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Pneumococcal Disease

Pneumococcal infection is a major cause of morbidity and mortality worldwide. It is a bacterial infection that causes pneumonia, meningitis, bacteraemia and other life-threatening ailments. Serious pneumococcal infections are a global health problem, but they can be prevented with vaccination.

Update: You can book a pneumococcal vaccination at a participating CHAS GP clinic here.

Pneumococcal Disease Causes and Risk Factors

Pneumococcal disease (PD) is caused by a bacterium called Streptococcus pneumonia, which is also known as pneumococcus. There are more than 90 serotypes of this bacterium.

Pneumococcus can attack different parts of the body and cause serious infection of the following systems:

• Lungs (pneumonia)

• Blood (bacteraemia)

• Coverings of the brain and spinal cord (meningitis)

• Middle ear (acute otitis media)

It is common for people, especially children, to carry pneumococcus in their nose and throat. The bacteria can spread from person to person by:

• Direct contact

• Droplets from an infected person through coughing or sneezing

• Articles contaminated with infected droplets

Not everyone exposed to the bacteria develops the disease. Some people become carriers, while others progress to develop the infection.

Although anyone can get pneumococcal disease, those at particularly high risk are infants and young children, adults who are 65 and older and individuals with chronic medical illnesses or weakened immune systems.

Related: Infectious Diseases

Pneumococcal Disease Signs and Symptoms

Children under the age of 5 and adults aged 65 years and above, are among those who are at highest risk for pneumococcal disease. Within three days of becoming infected the following signs and symptoms may appear.

Symptoms can vary based on the systems affected.

Bacteraemia — infection in the blood causing high fever and non-specific signs of illness
Meningitis — infection around the brain causing fever, severe headache, vomiting, nausea, photophobia (avoidance of bright light owing to pain) and/or stiffness of the neck. Infants often have fever and non-specific signs of illness
Pneumonia — infection in the lungs causing fever, chills, cough, chest pain and rapid breathing
Acute otitis media — infection in the ear causing ear pain and fever
Sinusitis — infection in the sinuses causing low-grade fever, runny nose and cough

Pneumococcal Disease Complications

• Pneumococcal pneumonia may lead to a lung abscess and pericarditis (inflammation of the sac surrounding the heart).

• Pneumococcal meningitis may cause significant learning disabilities, speech delays, paralysis and even death.

• Recurrent otitis media can cause hearing impairment.

Pneumococcal Disease Diagnosis

For non-invasive pneumococcal disease, such as pneumonia or otitis media, a physical examination and X-rays are required. Invasive pneumococcal disease is diagnosed by isolating the bacteria from the blood, spinal fluid, lungs or other body fluids.

Pneumococcal Disease Treatment

Prompt treatment with antibiotics, such as penicillin, is usually effective. However, in recent years, treatment has become more challenging with the emergence of strains resistant to antibiotics, particularly penicillin. In this case, a longer hospital stay, together with expensive alternative therapy, may be needed.

Related: About Antibiotics

Pneumococcal Disease Vaccines

Vaccination

Vaccination is generally the safest and most effective way to protect young children, older adults and those with specific medical conditions against pneumococcal disease. There are several types of pneumococcal vaccines described in the section below.

Babies need a total of 3 doses of PCV10 or PCV13 during their first year of life.
- At 4, 6 and 12 months of age. Children who fall behind should be given catch-up vaccination through to 59 months of age.
For seniors 65 & above, 2 pneumococcal vaccines provide life-long protection.
- 1 dose of PPSV23 and
- 1 dose of PCV13
People with specific medical concerns such as diabetes or chronic diseases of the heart, lungs, liver and kidneys as well as immunocompromised patients also require 2 pneumococcal vaccine doses.
- 1 dose of PPSV23 and
- 1 dose of PCV13 at any time and
- an additional dose of PPSV23 to be given after the age of 65

Pneumococcal Polysaccharide Vaccine (PPSV23)

This protects against 23 pneumococcal serotypes.

Pneumococcal Conjugate Vaccine (PCV13)

This protects against 13 pneumococcal serotypes.

Pneumococcal Conjugate Vaccine (PCV10)

This protects against 10 pneumococcal serotypes.

Refer to this table for the National Childhood Immunisation Schedule or ask your child's doctor for more details. The vaccine may cause mild fever and some soreness around the site of injection, which usually lasts only a short time.

Subsidised Pneumococcal Vaccinations

Fully subsidised for all Singaporean children at CHAS GP clinics and polyclinics.
Highly subsidised for eligible Singaporean adults at CHAS GP clinics and polyclinics

MediSave can be used to offset the remaining cost of Pneumococcal Vaccinations for eligible Singaporeans (Citizens and Permanent Residents). Up to $500/$700 per year per account can be used to pay for pneumococcal vaccinations for those in high-risk groups as indicated above.

Click here for more information on subsidies available, other vaccine-preventable diseases and frequently asked questions.

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This article was last reviewed on Wednesday, November 09, 2022