Every year, there are numerous deaths from pneumococcal infections worldwide. More than half of those affected are children under the age of five. Children of this age are particularly at risk because your immune system is not fully developed. But also for people over 60 years and persons with chronic diseases, pneumococcal infections are often fatal. The most effective protection against pneumococcal infection is vaccination.
What are pneumococci?
Pneumococci are bacteria that belong to the large group of cocci (globular bacteria). Depending on the nature of the connection, a distinction is made between different subgroups: chain-shaped cocci are called streptococci, while an association of four cocci is called tetrakocci. Pneumococci belong to the subgroup of diplococci - their bacteria are stored in pairs.
Pneumococci can be the cause of serious infections. Pneumococcal diseases include pneumonia, meningitis, otitis media, sinusitis, and corneal inflammation (keratitis). If the bacteria pass into the bloodstream, it can also lead to blood poisoning (sepsis).
There are more than 90 different types of pneumococci - however, 23 species are responsible for over 90 percent of the diseases.
Typical symptoms of pneumococcal disease
Because pneumococci can cause many different diseases, there are no typical symptoms of pneumococcal disease. However, many pneumococcal infections are associated with high fever and chills. The following are the most common illnesses caused by pneumococci and their typical symptoms.
- Pneumonia: Pneumonia usually arises from an infection of the upper respiratory tract. It is associated with symptoms such as high fever, coughing and purulent sputum and chills. In older people, however, the typical symptoms such as fever are partly absent.
- Meningitis: A meningitis is usually preceded by a disease of the upper respiratory tract. Typical symptoms include headache, neck stiffness and fever, nausea and loss of consciousness or even loss of consciousness. In addition, those affected often react sensitively to light or noise. If a characteristic rash occurs at the same time, this indicates that the infection was caused by meningococci and not by pneumococci.
- Otitis media: Middle ear inflammation causes strong, pulsating earache and fever, nausea and vomiting. Often, those affected also report a hearing loss. A middle ear infection caused by bacteria such as pneumococci can also lead to a breakdown of the eardrum - however, this can usually be prevented by the timely administration of antibiotics.
- Sinusitis: Typical symptoms of sinusitis include fever, headache, and suppurated sinuses. In most cases, sinusitis is not caused by bacteria but by viruses.
- Corneal inflammation: Corneal inflammation of the eye causes reddening of the eye, a foreign body sensation, a deterioration in vision and severe pain.
- Heart muscle inflammation: A heart muscle inflammation is usually shown by symptoms such as general fatigue, headache and dizziness as well as nausea and loss of appetite. In addition, it may cause fever, arrhythmia, shortness of breath and a feeling of tightness in the chest.
- Blood poisoning: The typical symptoms of blood poisoning include high fever, which often runs in spurts, a fast pulse, accelerated breathing, confusion and a very low blood pressure. If pneumococcal septicemia is not treated promptly, a life-threatening septic shock can occur.
This is how you get infected with pneumococci
An infection with pneumococci is in most cases an endogenous infection. This means that the pathogens are not from the outside, but from the body's own flora. Endogenous infections occur mainly in a weakened immune system. The bacteria are usually transmitted beforehand by a droplet infection and then preferentially populate the nasopharynx. Symptoms of colonization of the body with pneumococci usually do not occur - only when the immune system is weakened and the bacterium spreads.
Smokers have a particularly high risk of pneumococcal infection. As tobacco smoke ruptures the uppermost cell layer of the respiratory tract, bacteria can more easily enter the nasopharynx. In addition, the self-cleaning of the respiratory tract is disturbed in smokers, since the work of the cilia is obstructed by the tobacco smoke.
Treatment of pneumococcal infection
Pneumococcal infections are treated with antibiotics - preferably with penicillin. An exception is pneumococcal meningitis, which is often treated with cephalosporins. If the pneumococci are resistant to penicillin, rifampicin or vancomycin may be used as an alternative.
Note, however, that pneumococcal strains that are resistant to antibiotics continue to increase. Therefore, the prevention of pneumococcal disease by vaccination is becoming increasingly important.
Especially for groups at risk such as over 60 years, vaccination is the effective protection against pneumococcal disease. For babies and toddlers since 2001, there is a separate active ingredient that protects against seven particularly dangerous for babies and toddlers pneumococcal strains.
The vaccine is a dead vaccine consisting of parts of the envelope of the bacteria. These parts, however, are unable to cause disease. After vaccination, the body forms antibodies to the vaccine. If you later become infected with pneumococci, the antibodies fight the bacteria and thus prevent the onset of a disease. The vaccine protection starts about three weeks after the vaccination.
A pneumococcal vaccine is usually well tolerated. Nevertheless, only a small proportion of vulnerable groups are vaccinated: around seven percent of them have effective vaccination coverage. The health insurance company covers the costs of the pneumococcal vaccine - if the vaccine is recommended for the respective group of people. The vaccination against pneumococci is possible throughout the year.
For whom is the pneumococcal vaccine useful?
The Standing Committee on Vaccination (STIKO) recommends a pneumococcal vaccine for the following groups:
- Persons over 60 years
- Babies and toddlers between two months and two years
- People with chronic diseases or immunodeficiencies such as diabetes, asthma, AIDS, COPD, etc.
In young and healthy people, however, a vaccination against pneumococci is usually not necessary, because the pneumococci are controlled by their immune system and outbreak diseases usually run without complications.
In babies, the pneumococcal vaccine is usually divided into four injections administered in the second, third and fourth months of life and between the eleventh and fourteenth months. With increasing age, the number of required doses of vaccine is reduced.
Effectiveness of vaccination in babies controversial
Especially with babies and toddlers should be noted, however, that the effectiveness of the vaccine in them is controversial. For example, it is reported from other countries that after vaccination, there was an increase in disease caused by a non-vaccine type of pneumococcal. Long-term studies on pneumococcal vaccination in infants are still pending.
How many vaccinations are needed?
In adults, a vaccine is enough for safe protection. In certain pre-existing conditions, the pneumococcal vaccine should, however, be refreshed every five to six years to continue to provide safe protection against a disease. These diseases include:
- congenital or acquired immune deficiencies with T and / or B-cellular residual function
- chronic kidney disease, nephrotic syndrome
Once a pneumococcal disease has survived, it provides no protection against further diseases.
Possible side effects of a pneumococcal vaccine
In pneumococcal vaccination, the vaccine is injected into the upper arm. Around the puncture site mild pain and redness can occur after vaccination. Normally, however, the symptoms disappear after one to two days. It can also lead to a general feeling of fatigue, gastrointestinal complaints or a slight increase in temperature. As a rule, further side effects are not expected.
In babies and toddlers is usually also expected with little side effects. In rare cases, however, it can lead to loss of appetite, disrespect, fever and drowsiness after vaccination.
Now do the test if a pneumococcal vaccine makes sense for you.