What is pneumococcal disease?

Pneumococcal disease is when you have an infection caused by the bacteria called streptococcus pneumoniae.

Types of pneumococcal disease can be:

• Non-invasive pneumococcal disease is less serious but the more common type of pneumococcal disease, such as otitis media (middle ear infection) and sinusitis.
• Severe invasive pneumococcal disease is a serious condition where bacteria enter body parts that are normally 'sterile', such as the bloodstream (bacteraemia), brain and spinal cord (meningitis), and lungs (pneumonia).

Pneumococcal infections are more common in winter and spring. Small children and older people are most at risk.

What are the symptoms of pneumococcal disease?

Your symptoms can range from mild to severe. Your symptoms will also depend on where the infection is in your body and how old you are.

Otitis media (middle ear infection) can cause:

• pain in your ear
• fever
• poor hearing
• sometimes diarrhoea and vomiting

Young children with otitis media may:

• cry
• tug at their ear
• be irritable

Sinusitis (sinus infections) can cause:

• an aching face
• blocked nose
• nasal mucus (runny nose)
• headache

Pneumonia can cause:

• shortness of breath
• fever
• cough
• lack of energy
• loss of appetite
• chest pain
• headache

Bloodstream infections (bacteraemia or sepsis) can cause:

• fever
• chills
• drowsiness
• pain

Meningitis (infection of the membranes covering your brain) can cause:

• fever
• headache
• stiff neck
• nausea (feeling sick) and vomiting
• drowsiness

The time between being infected with the bacteria and becoming sick is not known. But it may be as short as 1 to 3 days.

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What causes pneumococcal disease?

Pneumococcal disease is a bacterial infection caused by streptococcus pneumoniae. This germ is also sometimes called pneumococcus. There are many strains (types) of pneumococcal bacteria.

Most people carry pneumococcus in their nose and throat without becoming sick. But sometimes the bacteria can grow and spread to other parts of your body and make you sick. These parts of the body include your middle ear, blood, brain and lungs.

The bacteria are easily spread from person to person. This can happen through:

• coughing and sneezing
• contact with mucus from the nose and throat

Who is most at risk of pneumococcal disease?

People who are more likely to get pneumococcal disease are:

• children under 2 years of age
• older adults
• Aboriginal and/or Torres Strait Islander people

You may also have a higher chance of infection with pneumococcal disease if you have:

• lung disease
• heart disease
• cancer
• kidney disease
• a condition that affects your immune system, such as HIV infection or having your spleen removed
• malnutrition

Your chance of getting pneumococcal disease is also higher if you smoke or vape.

When should I see my doctor?

If you think you or a person in your care may have pneumococcal disease, you should call your doctor straight away. Early diagnosis and treatment with antibiotics can treat most mild infections, but pneumococcal disease can be a very serious illness. Severe cases need prompt treatment with antibiotics in hospital.

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How is pneumococcal disease diagnosed?

Your doctor will ask you about your symptoms and examine you. Some infections, like ear and sinus infections, may be diagnosed based on your symptoms.

If you have more severe symptoms, your doctor may arrange for some tests to be done, including x-rays and samples to test for the presence of bacteria. These tests may include:

• urine tests
• sputum tests (tests on the mucus you cough up)
• blood tests
• a lumbar puncture test (taking fluid from around your spinal cord)

Pneumococcal disease is a notifiable condition. This means that your doctor needs to tell the local health authorities about the cases they see.

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How is pneumococcal disease treated?

Treatment for pneumococcal disease will depend on your symptoms. Treatments include:

• antibiotics
• medicines to control your fever and pain
• fluids to stop dehydration
• rest

Pneumococcal bacteria are becoming increasingly resistant to some antibiotics.

People with severe pneumococcal infections need quick treatment and usually need to go to hospital.

Can pneumococcal disease be prevented?

The best protection against pneumococcal disease is vaccination.

Vaccination prevents most cases of serious illness caused by pneumococcal disease. It also reduces the number of pneumococcal disease cases in the community. This will protect people who are young or unable to get vaccinated.

The Australian Immunisation Handbook recommends pneumococcal vaccination for specific groups, including:

• routine vaccination in infants and children under 5 years
• non-Aboriginal and/or Torres Strait Islander adults aged 70 years and over
• Aboriginal and/or Torres Strait Islander adults aged 50 years and over
• children, adolescents and adults with conditions that increase their risk of pneumococcal disease

Vaccination is given for free through the National Immunisation Program.

Vaccines against different strains of pneumococcal disease come as a single vaccine. There are 2 pneumococcal vaccines available on the National Immunisation Program Schedule in Australia:

• Prevenar 13 covers 13 strains of pneumococcal disease
• Pneumovax 23 covers 23 strains of pneumococcal disease

Your doctor will tell you which one is right for you. This will depend on your age and situation.

At what age is vaccination recommended for children?	Childhood vaccination is recommended at the age of: 2 months 4 months 12 months Extra doses are recommended at 6 months for: Aboriginal and Torres Strait Islander children who live in Northern Territory, Queensland, South Australia or Western Australia children with conditions that put them at risk of infection Vaccination at the age of 4 years, and another dose at least 5 years later is recommended for: Aboriginal and Torres Strait Islander children who live in Northern Territory, Queensland, South Australia or Western Australia children with conditions that put them at risk of infection
At what age is vaccination recommended for adults?	Aboriginal and Torres Strait Islander adults are recommended to get the vaccination: at 50 years of age or older 12 months later at least 5 years later Non-Aboriginal and Torres Strait Islander adults are recommended to get the vaccination again at aged 70 years or older. Ask your doctor how many doses you should have.
How is the vaccine administered?	You will receive the vaccine by injection.
Is it free?	Vaccination is free through the National Immunisation Program for eligible people with a Medicare card. Your doctor may charge a consultation fee for your visit. You can find your nearest bulk billing (no fee) GP clinic using the healthdirect Service Finder tool.
Common side effects	Vaccination against pneumococcal disease is safe, but it can cause minor side effects. Common side effects are: pain, redness and swelling at the injection site occasionally, an injection site lump mild fever

The National Immunisation Program also provides free extra vaccinations for people with certain medical conditions. Check with your doctor about whether you need extra vaccinations.

Yearly flu vaccination can also lower your chance of pneumococcal disease. This is because pneumococcal disease can be a complication of influenza.

What are the complications of pneumococcal disease?

Pneumococcal disease can be a serious, life-threatening condition. Children and older people are at higher risk of serious illness.

Pneumococcal meningitis can cause long-term problems in young children, such as:

• hearing loss
• cognitive impairment
• developmental delay

Possible complications of pneumococcal pneumonia are:

• pleural effusion (an abnormal build-up of fluid in the space around your lungs)
• sepsis

Resources and support

For more information about immunisation in Australia, visit the Department of Health Immunisation website.

The Sharing Knowledge About Immunisation website has videos and other tools to help you make decisions about vaccination.

The Health Translations website has information on childhood pneumococcal vaccine in languages other than English.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.