year4,5. In the majority of cases the bug will stay in the back of the nose or throat without causing any harm.
However, nearly all children will have had an ear infection by their third birthday and half of them will have another episode within two years6.
Before the pneumococcal conjugate vaccine was introduced into the UK's routine childhood immunisation programme, the pneumo bug was recognised as the most common cause of bacterial pneumonia in children under two years of age7. It was estimated that in the UK, 1 in 200 children were being hospitalised from pneumonia due to the pneumo bug before their fifth birthday8.
Although a very serious condition, meningitis of any type is rare. Based on pre-vaccination data from England and Wales, there were about 170 cases of pneumo meningitis and about 450 cases of pneumo bacteraemia reported in children under five throughout the UK per year9. This is widely accepted to be an underestimate of the true number of cases.
It was also estimated that 50 British children under five years of age die each year due to pneumo disease, and many, many more are left struggling with severe disabilities10.
The introduction of the pneumococcal conjugate vaccine into the routine childhood immunisation schedule in 2006 is expected to reduce the number of cases of invasive pneumococcal disease. The Health Protection Agency in England and Wales, and HPS in Scotland are responsible for monitoring the impact of the vaccine introduction, and as of June 2007 early results indicate a reduction in the number of cases of the disease. For England and Wales, further information can be found at the HPA website.
- Miller, E et al. Epidemiology of invasive and other pneumococcal disease in children in England and Wales 1996-1998. Acta Paed Suppl 2000; 435: 11-16
- Ispahani P et al. Twenty year surveillance of invasive pneumococcal disease in Nottingham: serogroups responsible and implications for immunisation. Arch Dis Child 2004; 89: 757-762.
- McIntosh et al. How many episodes of hospital care might be prevented by widespread uptake of 7 valent pneumococcal conjugate vaccine? Arch Dis Child 2003; 88: 859-861.
- Hussain M et al. A household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK setting. Epid Inf 2005; 133:891-898.
- Giebink S. The prevention of pneumococcal disease in children. NEJM 2001; 345: 1177-1182.
- Rovers MM et al. Otitis Media, Lancet 2004; 363: 465-73.
- Drummond P et al. Community acquired pneumonia - a prospective UK study. Arch Dis Child 2000; 83:408-412.
- Djuretic T et al. Hospital admissions in children due to pneumococcal pneumonia in England. J Infect 1998; 37:54-58
- Derived from Miller, E et al. Epidemiology of invasive and other pneumococcal disease in children in England and Wales 1996-1998. Acta Paed Suppl 2000; 435: 11-16
- Derived from McIntosh EDG, Booy R. Invasive pneumococcal diseases in England and Wales: what is the true burden and what is the potential for prevention using 7-valent pneumococcal conjugate vaccine? Arch Dis Child 2002; 86:403-406.
