Pneumococcal Infections on the Rise: Are you at risk?
Pneumococcal disease is a leading cause of vaccine preventable deaths globally, each year
Tweet-- Rahul Gupta, a 55 year old, well-established business entrepreneur with an active social life developed what he thought was a viral infection--a cough, fever and general weakness. But on the third night his wife panicked when he had sudden onset of high-grade fever with shaking chills and a productive cough. He later became breathless and turned gray and had to be shifted to the emergency department where he was found to be in a state of shock. What his wife didn't know was that Rahul had acquired a serious blood infection (sepsis), which is caused by a bacterium Streptococcus Pneumoniae. His blood and lungs were infected with this bacterium. Rahul was a healthy man, with no previous record of long-term respiratory ailments, though he was a heavy smoker and a diabetic.
Like the Gupta family, most of us are not aware of this potentially life threatening disease and its implications. Thousands of other such families have endured similar ordeals when their parents or spouses were infected with pneumococcal bacteria. Many others have watched their close relatives suffer the ravages of this disease with several trips in and out of the hospital, weeks of illness, months of recovery. The anxiety, trauma and the financial burden due to piling up medical bills and hospitalization costs have not been measured in our country. These consequences are due to a lack of awareness on the burden of vaccine preventable diseases, which constitute for a high morbidity and mortality rate among certain adults as well as the elderly population in India.
Did you know?
Ø Pneumococcal bacterium kills 1.6 million people annually worldwide
Ø Pneumococcal disease causes more deaths than any other vaccine preventable diseases including Hepatitis B
Ø Major clinical syndromes caused by pneumococci include pneumonia (lungs), bacteremia (blood) & meningitis (brain)
Ø Pneumococci are transmitted by direct contact with respiratory secretion from patients and healthy carriers.
Ø In India, Streptococcus pneumoniae is the most common cause of community acquired pneumonia (CAP), identified in 35.8% of isolates
Ø Pneumococcal Vaccine can help prevent Pneumococcal infection amongst adults.
Streptococcus pneumoniae is the most common cause of community acquired bacterial pneumonias. According to the Centres for Disease Control and prevention (CDC), recommendations of the Advisory Committee on Immunization practices (ACIP) at least 500,000 cases of pneumococcal pneumonia are estimated to occur annually in the United States. Streptococcus pneumoniae accounts for 25-35% of all the community acquired bacterial pneumonias in persons who require hospitalization. Pneumococcal infection causes an estimated 40,000 deaths annually in the United States.
There is high mortality reported with these Streptococcus pneumoniae infections. Despite appropriate therapy and intensive care support the over all mortality rate is 15-20%. This rate amongst the elderly is as high as 30-40%.
To make matters even more complicated, there are reports of multi drug resistant strains of Streptococcus pneumoniae not only from US but also from the Asia Pacific region. What this translates into is that even after proper diagnosis, doctors in the best of centers might find it difficult to treat this disease. Resistance to several drugs like Penicillin, Cotrimoxazole and Erythromycin has been reported.
Despite the many advances in modern medicine, each year thousands of people in India die from diseases that could be prevented by vaccines. This illustrates the urgent need for further epidemiological and disease burden studies on vaccine preventable diseases. Instituting properly designed clinical trials would provide information both on vaccine efficacy and disease burden In India.
Anyone can get pneumococcal disease. However some groups are more at risk for these infections and its complications.
So most often the obvious question that would arise in your mind might be, am I really at risk of acquiring pneumococcal infections?
The answer is you could be at risk,
- If you are an elderly person;
- If you have a chronic illness such as lung, heart, liver, kidney disease,
- If you have Diabetes mellitus
- If you have a weak immune system due to cancer, leukemia, HIV infection
- If you are suffering from sickle cell disease or without a functioning spleen (Asplenia);
Older adults over the age of 50 years, or anyone with certain underlying chronic conditions, as well as those who are Immuno-compromised are more vulnerable to pneumococcal infections and its severe complications.
So if you check positive for any of the above mentioned, then consult your physician today and find out how if you are at risk and get to know about pneumococcal disease and its prevention.
If I am at risk how do I help protect myself?
Pneumococcal disease amongst adults and elderly can be prevented with the administration of the appropriate Pneumococcal vaccine. The vaccine can help prevent Pneumococcal infection. Vaccines are not only cost effective but also an efficient intervention to reduce the impact of many infectious diseases.
There is not enough research data available on the incidence rates and adult deaths attributable to pneumococcal disease in India. But the problem at hand can be estimated by glancing at the corresponding figures as per US Data on pneumococcal vaccine coverage. In 2000, only 53 percent of general population 65 years of age and older reported having ever received pneumococcal vaccine.
This falls short of the Healthy People 2010 goal of vaccinating 90 percent of adults 65 years of age and older against pneumococcal disease, according to "Health, United States 2002," a publication of the National Center for Health Statistics, published by the CDC.
Cost–effective interventions like vaccination schemes can help reduce the burden of pneumococcal disease. When the burden of vaccine preventable diseases is substantial, educating doctors on the importance of initiating vaccination in appropriate patients could translate into savings with respect to worker productivity and medical costs. Most importantly, it can also help save lives.
Although we’ve worked to protect our children from vaccine-preventable diseases, millions of Indian adults are not protected. The lack of an Adult Immunization Program (AIP) is far reaching. Health officials, doctors, nurses, scientists and vaccine makers have recognized this problem for years. There is a need for experts and key decision makers to join in deliberations and create forums to discuss potential solutions.
**References: Centre for Disease Control (CDC); www.vaccineinformation.org; www.nifd.gov; ACIP Recommendations
Notes to Editor
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