There is controversy surrounding vaccines against childhood diseases, but a new study has shown that pneumococcal vaccines could be the reasons for the drop in ear infections.
South African statistics aren't available, but ear infections in American kids dropped threefold over 10 years, compared to the 1980s, largely due to pneumococcal vaccines that protect against one type of bacteria that causes them, a new study suggests.
A shift in bacteria
However, the study, which tracked more than 600 children from 2006 to 2016, also found a shift in the bacteria now triggering greater numbers of ear infections. The investigators also found that these germs are not killed by amoxicillin, the top-recommended antibiotic for the condition.
"The magnitude of the drop in the occurrence of ear infections was more than I expected," said study author Dr Michael Pichichero. He's director of the Rochester General Hospital Research Institute in Rochester, New York.
"The second big finding is we've got this shift in the no 1 bacteria. If something is not done, I would expect ear infections to come back in frequency," Pichichero added.
Common among children
Children in the United States experience more than 5 million ear infections each year, resulting in more than 10 million antibiotic prescriptions and about 30 million annual visits for medical care, according to the American Academy of Pediatrics.
At this stage, no published figures are available for the prevalence of ear infection in South African children.
Known medically as "acute otitis media", ear infections are the most common condition treated with antibiotics. Streptococcus pneumoniae has been driving most of the infections, the study authors noted.
According to a Health24 article, cold, allergy, or upper respiratory infection (including the nose, sinuses, larynx or voice box, and throat) and the presence of bacteria or viruses lead to the accumulation of pus, inflammation, and mucus behind the eardrum, blocking the eustachian tubes (leading from the ear to the throat).
Minor surgical procedure
In the new study, Pichichero's team determined the type of bacteria causing each case of ear infection among the participants by performing a minor surgical procedure in which a doctor drains the pus from behind the ear to relieve pain and remove infection.
During the study period, 23% of the children experienced at least one ear infection, and 3.6% had at least three ear infections by 12 months of age. By the age of three, about 60% of the children had one or more ear infections, and about 24% had three or more ear infections.
But those ear infection rates are drastically lower than three decades ago due to the pneumococcal vaccine, which wipes out Streptococcus pneumoniae, the researchers reported.
The pneumococcal vaccine was introduced in 2000 and improved in 2010 with a version that enhanced its effectiveness by protecting for additional strains of the bacteria, Pichichero noted. The vaccine is administered routinely to babies in the United States as part of check-ups at two, four and six months of age, with a booster given at 12 to 15 months, he said. When older children or adults receive the vaccine, they require only one dose.
On the other hand, the pneumococcal vaccine has been so effective at reducing ear infections caused by Streptococcus pneumoniae that other bacteria have stepped up to become the main source of current ear infections, the study authors said.
The study was released online in advance of publication in the September print issue of the journal Pediatrics.