Pneumococcal infections 

Introduction 

Pneumococcal disease

Professor Brian Duerden, CBE, explains how pneumococcal disease can cause pneumonia and other invasive infections. He describes the effects of the disease on older people and children, and what you can do to prevent it.

Media last reviewed: 30/04/2013

Next review due: 30/04/2015

Multidrug-resistant Streptococcus pneumoniae (MDRSP)

During the 1990s, the increasing levels of S. pneumoniae that had developed a resistance to three or more types of antibiotics was a major concern. These types of bacteria are known as multidrug-resistant Streptococcus pneumoniae (MDRSP).

MDRSP is a real concern because it is challenging to treat and carries a higher risk of causing complications.

Since the introduction of pneumococcal vaccines, fewer cases of infection have led to antibiotics being used less and the smaller chance of bacteria developing resistance to antibiotics.

However, data from 2008-09 suggest that levels of MDRSP are rising again, particularly a strain known as serotype 19A that is not covered by the PCV vaccine.

The ability for bacteria to become resistant to antibiotics is the reason why GPs are becoming increasingly reluctant to prescribe antibiotics for mild infections.

Pneumococcal infections are caused by the Streptococcus pneumoniae (S. pneumoniae) bacterium. They can be mild or severe. There are more than 90 different strains of S. pneumoniae bacteria, which are known as serotypes.

S. pneumoniae enters the human body through the nose and mouth.

The symptoms of a pneumococcal infection can vary depending on the type of infection you have. Common symptoms include a high temperature (fever) of 38°C (100.4°F) or above, aches and pains, and a headache.

Types of pneumococcal infection

Pneumococcal infections usually fall into one of two categories:

  • non-invasive pneumococcal infections – these occur outside the major organs or the blood and tend to be less serious
  • invasive pneumococcal infections – these occur inside a major organ or the blood and tend to be more serious

These are described in more detail below.

Non-invasive pneumococcal infections

Non-invasive pneumococcal infections include:

  • bronchitis – infection of the bronchi, the tubes that run from the windpipe down into the lungs
  • otitis media – ear infection
  • sinusitis – infection of the sinuses

Invasive pneumococcal infections

Invasive pneumococcal infections include:

  • bacteraemia – a relatively mild infection of the blood
  • septicaemia (blood poisoning) – a more serious blood infection
  • osteomyelitis – infection of the bone
  • septic arthritis – infection of a joint
  • pneumonia – infection of the lungs
  • meningitis – infection of the meninges, the protective membranes surrounding the brain and spinal cord

Who is at risk?

People with a weakened immune system are most at risk of catching a pneumococcal infection. This may be because:

  • they have a serious health condition, such as HIV or diabetes, that weakens their immune system
  • they are having treatment or taking medication that weakens their immune system, such as chemotherapy

Other at-risk groups include:

  • babies and young children under two years of age
  • adults over 65 years of age
  • people who misuse alcohol

Read more about the causes of pneumococcal infections.

Cases of invasive pneumococcal infection usually peak in the winter during December and January.

Treating pneumococcal infections 

Non-invasive pneumococcal infections are usually mild and go away without the need for treatment.

More invasive types of pneumococcal infections can be treated with antibiotics, either at home or in hospital.  

Read more about how pneumococcal infections are treated.

Pneumococcal vaccines

There are two different types of pneumococcal vaccine used:

  • pneumococcal conjugate vaccine (PCV), which is given to all children under two years of age as part of the childhood vaccination programme
  • pneumococcal polysaccharide vaccine (PPV), which is given to people aged 65 years or over and others who are at high risk

The PCV protects against 13 types of S. pneumoniae bacteria and the PPV protects against 23 types. It is thought that the PPV is around 50-70% effective at preventing more serious types of invasive pneumococcal infection.

Read about pneumococcal vaccination and when pneumococcal vaccination is used.

Outlook

The outlook for pneumonia in people who are otherwise healthy is good, but the infection can lead to serious complications in people who are very young, very old or have another serious health condition.

However, due to the introduction of the PCV in 2002, the number of people dying from complications that arise from pneumonia has fallen to around 7%.

The outlook for other types of invasive pneumococcal infections such as bacteraemia is generally good, although there is about a one in 20 chance that bacteraemia will trigger meningitis as a secondary infection.

Page last reviewed: 24/07/2012

Next review due: 24/07/2014

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