IPD

Pneumococcal bacteria may live in the nose and throat without causing symptoms. They can spread from person to person through respiratory droplets and secretions released during coughing, sneezing, or close contact.

The term invasive pneumococcal disease is used when the bacteria enter normally sterile areas of the body, such as the bloodstream or the fluid surrounding the brain and spinal cord.

IPD may cause serious conditions, particularly:

๐ Meningitis

๐ Bloodstream infection or bacteraemia

๐ Sepsis

๐ Pneumonia accompanied by bloodstream infection

Pneumococcus is also an important cause of non-invasive infections such as middle ear infections, sinusitis, and some forms of pneumonia.

Symptoms of Pneumococcal Infection

Symptoms and severity depend on the part of the body affected.

Infection of the Nervous System

When pneumococcal bacteria cause meningitis, children may experience:

๐ High fever

๐ Severe headache

๐ Nausea and vomiting

๐ Stiff neck

๐ Sensitivity to light

๐ Seizures

Meningitis can be more difficult to recognise in infants. Possible signs include:

๐ Irritability or persistent crying

๐ Unusual drowsiness

๐ Poor feeding or refusal to breastfeed

๐ Vomiting

๐ Seizures

๐ Reduced responsiveness

Without prompt treatment, pneumococcal meningitis may cause brain damage, hearing loss, long-term disability, or death.

Bloodstream Infection

Children with pneumococcal bloodstream infection may develop:

๐ High fever

๐ Irritability

๐ Unusual crying

๐ Drowsiness

๐ Rapid breathing

๐ Reduced alertness

Severe bloodstream infection may progress to sepsis, low blood pressure, shock, organ failure, or death.

The bacteria may also spread through the bloodstream to other organs, including the brain, lungs, bones, and joints.

Upper Respiratory and Ear Infections

Pneumococcal infection may cause middle ear infection or sinusitis.

Possible symptoms include:

๐ Fever

๐ Ear pain

๐ Irritability

๐ Ear discharge

๐ Reduced hearing

๐ Nasal congestion or facial discomfort

If a middle ear infection is not treated appropriately, complications may include:

๐ Chronic ear discharge

๐ A perforated eardrum

๐ Hearing impairment

๐ Delayed speech and language development

๐ Spread of infection to nearby tissues or the brain

Lower Respiratory Infection

Pneumococcal pneumonia may cause:

๐ Fever

๐ Cough

๐ Rapid breathing

๐ Shortness of breath

๐ Chest discomfort

๐ Laboured breathing

๐ Reduced feeding in infants

Severe cases may require oxygen therapy, mechanical ventilation, or intensive hospital care.

Children at Higher Risk of IPD

Although any child can develop pneumococcal disease, the risk is higher among:

๐ Children younger than two years old

๐ Children with chronic heart disease

๐ Children with chronic lung disease

๐ Children with chronic liver disease

๐ Children without a spleen or whose spleen does not function properly

๐ Children attending nurseries or daycare centres

๐ Children with weakened immune systems

๐ Children with cerebrospinal fluid leakage

๐ Children with cochlear implants

How Is IPD Treated?

Pneumococcal infections are generally treated with antibiotics.

Mild or Localised Infections

Less severe infections, such as selected cases of middle ear infection or sinusitis, may be treated with oral antibiotics when considered necessary by a doctor.

Treatment depends on:

๐ The child’s age

๐ The location and severity of the infection

๐ Previous antibiotic use

๐ Local patterns of antibiotic resistance

๐ The child’s underlying health conditions

Invasive Pneumococcal Disease

Children with IPD usually require hospital admission.

Treatment may include:

๐ Intravenous antibiotics

๐ Intravenous fluids

๐ Oxygen support

๐ Medicines to control seizures

๐ Treatment for low blood pressure or shock

๐ Respiratory support in severe cases

๐ Close monitoring for complications

Prompt treatment is essential, particularly when meningitis or sepsis is suspected.

Antibiotic Resistance

Although pneumococcal disease can be treated with antibiotics, some strains of Streptococcus pneumoniae have become resistant to commonly used medicines.

Antibiotic resistance means that bacteria adapt and are no longer effectively controlled by medicines that previously worked.

This may result in:

๐ More complicated treatment

๐ The need for stronger or alternative antibiotics

๐ Longer hospital stays

๐ A higher risk of complications

๐ Increased treatment costs

Antibiotics should therefore be used only when prescribed and should be taken for the complete recommended course.

How to Reduce the Risk of IPD in Children

1. Practise Good Hygiene

Teach children to:

๐ Wash their hands regularly with soap and water.

๐ Cover their mouth and nose when coughing or sneezing.

๐ Use a tissue or cough into the inside of the elbow.

๐ Avoid touching their eyes, nose, and mouth with unwashed hands.

2. Avoid Close Contact with Sick People

Children should avoid close contact with people who have fever, respiratory infections, or cold-like symptoms whenever possible.

Personal items such as drinking cups, spoons, bottles, and toothbrushes should not be shared.

3. Support Breastfeeding

Breast milk provides nutrients and antibodies that help support an infant’s developing immune system.

4. Avoid Unnecessary Exposure to Crowded Places

Infants and young children may be more easily exposed to respiratory droplets in crowded or poorly ventilated environments.

During outbreaks, avoid unnecessary visits to crowded places and maintain good indoor ventilation.

5. Receive Pneumococcal Vaccination

Pneumococcal vaccination is one of the most effective ways to reduce the risk of serious pneumococcal disease.

Vaccination may begin from approximately two months of age. A commonly used infant schedule includes doses at:

๐ Two months

๐ Four months

๐ Six months

๐ A booster dose between 12 and 15 months

The exact number of doses and timing depend on the vaccine product, the child’s age, previous vaccination history, medical risk factors, and the immunisation schedule recommended by the doctor.

When to Seek Immediate Medical Attention

Parents should seek urgent medical care when a child develops:

๐ High fever with unusual drowsiness

๐ Difficulty waking or reduced responsiveness

๐ Stiff neck

๐ Seizures

๐ Rapid or difficult breathing

๐ Blue lips or skin

๐ Refusal to drink or breastfeed

๐ Repeated vomiting

๐ A widespread purple or red rash

๐ Signs of shock, such as cold skin, weakness, or reduced consciousness

IPD can progress rapidly. Early diagnosis and prompt treatment can reduce the risk of severe complications, permanent disability, and death.

 

Reference:

Bangphai Hospital IPD

ArokaGO Providers Bangphai Hospital