Facts About Pneumococcal Virus:

 

Definition

Pneumococcal disease is an infection caused by bacteria, Streptococcus pneumoniae, that can attack different parts of the body.  Pasteur first isolated the bacterium, also called pneumococcus, in 1881 from the saliva of a patient with rabies.  Streptococcus pneumoniae bacteria are lancet-shaped, gram positive, faculative anaerobic organisms (Pneumococcal Disease, 2012).  Most S. pneumoniae serotypes have been shown to cause serious disease, but only a few serotypes produce the majority of pneumococcal infections.  The bacteria can cause serious infections of the lungs (pneumonia), the bloodstream (bacteremia), and the covering of the brain (meningitis).

 

 

Symptoms

Pneumococcal pneumonia is the most common clinical presentation of pneumococcal disease among adults.  The incubation is short, about 1-3 days.  Symptoms generally include an abrupt onset of fever and chills or rigors.  Other common symptoms include pleuritic chest pain, cough productive of mucopurulent , rusty sputum, dyspnea (shortness of breath), tachypnea  (rapid breathing), hypoxia (poor oxygenation), tachycardia (rapid heart rate), malaise and weakness.  Nausea, vomiting and headaches occur less frequently (Pneumococcal Disease, 2012).  If left untreated, this toxic illness can progress to acute respiratory failure, septic shock, multiorgan failure and death within several days from onset (Van der Poll & Opal, 2009).  According to the Illinois Department of Health, pneumococcal pneumonia is a serious illness and accounts for 10-25 percent annually of all pneumonias and nationally, about 40,000 people die each year as a result of this disease (Pneumococcal Disease).  This illness is particularly dangerous for the very young, the elderly and persons with certain high risk conditions such as decreased immune function from disease or drugs, functional or anatomic asplenia, chronic heart, pulmonary, liver or renal disease, and smoking cigarettes.

 

Transmission modes

 

S. pneumoniae is a human pathogen and the reservoir for pneumococci is the nasopharynx of asymptomatic human carriers.  There is no animal or insect vector.  The transmission of S. pneumoniae occurs as a result of direct person-to-person contact via respiratory droplets and by autoinoculation in persons carrying the bacteria in their upper respiratory tract.  The pneumococcal serotypes most often responsible for causing infection, are those most frequently found in carriers.  The spread of the organism within a family or household is influenced by such factors as crowding, season, and the presence of upper respiratory infections or pneumococcal disease such as pneumonia or otitis media.  According to Van der Poll and Opal (2009), pneumococci are generally not regarded as highly contagious, and respiratory isolation of patients who are infected in the community or hospital settings is rarely indicated (p.1543).  Pneumococcal infections are more common during the winter and in the early spring when respiratory diseases are more prevalent.  The period of communicability for pneumococcal disease is unknown, but transmission can occur as long as the disease appears in respiratory secretions.

 

Treatment

Pneumococcal pneumonia is effectively treated with antimicrobial agents.  For best outcome, antibiotics are started as soon as possible.  Optimum supportive care with supplemental oxygen, ventilatory support, volume resuscitation and vasopressors are lifesaving (Van der Poll & Opal, 2009).  Physical and mental rest is important.  Supportive nutrition is necessary as well.  The diet should be simple and sustaining and fluids must be administered in copious amounts to aid in the disposal of toxins and to replace water lost by perspiration and rapid breathing.

 

Prevention

Getting vaccinated can prevent Pneumococcal pneumonia.  Getting the pneumococcal vaccine is the main way to reduce the chances of getting pneumococcal pneumonia.  Vaccines cannot prevent all cases of infection.  However, compared to people who do not get vaccinated, those who do and still get the pneumonia tend to have milder cases of the infection, pneumonia that does not last long and fewer serious complications.  One shot of the vaccine is good for at least five years of protection.

 

Vaccination Facts

Research studies support the use of pneumococcal vaccine to reduce morbidity and mortality in patients 65 years and older.  According to Ludwig et al. (2012) the use of polysaccharide vaccines have shown to be effective against invasive pneumococcal disease, caused by the S.pneumoniae bacteria.  Ridda and Musher (2012), also support the use of polysaccharide vaccine as a protective mechanism for older adults over 65 years.  According to Ridda and Musher (2012), streptococcus pneumonia is a major cause of morbidity and mortality worldwide, they recommend revaccination every five years to maintain blood antibody levels at a protective level.  Chang, Chou Liu , Yeh and Huang (2012) suggested vaccination with the pneumococcal vaccine for the elderly must be considered essential in preventing risk of mortality and hospitalization in the older adult patients.
 

 

References

 

 

Chang, Y. C., Chou, Y. J., Liu, J. Y., Yeh, T. F., & Huang, N. (2012). Additive benefits of pneumococcal and influenza vaccines among elderly persons aged 75 years or older in Taiwan–A representative population-based comparative study. Journal of Infection, 65(3), 231-238.  Retrieved from http://ezproxy.stevenson.edu:  2129/science/article /pii/S0 163445 312001260

Kishel, J. J., Maguire, M., Pankratz, L., & Julian, K. (2009). Implementing an electronically based,nurse driven pneumococcal vaccination protocol for inpatients. American Society of Health-System Pharmacists, 1304-1308.

Lin, C. J., Zimmerman, R. K., & Smith, K. J. (2013). Cost- effectiveness of pneumococcal and influenza. American Journal of Managed Care, pp. e30-37.

Ludwig, E., Ünal, S., Bogdan, M., Chlíbek, R., Ivanov, Y., Kozlov, R., ... & Uzaslan, E. (2012). Opportunity for healthy ageing: lessening the burden of adult pneumococcal disease in central and eastern Europe, and Israel. Cent Eur J Public Health, 20(2), 121-125.  Retrieved from http://ezproxy.stevenson.edu:2065/ehost/detail?sid=523a7c33-a013-4b87-8a06-35b4907629e9%40sessionmgr11&vid=1&hid=2&bdata =JnNpdGU9ZWhv c3QtbGl2 ZQ%3d%3d#db=mnh&AN=22966736

Pneumococcal disease (2012).  Epidemiology and prevention of vaccine-preventable diseases.  The pink book:  Course textbook (12th ed.).  Retrieved from www.cdc.gov/vaccines/pubs/pinkbook/pneumo.html

Pneumococcal disease.  Illinois department of public health, healthbeat.  Retrieved from www.idph.state.il.us/public/hb/hbpneumo.htm

Ridda, I., & Musher, D. M. (2012). Is there a potential role for protein-conjugate pneumococcal vaccine in older adults? The Australasian medical journal, 5(4), 231-235. doi 10.4066/AMJ.2012.1160

Robke, J. T., & Woods, M. (2009). A decade of experience with an inpatient pneumococcal vacciantion program. American Journal of Health-System Pharmacy, 148-152.

Van der Poll, T., Opal, S. (2009).  Pathogenesis, treatment and prevention of pneumococcal pneumonia.  Lancet, 374, 1543-1551.  Retrieved from jvsmedicscorner.com/Medicine_ files /Pneumoccoal%20pneumonia%2Review.pdf