Pneumococcal meningitis

Meningitis is the inflammation of the meninges (the membrane lining of the brain and spinal cord). It usually refers to infections caused by viruses, bacteria, fungi or other microorganisms.

Pneumococcal disease and risk

 The bacterium called “Streptococcus pneumoniae” or the “pneumococcus” is a leading cause of serious infections such as meningitis,pneumonia (inflammation in the lungs) and septicaemia (blood poisoning)[1] ,[2] in Australia. Pneumococcal meningitis and septicaemia are both life threatening diseases and need to be treated in hospital with intravenous antibiotics (antibiotics administered into a vein and into the circulating blood). The pneumococcus is also a common cause of otitis media[3] (middle ear infections) and sinsusitis. [pr1]   The pneumococcus is a significant cause of disease in Australia especially in the very young, the elderly and those with medical risk factors.[4]    Aboriginal and Torres Strait Islander people are at particularly high risk of pneumococcal disease.

Certain types of people are at increased risk from pneumococcal infection including people with recent head injuries or structural defects of the spine or skull, people with no spleen or depressed immune systems, people with certain medical conditions such as chronic diseases of the heart and lungs, cirrhosis, diabetes[5] and alcohol related problems. Children with recurrent middle ear infections are also at raised risk.

Certain environmental factors also put people at increased risk of pneumococcal disease.  For example children or infants who attend day care and adults who smoke are at greater risk of pneumococcal infections.[6]

How the pneumococcus is spread between people

There are over ninety different strains (serotypes) of pneumococcal bacteria.  The pneumococcus is often  carried in the upper respiratory tract and the back of the nose and throat of healthy children and adults.  The bacteria are spread from person-to-person through inhaling droplets from the respiratory tract[7] and through close personal contact. Many people naturally carry the bacteria in the back of their nose but few become ill.

Contact with someone who has pneumococcal meningitis or septicaemia, does not raise a person’s risk of catching the disease[8] . However it is important to always remain vigilant and seek immediate medical attention if you are concerned someone may have meningitis or septicaemia.

Pneumococcal disease statistics

In Australia in 2002 there were 2271 proven cases and 175 deaths from pneumococcal disease[9] .  Of these, 761 occurred in children under five years of age, 9 of whom died.  There are more cases of pneumococcal disease but often it is difficult to confirm the diagnosis.  It is estimated that the pneumococcus is responsible for causing about 70 cases of meningitis annually in Australia and about 700 cases of septicaemia in children under 5 years.[10] *

There are also thousands of cases of otitis media (ear infections) caused by the pneumococcus every year in young children.

Symptoms of pneumococcal disease

The symptoms for ‘pneumococcal disease’ will depend on the location of the infection and its severity. 

Pneumococcal meningitis symptoms (See ‘Signs and symptoms of meningitis’ section of web site for symptoms in infants)

Children or adults with pneumococccal meningitis may have some of the following symptoms which include:-

Fever
Headache
Nausea
Vomiting
Stiff neck
Avoidance of bright light
Sudden shaking or convulsions,
Joint pain
Irritability Drowsiness or confusion
Chills, cough, chest congestion and earache may also occur if there is a preceding infection. 
The onset of the disease may be slower than meningococcal meningitis and people may have a preceding infection such as a middle ear infection or a chest infection.

For more signs and symptom information visit Meningitis signs and symptoms

Middle ear infection symptoms

People who have a middle ear infection may have some of the following symptoms[11] :

Earache
Fever
Children may tug at their ears when they have an acute ear infection.  
Children may also hold their head to one side 
Irritability
Children may cry
Hearing deficit
Vomiting Sometimes diarrhoea

Pneumonia symptoms

Children or adults who have pneumonia (inflammation in the lungs) may have some the following symptoms[12] :

Rapid breathing
Cough
Congestion in the chest
Coughing up sputum
Fever
Chills or shaking
Drowsiness
Headache
Chest pain
Difficulty breathing or shortness of breath
Tiredness
Loss of appetite
They may also sweat and in some cases children may have a convulsion.
Difficulty feeding

Pneumococal septicaemia symptoms (See signs and symptoms of septicaemia)

Children or adults with pneumococcal septicaemia may have some of the following symptoms:-

Nausea or Vomiting
Chills
Diarrhoea
Stomach pains or pains in arms or legs
Breathing problems or rapid breathing
Fever (possibly with cold hands and feet)
Generalized joint aches and pains
Mottled or pale complexion
Irritability and or drowsiness
Confusion
Sometimes a rash may occur.

Infants  - possible signs and symptoms of septicaemia

Fever (possibly cold hands and feet)
Refusing feeds or Vomiting
Whimpering or crying
Dislike of being handled or fretful  
Mottled or pale complexion
Sometimes a rash may occur
Diarrhoea
Breathing problems – may be rapid breathing
Drowsiness
Blank staring expression
Floppy or stiff body or jerking body movements

For more signs and symptoms information visit Meningitis signs and symptoms  and Septicaemia signs and symptoms   

Disclaimer

The Meningitis Centre is a 'not for profit' support organisation based in Australia, not a professional medical authority. Consequently the text on this website provides general information about meningitis and septicaemia, not medical advice and is not intended for use in the diagnosis or treatment of the disease. Please consult your doctor to discuss the information or if you are concerned someone may be ill.

References

1 Collignon, P. and Turnbrige, J. (2000). “Antibiotic resistance in Streptococcus Pneumoniae.” MJA 173: s58 – s63.