Streptococcus pneumoniae Infection (Pneumococcal Disease)

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Streptococcus pneumoniae

Organism
Streptococcus pneumoniae (pneumococcal) invasive disease is caused by a type of bacteria called Streptococcus pneumoniae. (S. pneumoniae).

Transmission
S. pneumoniae bacteria can be found in many people’s noses and throats and is spread from person to person by coughing, sneezing, or coming into contact with respiratory secretions.

Symptoms
S. pneumoniae can cause both invasive diseases (such as a meningitis or a blood stream infection) and non-invasive diseases (such as pneumonia). Only invasive disease is reportable to the Texas Department of State Health Services.

Invasive disease symptoms can be different depending on the type of infection the disease has caused. 

• Pneumococcal pneumonia symptoms: include fever, cough, chills, shortness of breath, and chest pain. Pneumococcal meningitis symptoms: include stiff neck, fever, mental confusion and disorientation, and visual sensitivity to light.
• Pneumococcal bacteremia (infection in the bloodstream) symptoms: may be similar to symptoms of pneumonia and meningitis and may also include joint pain and chills.
• Sepsis (complication caused by the body’s overwhelming and life-threatening response to an infection) symptoms: confusion or disorientation, shortness of breath, high heart rate, fever, shivering, or feeling very cold, extreme pain or discomfort, clammy or sweaty skin.

Complications of S. pneumoniae invasive disease can include brain damage, hearing loss, limb loss, and death. 

Groups at increased risk for invasive disease caused by S. pneumoniae:

• Children younger than 2 years old
• Children in group child care settings
• People who are 65 years old and older
• People with weak immune systems due to cancer, leukemia, Hodgkin’s disease, or human immunodeficiency virus (HIV)
• People with long-term or chronic illnesses such as lung, heart or kidney disease, diabetes or sickle cell disease
• People without a functioning spleen
• People with alcoholism
• Residents of long term care facilities

Incubation Period

The incubation period varies by type of infection and can be as short as 1 to 3 days.

Communicability
The period of communicability is unknown. It may be as long as the organism is present in respiratory tract secretions but is probably less than 24 hours after effective antibiotic therapy is begun.

Prevention and Vaccination

The pneumococcal vaccines can help prevent infection with Streptococcus pneumoniae. 

Maintaining healthy habits like getting plenty of rest and not coming into close contact with people who are sick can also help prevent infection. Using good health practices such as covering your mouth and nose when coughing or sneezing and washing your hands frequently with soap and water can also help stop the spread of the bacteria.

More information on Pneumococcal vaccination.

School Exclusion Policy
Children with a fever should be kept out of school or childcare until they are fever free for 24 hours without the use of fever suppressing medications. Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically 25 Tex. Admin. Code §97.7.

Recent Texas Trends
In Texas, only invasive cases of Streptococcus pneumoniae (pneumococcal) disease are reportable. The incidence of Streptococcus pneumoniae (pneumococcal) invasive disease cases reported in Texas has been fairly stable for the past ten years with between 1,535-2,029 cases reported each year (1,983 cases in 2019).