August 2001

Pneumonia

What is Pneumonia?

Pneumonia is a lung disease that can be caused by a variety of viruses, bacteria, and sometimes fungi. The U.S. Centers for Diseases Control and Prevention (CDC) estimate nearly 90,000 people in the United States died from one of several kinds of pneumonia in 1999. In the United States, pneumonia is the fifth leading cause of death [Natl Vital Stat Report 47 (25), 10/5/1999]. Rates of infection are three-times higher in African Americans than in whites and are 5- to 10-times higher in Native-American adults and 10-times higher in Native-American children [J Infect Dis;170:368-76, 1994].

On an international scale, acute respiratory infection ranks as the third most frequent cause of death among children less than 5 years old and was responsible for approximately 3.5 million deaths in 1998.

What is Pneumococcal Pneumonia?

Pneumococcal pneumonia is an infection in the lungs caused by bacteria called Streptococcus pneumoniae. S. pneumoniae, also called pneumococcus, can infect the upper respiratory tracts of adults and children and can spread to the blood, lungs, middle ear, or nervous system. CDC estimates S. pneumoniae causes 40,000 deaths and 500,000 cases of pneumonia annually in the United States. The yearly incidence of pneumococcal pneumonia is twice as high in African Americans than in whites and is responsible for 3,000 cases of meningitis (inflammation of spinal cord membranes), 50,000 cases of bacteremia (bacteria in the blood), and 7 million cases of otitis media (inner ear infection) [JAMA; 285:1729-1735, 2001].

According to the World Health Organization, S. pneumoniae is the leading cause of severe pneumonia worldwide in children younger than 5 years old, causing more than 1 million deaths in children each year [Pneumococcal Vaccines: WHO Position Paper: Wkly Epidemiol Rec, Vol 74, 177-183, 1999].

Pneumococcal pneumonia primarily causes illness in children younger than 2 years old and adults 65 years of age or older. The elderly are especially vulnerable to getting seriously ill and dying from this disease. In addition, people with certain medical conditions such as chronic heart, lung, or liver diseases or sickle cell anemia are also at increased risk for getting pneumococcal pneumonia as are people with HIV infection or AIDS or people who have had organ transplants and are taking medicines that lower their resistance to infection.

How is Pneumococcus Spread?

The noses and throats of up to 70 percent of healthy people contain pneumococcus at any given time. It is spread from person to person by coughing, sneezing, or close contact. Researchers don't know why it suddenly invades the lungs and the bloodstream to cause disease.

What are the Symptoms of Pneumococcal Pneumonia?

Pneumococcal pneumonia may begin suddenly, with a severe shaking chill usually followed by

There may be other symptoms as well.

In an otherwise healthy adult, pneumococcal pneumonia usually involves one or more parts of the lungs, known as lobes. Thus, it is sometimes called lobar pneumonia. The remainder of the respiratory system is comparatively not affected. In contrast, infants, young children, and elderly people more commonly develop a relatively mild infection in other parts of the lungs, such as around the air vessels (bronchi) causing bronchopneumonia.

How is Pneumococcal Pneumonia Diagnosed?

A doctor or other health care provider diagnoses pneumonia based on

Because a number of bacteria, viruses, and other infectious agents can cause pneumonia, if you have any of the symptoms, you should get diagnosed early and start taking the right medicine if you have any of the symptoms. The presence of S. pneumoniae in the blood, saliva, or lung fluid helps lead to a diagnosis of pneumococcal pneumonia.

How is Pneumococcal Pneumonia Treated?

Health care providers usually prescribe antibiotics, such as penicillin, to treat this bacterial disease. The symptoms of pneumococcal pneumonia usually subside within 12 to 36 hours after treatment has begun. Bacteria such as S. pneumoniae, however, are resisting and fighting off the powers of antibiotics to destroy them. Such antibiotic resistance is increasing worldwide because these medicines have been overused or misused. Therefore, if you are at risk of getting pneumococcal pneumonia, you should talk with your doctor about taking steps to prevent it.

Can Pneumococcal Pneumonia be Prevented?

The pneumococcal vaccine is the only way to prevent getting pneumococcal pneumonia. Vaccines are available for children and adults.

The CDC National Immunization Program (NIP) recommends that you get immunized against pneumococcal pneumonia if you are in any of the following groups.

In February 2000, the U.S. Food and Drug Administration approved a pneumococcal vaccine for use in toddlers and children. It is the first pneumococcal vaccine approved for children younger than 2 years old [http://www.fda.gov/cber/inside/annrpt.htm,: CBER Annual Report FY2000 Issued:01-08-01, Posted: 03-15-01, Updated: 04-10-01]. NIP recommends that all children ages 2 to 23 months old get this vaccine.

Does Pneumococcal Pneumonia Cause Complications?