Childhood Diseases

30 October 2012

Pneumococcal disease facts

Globally, over 2-million children die from pneumonia each year. Knowledge is power, which is why understanding pneumonia – the risks, causes and symptoms is good parenting.


Globally, over 2-million children die from pneumonia each year. Knowledge is power, which is why understanding pneumonia – the risks, causes and symptoms – is not just worthwhile, it’s good parenting. 

“Pneumonia kills more children than any other illness – more than AIDS, Malaria and Measles combined.”This statement, made by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) in a report entitled ‘Pneumonia: The forgotten killer of children’ is enough to send a chill down any mother’s spine, and so it should – Pneumonia is serious.   

What is pneumonia?

Our body’s respiratory system (airway) consists of the lungs and air passages. While infections of the airways can occur in any part of the system (the nose, throat, and airways), pneumonia is a severe form of an infection of the lower airway that specifically affects the lungs.

The lungs are composed of thousands of tubes (bronchi) that subdivide into smaller airways (bronchioles). At the end of these smaller airways (bronchioles) there are small sacs (alveoli) that fill with air when a healthy child breathes. The alveoli contain minute vessels called capillaries, it is here that oxygen is added to the blood and carbon dioxide is removed. When a child has pneumonia, breathing is difficult and painful because pus and fluid fill the alveoli in one or both lungs, interfering with oxygen absorption. 

What causes pneumonia?

The leading cause of severe pneumonia among children in the developing world is a group of bacteria called Streptococcus pneumoniae (also known as pneumococcus / pneumococci).

Pneumococci occur naturally as part of the normal microbial flora of the nose and pharynx, particularly among young children. This is called colonisation (the presence of bacteria on a body surface without causing disease in the person).Virtually every child in the world is colonised, becoming a carrier during their early life due to pneumococci being easily transmitted (through coughs, sneezes and other secretions) within families and between households and communities.  

In most cases carriage of pneumococci is asymptomatic but children who have not developed immunity or whose defenses are compromised (by the flu virus, for example) are at risk of developing pneumococcal infection.  

What are the symptoms? 

The symptoms of pneumonia in children vary, dependent on age and the cause of infection.  

Bacterial pneumonia usually causes children to become severely ill (with a high fever and rapid breathing), in addition, young infants may suffer convulsions, unconsciousness, hypothermia, lethargy and feeding problems.

Some common symptoms of pneumonia in children and infants include:

  • rapid or difficult breathing
  • coughing and/or wheezing
  • fever and/or chills
  • headaches
  • loss of appetite

 Who is at risk?

Anyone can get pneumococcal disease but infants and young children, especially those under the age of two years, are at a higher risk.      

The risk may be increased in children who:

  • attend daycare centres or crèches, or have older siblings in daycare
  • have had a recent ear infection or a recent course of antibiotics   
  • have an underlying illness or a poorly functioning immune system
  • are from a socially deprived background
  • are not breastfed

 How toprotect your child?

Since the turn of the century, vaccines suitable to protect infants and toddlers against pneumococcal infection have been available. Preventing children from developing pneumonia in the first place is essential for reducing child deaths. The World Health Organization (WHO) strongly advocates the routine vaccination of infants to prevent pneumococcal disease.

Although there are more than 90 different strains of Streptococcus pneumoniae, approximately 20 serotypes (strains) cause most disease.  In 2000 a conjugate vaccine containing seven of the very common strains found in industrialised countries was introduced in the United States of America (USA) for routine immunisation of all infants. This vaccine was made available in South Africa in 2005 and introduced into the Expanded Programme on Immunisation (EPI) in April 2009.

Fast-forward to 2011 and there is a vaccine available that covers 13 of the most common global strains of Streptococcus pneumoniae and provides increased coverage of the strains most commonly found in developing countries.

This vaccine has become available in South Africa where, in 2009, 85% of severe pneumococcal disease reported in children less than 5 years of age was caused by the 13 strains of Streptococcus pneumoniae the vaccine contains.

Why vaccinate?

The answer is simple – Pneumococcal disease (including pneumococcal pneumonia) remains a leading cause of serious illness among children under five years of age and it is vaccine-preventable.

The bottom line is that prevention is better than cure. If your child is between six weeks and five years of age, visit your local clinic and help prevent pneumococcal disease. 

(Pfizer press release, October 2012)


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Prof Eugene Weinberg worked in the Paediatrics Department of the Red Cross Children’s Hospital for many years. He is presently a paediatric allergist at the Allergy Diagnostic Unit of the UCT Lung Institute in Mowbray.

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