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Diseases / Pneumococcal infections

Pneumococcal infections

What is it?: 

Pneumococcal infections include serious diseases such as meningitis, bacteraemia, and pneumonia, as well as milder but more common illnesses, such as sinusitis and otitis media. The causative agent, Streptococcus pneumoniae, frequently colonizes the human nasopharynx, and is transmitted mainly through respiratory droplets. Infants and young children are thought to be the main reservoir of this agent with cross-sectional point prevalences of nasopharyngeal carriage ranging from 27% in developed to 85% in developing countries.1

Of the estimated 5.83 million global annual deaths amongst children <5 years of age in 2015, WHO estimated that 294 000 (192,000–366,000) were caused by pneumococcal infections.1

Clinical features: 

Streptococcus pneumoniae causes a wide range of diseases, more common ones include middle ear infection (acute otitis media) and chest infection (pneumonia). It may also cause various forms of invasive pneumococcal diseases (IPD), such as infection of the brain membranes (meningitis) and blood stream (bacteraemia and sepsis). The infection can be serious or even life-threatening. 2

Clinical presentation depends on the site of infection:2

  • Middle ear infection (otitis media) can present with fever, ear pain and sometimes with discharge. It may lead to hearing loss in recurrent infection.
  • Chest infection (pneumonia) can present with fever, shortness of breath, chills and productive cough. It may result in death in severe cases.
  • Infection of the brain membranes (meningitis) can present with fever, stiff neck and confusion. It may result in long-term hearing loss or even death.
  • Infection of the blood stream (bacteraemia and sepsis) can present with joint pain and chills. It may also present along with infection at other site, such as pneumonia and meningitis.
Mode of transmission: 

Pneumococci are commonly found in the nose and throat of healthy people, particularly in children. Occasionally, these bacteria will cause an infection. They mainly spread through droplets via coughing and sneezing, close contact with the patients or contact with materials soiled with the bacteria.2

Incubation period: 

About 1 - 3 days.2


Pneumococcal vaccination2

Observe hygiene practices2

  • Build up good body immunity by having a balanced diet, regular exercise and adequate rest, reducing stress and do not smoke.
  • Keep hand clean at all time. Perform hand hygiene frequently, especially before touching the mouth, nose or eyes, after touching public installations such as handrails or door knobs or when hands are contaminated by respiratory secretion after coughing or sneezing.
  • Wash hands with liquid soap and water properly. When hands are not visibly soiled, clean them with 70 - 80% alcohol-based handrub as an effective alternative.
  • Cover nose and mouth with tissue paper when sneezing or coughing. Dispose the soiled tissue paper into a lidded rubbish bin, and then wash hands thoroughly.
  • Put on a surgical mask when having respiratory symptoms.
  • Maintain good indoor ventilation. Avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks while in such places.
  • Refrain from work or school when having respiratory symptoms. Seek medical advice if symptoms persist or deteriorate.
  • Frequently clean and disinfect touched surface such as furniture, toys and commonly shared items with 1:99 diluted household bleach (mixing 1 part of 5.25% bleach with 99 parts of water), leave for 15 - 30 minutes, and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol.
  • Use absorbent disposable towels to wipe away obvious respiratory secretions, vomitus and excreta and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach (mixing 1 part of 5.25% bleach with 49 parts of water), leave for 15 - 30 minutes and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol.

The disease can be treated with appropriate antibiotics. However, the emergence of drug-resistant strains of pneumococci has made treatment more difficult.2


  1. World Health Organization. Weekly epidemiological record. Pneumococcal vaccines: WHO position paper – February 2019. 2019;8(94):85-104.
  2. Centre for Health Protection. Communicable diseases – Pneumococcal Infection. 5 July 2019. [ONLINE] Accessed on 29 Mar 2021.