The classic symptoms of pneumococcal pneumonia include fever, cough, rust-colored sputum, chest pain, and shortness of breath/ShutterStock
Winter Summer Fall Spring, the pneumococcal bacterium is a bacterium that is always around.
What is important to know about the morbidity caused by this bacterium?
Who is the population that is at the highest risk of morbidity?
And what can be done to defend against it?
These questions will be answered by Dr. Regev Cohen, director of the infection prevention unit at Hillel Yaffe Hospital.
What is the pneumococcal bacterium?
Pneumococcus (Streptococcus pneumoniae) is a ball-shaped bacterium of the streptococcus family that is seen in the laboratory in the form of pairs or short chains. This bacterium is very common as a cause For invasive and non-invasive diseases in humans. In many cases, the bacterium is carried in the pharynx, especially in children, and in the joints it penetrates into nearby areas such as the sinus system, ears and lungs, causing local inflammation. It may also invade the bloodstream and even the meninges. The pneumococcal bacterium is one of the most common causes most for community-acquired bacterial pneumonia. In pneumonia, it is not always possible to isolate the causative agent, but when the causative agent can be isolated, pneumococcus will be found in high frequency.
Who is the main population carrying the pneumococcal bacterium and what are its modes of transmission?
The common mode of transmission of bacteria and viruses that cause For respiratory diseases, it is droplet (that is, small droplets of saliva that are released when coughing or sneezing), but since the main carriers are children, there can also be contact transmission (for example, when small children share toys and put them in their mouths). Most of the children who are carriers do not develop a disease, but they can to transfer the bacteria dropwise from their throat to their siblings, parents or grandparents.
The main mechanism for the bacteria to reach the lungs is by inhaling it from the pharynx area into the lungs.
Invasion of the bacterium into the lungs and bloodstream occurs more frequently among people suffering from damage to the immune system, such as patients with hematological malignancies, splenectomy patients, patients undergoing chemotherapy, AIDS patients.
Pneumonia is also common in situations where people are unable to clear secretions from the respiratory tract, such as patients with asthma or chronic lung disease or in people with difficulty coughing due to various disabilities, and also after viral infections.
In people suffering from an injury to the base of the skull with a spinal fluid leak, there can be penetration of the bacteria into the meninges in this way.
Can the pneumococcal bacterium cause disease only in humans?
The pneumococcal bacterium is a bacterium that causes disease only in humans, as far as is known today.
What are the types of morbidity that this bacteria causes and what is the most common morbidity among adults?
The main morbidity is of the upper respiratory tract such as sinuses, middle ears, and pneumonia.
At a lower rate, invasive disease such as bacteremia (invasion of the bacterium into the bloodstream) and meningitis occur at lower rates.
Rarer cases of pneumococcal disease such as inflammation of the peritoneum, arthritis or endocarditis are sometimes encountered.
The most common morbidity among adults is non-invasive pneumococcal pneumonia.
Which groups in the population are at the highest risk of pneumococcal pneumonia and why?
There is a group that is defined under high risk, these are elderly people - over 65 years of age, or younger people with underlying diseases such as diabetes, chronic lung disease due to smoking, heart failure or chronic liver disease.
There are people who are at a particularly high risk of developing invasive disease and pneumococcal pneumonia, including people with splenectomy, patients with sickle cell anemia, chronic kidney failure and dialysis patients, organ transplant recipients, bone marrow transplant recipients, HIV carriers and those suffering from hematological malignancies and people with spinal cord fluid leakage.
People without a spleen, for example, lose a very important filter of bacteria from the bloodstream and as soon as it is not present - the pneumococcal bacteria can cause a severe and rapid invasive disease.
In organ transplant recipients, there is a decrease in the function of the immune system due to deliberate suppression (by drugs to prevent transplant rejection).
Patients with autoimmune diseases treated with steroids or other drugs that affect the function of the immune system - are also at a higher risk of pneumococcal infection.
Is there a connection between morbidity caused by viruses (for example, the influenza virus or the corona virus) and the increase in the risk of pneumococcal pneumonia?
Absolutely yes, the flu virus for example can cause severe damage to the mucous membranes of the upper respiratory tract.
The destruction of the mucous membrane, which is a significant and important factor in resistance to infections, makes it very easy for bacteria, such as the pneumococcus or other bacteria found in the pharynx area, to invade the lungs.
The Spanish flu of 1918 did cause cases of pneumonia directly from the virus itself, but in practice, most of the deaths were actually caused by secondary bacterial infections, with the pneumococcal bacterium being one of the leading ones.
Even today we encounter cases of severe lung infections that appear several days after infection with the flu, and sometimes these cases end in tragedy.
If we refer to today's pandemic - in a study conducted at Laniado Hospital, a very high percentage of secondary bacterial infections were found during the hospitalization of corona patients. In the more advanced stages, when the patients are breathing, there is no doubt that pulmonary infections that may be caused by infection with bacteria acquired in the hospital, can cause even to death.
What are the symptoms of pneumococcal pneumonia?
The classic symptoms of pneumococcal pneumonia include fever, cough, rust-colored sputum, chest pain, and shortness of breath. Classically, this is an inflammation that involves an entire lobe of the lung, that is, a defined anatomical area of the lung, and in the event that the infection Involves the lining of the lung, it may cause local pain during inhalation. In older people, pneumonia can be manifested by confusion or a general decline in condition. Laboratory tests show evidence of inflammation. The picture as a whole is not fundamentally different from pneumonia caused by other bacteria, but there is a chest X-ray characteristic of a bacterial infection It.
How long does it usually take to heal or recover from pneumococcal pneumonia?
It very much depends on the patient - young patients can recover in about a week and gradually return to routine, in other patients the recovery period may be longer.
If a complication of the pneumococcal infection appears - for example, an accumulation of contaminated fluid in the lining of the lung, it is necessary to insert a drain into the pleural space (a space in the double-layered membrane that surrounds the lungs), and the duration of hospitalization will be extended.
Even patients who need artificial respiratory support may be hospitalized for longer periods.
Are there health effects or consequences even after recovery from pneumococcal pneumonia?
A severe bacterial infection can cause various complications.
Patients tend to be re-hospitalized after suffering a severe infection, the immune system has difficulty recovering and new infections may appear.
Chronic diseases, such as heart failure or diabetes can go out of balance and non-infectious complications such as the appearance of dangerous blood clots in the leg veins can also be seen.
Most of the morbidity will appear around the winter months, when there is activity of respiratory viruses/ShutterStock
Is it possible to get pneumococcal pneumonia only during the winter months?
Most of the morbidity will appear around the winter months, when there is activity of respiratory viruses such as influenza and RSV.
But the bacterium may find opportunities to invade the lungs, blood and meninges even outside the winter season.
If I've already had pneumococcal pneumonia, can I get it again?
Over 100 strains of the pneumococcal bacterium have been discovered so far, including strains that can cause an invasive disease and it is possible to be infected with a different strain each time, even after a previous infection.
Unlike most viruses, in bacterial diseases the body does not develop immunity over time and it is possible to get sick again and again.
What are the ways to protect yourself from pneumococcal pneumonia and its complications?
The best way to maintain health is to prevent the onset of diseases.
Maintaining a healthy lifestyle, a balanced diet, performing physical activity, avoiding smoking or obesity will lead to a decrease in the incidence of chronic lung diseases, malignancies, diabetes with its many complications, and so will the risk of contracting pneumococcal infections.
Vaccines against viral diseases - flu and corona and vaccines against the pneumococcal bacterium, may reduce morbidity and mortality from these pathogens.
What is important to you that whoever reads the article will take to heart?
According to the World Health Organization, the greatest contribution to improving life expectancy and quality of life, beyond sanitation and the supply of good drinking water, is reserved for vaccines.
We often cannot cure chronic diseases and therefore we must do everything in our power to reduce the risk of getting sick - for example encouraging people who are at increased risk to get vaccinated against the pathogens for which there is a vaccine against.
Since in my view preventive medicine is of the utmost importance, for people aged 65 and over or those who are at increased risk due to underlying diseases - it is recommended to consult with the family doctor, in order to understand the risks and minimize them as much as possible.
Served as a public service by Pfizer
For more information, consult your doctor.
For more information regarding pneumonia, pneumococcal pneumonia |
Pfizer Israel (pfizerisrael.co.il)
PP-PNR-ISR-0043
October 2023
In collaboration with Pfizer
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