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Dec 4, 2007

Wake up to this deadly disease

ASK any parent about pneumococcal disease and the most likely response will probably be, “Pneumo-what?”

Not many people know that it is a highly contagious disease that easily spreads among children in droplets released into the air through sneezing or coughing. Particularly vulnerable to pneumococcal disease are children below 24 months, those who attend day care centres and those with poor immunity.

We had a chat with Dr Mary Marret, consultant paediatrician, and member of Positive Parenting’s expert panel, to find out more about this deadly disease and why more parents need to sit up and take notice.

While cost is obviously an issue, it is important to remember that the benefits of vaccinating against pneumococcal infection will far outweigh the money spent.
Until recently, most parents have never heard about pneumococcus. Why is it an important topic now?

Dr Marret: The medical community has been aware of the pneumococcal bacteria and the diseases it causes for a long time, so pneumococcal disease is really not a new thing.

What is new is the availability of a vaccine that can protect very young infants against this deadly infection. Such a vaccine was not available in the past. In addition, the bacteria is getting resistant to more antibiotics now.

What are the first signs that a child may have pneumococcal disease?

Dr Marret: The pneumococcal bacteria causes a host of deadly illnesses such as pneumonia, middle ear infection, infection of the blood (bacteraemia) and meningitis. Because of this, early signs really depend on the site of infection (ie the ear, lung, brain, or blood) or the age of the child.

For example, children with pneumonia may have respiratory symptoms such as cough and breathing difficulty. On the other hand, those with middle ear infection may have high fever, and occasionally, ear discharge.

Often, the symptoms can be very non-specific, especially in children who have bacteraemia and meningitis. Symptoms may include high fever, lethargy, vomiting and irritability. Sometimes, children may develop seizures.

All these symptoms I have mentioned are very similar to those of illnesses caused by a number of other bacteria or viruses. A diagnosis of pneumococcal disease can be achieved by laboratory tests which isolate the bacteria from blood, sputum or other fluid samples taken from the child.

What happens to children who have been infected with pneumococcal disease?

Dr Marret: This depends on the type of infection, early diagnosis and prompt treatment.

Healthy children who have pneumonia, middle ear infection and even blood infection can make a complete recovery if diagnosed and treated early.

However, an infection such as pneumonia can be fatal in a young baby living in a remote area who does not receive treatment in time.

This is unfortunately the case for many children who live in places without easy access to medical facilities.

One of the most serious infections caused by pneumoccocal disease is meningitis, or infection of the membranes covering the brain. Pneumococcal meningitis can cause severe brain damage, which may result in complications such as mental retardation, physical disabilities such as cerebral palsy, epilepsy and also hearing impairment.

Even with antibiotic treatment, it is not always possible to prevent these complications, especially in very young babies.

Prevention is still better than cure. How are parents responding to the new pneumoccocal vaccine?

Dr Marret: The Malaysian Paediatric Association has started providing information in the media about the vaccine. This is slowly raising awareness among parents and we are starting to get enquiries from parents who are keen to protect their children.

However, there are still a number of parents who are not aware of the problem or hesitate to have their children vaccinated because of the cost of the vaccine. While cost is obviously an issue, it is important to remember that the benefits will far outweigh the money spent. The risk of developing severe complications and the suffering caused by pneumoccocus are very real and if parents can prevent this from happening to their children, then it is certainly something they should really consider doing.

Any side effects to the pneumoccocal vaccine?

Side effects include fever, pain and swelling at the injection site, irritability and rashes. These are usually self-limiting and will clear up in a few days.

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