What pneumococcal disease is and how it spreads
Pneumococcal disease is a group of illnesses caused by the bacterium Streptococcus pneumoniae, or pneumococcus. The bacterium often lives in the nose and throat of healthy people, especially children, without causing any trouble. It spreads through droplets, saliva and mucus during coughing, sneezing and close contact. Illness develops when the bacterium goes deeper: into the lungs, middle ear, sinuses, blood or the membranes around the brain.
Which illnesses pneumococcus causes
- pneumonia, the most common bacterial cause of pneumonia in children and an important one in adults;
- middle ear infection and sinusitis, milder but common;
- meningitis, an infection of the membranes around the brain, which is severe and dangerous;
- bacteremia and sepsis, when the bacterium enters the bloodstream.
Symptoms
They depend on the type of infection. Pneumonia brings fever, chills, cough, shortness of breath, chest pain when breathing and weakness. In children under 5, fast breathing, chest indrawing and refusing to eat or drink are warning signs. An ear infection causes ear pain and fever. Meningitis brings severe headache, a stiff neck, vomiting and sensitivity to light, and in infants irritability, listlessness and a bulging soft spot. Meningitis and sepsis need emergency care.
Who is at higher risk
The illness is more severe in young children, older adults, people with chronic heart, lung, liver or kidney disease, diabetes, a weakened immune system, no spleen, and smokers. A recent flu raises the risk too, because bacterial pneumonia often follows a viral infection; see our page on influenza.
Diagnosis and treatment
A doctor diagnoses the infection from an exam and further tests: a chest X-ray, blood tests and, if meningitis is suspected, a test of the spinal fluid. The bacterium can be found in a blood culture or another fluid sample. Pneumococcal infection is treated with antibiotics. The choice and the length of treatment are for the doctor to decide, because some strains resist certain drugs, so do not choose antibiotics yourself or stop a course early. Severe cases are treated in hospital.
Pneumococcal vaccine in Georgia
Vaccination is the main way to prevent the disease. Georgia's national immunization calendar includes a pneumococcal conjugate vaccine given in three doses, at 2, 4 and 12 months (Minister's Order No. 01-60/n, version of July 13, 2023). For children who start later, a pediatrician will plan a catch-up schedule. Calendar vaccines are free for children under 18 under the state program.
For adults, vaccination is given on a doctor's advice: under the 2026 state immunization program, the vaccine is provided to adults over 18 on a doctor's recommendation and to residents of care homes for older people. In many countries it is recommended for older adults and for people with chronic disease, a weakened immune system or no spleen; age limits depend on the country and the vaccine, so decide together with a doctor. Clinics use, among others, the conjugate vaccines Prevenar 13 and Prevenar 20 (Pfizer) and the polysaccharide vaccine Pneumovax 23 (MSD). They differ in composition and schedule, and a doctor will explain which fits you or your child. Vaccine prices at clinics in Georgia are listed further down this page.
The vaccine covers only the pneumococcus types it contains, not all of them, so pneumonia after vaccination is still possible, though usually milder. Quitting smoking, treating chronic conditions and getting a flu shot also help. For young children, vaccination against Hib matters as well, since that bacterium also causes pneumonia and meningitis.
When to see a doctor urgently
- shortness of breath, fast or labored breathing, bluish lips;
- fever lasting more than three days, or returning after you felt better;
- severe headache, a stiff neck, vomiting, confusion, a rash or unusual drowsiness;
- in an infant, refusing to feed, listlessness, a high-pitched cry or a bulging soft spot;
- you or your child belong to a risk group and have symptoms of pneumonia.
