He pneumococcusscientifically known as Streptococcus pneumoniaeis a bacteria that can live in the nasal or pharyngeal mucosa of humans without causing symptoms. However, under certain conditions, it can become pathogenic and cause serious diseases. This bacteria is second cause of acquired pneumonia in the community (NAC) in children what do you require hospitalizationIn addition to pneumonia, pneumococcus can cause meningitissepticemia and otitis media, among other infections.
Meningitis is a inflammation of the membranes surrounding the brain and spinal cordcan leave serious and permanent after-effects on survivors. In fact, it is estimated that one in five individuals who survive the infection face long-term consequences, which may include brain damage, hearing loss and cognitive disabilities.
Another vaccine is available in Argentina as of today to protect the pediatric population. The inoculant is added to those already available and is indicated for active immunization in the prevention of invasive diseases, such as meningitis and pneumonia, and other non-invasive diseases, such as acute otitis media caused by pneumococcus, in infants, children and adolescents from 6 weeks to 18 years.
People People over 18 years of age can receive the vaccine to help protect them from diseases such as lung infection (pneumonia), inflammation of the membranes that cover the brain and spinal cord (meningitis) and a serious blood infection (bacteremia).
The new formula is available in vaccination centers and pharmaciesbut at least for the moment the National Vaccination Calendar has not been incorporated.
The novelty of the new form of prevention comes at a time when vaccination coverage rates in infants to prevent the disease caused by pneumococcus have presented a decreasing trend in recent years and the levels of vaccine coverage prior to the COVID-19 pandemic have not yet been reached.
As reported by the National Administration of Medicines, Food and Medical Technology (ANMAT), it is the vaccine antipneumococcal polysaccharide conjugate 15 valent adsorbed which “will be marketed in the Argentine Republic by MSD Argentina SRL”.
Transmission of pneumococcus occurs mainly through small respiratory droplets When an infected person cough either sneezes. Although many people can carry the bacteria without getting sick, pneumococcus primarily affects the pediatric population and also has a considerable impact on adults, especially those with risk factor’s.
The adults over 65 years of age, the active smokers, people who live with HIV, people alcoholic and patients with chronic diseases such as diabetes, diseases of the heart, pulmonary, renal either liverwortare at increased risk for serious pneumococcal infections.
In Argentina, the vaccination against pneumococcus in adults has worryingly low coverage rates. World Health Organization (WHO) reported that in 2019 bacterial meningitis caused approximately 250,000 deaths worldwide. This disease, despite being largely preventable through vaccinationcontinues to represent a significant threat to public health.
In Argentina, during the year 2022, a worrying increase in the fatality rate of meningitis caused by pneumococcus was observed. According to data from the Ministry of Health, the mortality level reached a value of 9.9%the highest recorded in five years. This increase reflects not only the severity of the disease, but also possible gaps in vaccination coverage.
“The symptoms caused by pneumococcus disease vary depending on the clinical picture. Among them are: fever, chills, cough, rapid breathing or difficulty breathing, chest pain, headache, stiff neck, photosensitivity, confusion and/or low alertness,” said the Dr. Virginia VerdaguerMedical Director of MSD Argentina.
The pneumonia has an incubation period of between 1 and 3 days after entry of the bacteria Streptococcus pneumoniae in the body. In general, all people are susceptible to infections caused by this agent. However, some conditions increase susceptibility to this bacteria.
Thus, the chances of contagion are greater depending on the following factors:
-Age
—A chronic illness
-Overcrowding
-Poverty
—Active or passive exposure to tobacco smoke
—Concurrent infections of the upper respiratory tract.
Pneumococcus infection is more common between 2 months and 3 years, Although it declines after 18 months of age, the risk increases again after age 65, according to data from the Pan American Health Organization (WHO).
As mentioned before, in both children and adults the bacteria can cause several different diseases. They can be invasive such as those infections that are located in tissues, organs and fluids that are normally sterile, generally associated with severe clinical processes. And also non-invasiveless serious but more common diseases, such as sinusitis or otitis media.
The pneumonia and meningitis They are the most frequent manifestations of pneumococcal diseases invasive. The middle ear infections, sinusitis and bronchitis They represent non-invasive and less severe manifestations of pneumococcal infections, but are considerably more common.
Health authorities incorporated the National Vaccination Schedule in 2012 the 13-valent conjugate vaccine in a two-dose scheme and a booster, for children under 1 year of age (2, 4 and 12 months).
According to data from the Ministry of Health, a significant reduction of the serotypes that cause invasive pneumococcal disease in children under 5 years of age. The proportion of vaccine serotypes decreased from 87% in 2010 to 19% in 2020, with an increase to 36% in 2022.
On the other hand, there has been an increase in cases of serotypes for which there are no vaccinesalthough they have not reached the disease burden before 2012 and since 2014, they represent the majority of cases identified in Argentina.
According to the capsular antigenic differences, that is, the variations in the antigens present in the capsule of microorganisms, have been identified more than 90 serotypesof which one limited number It causes invasive pneumococcal disease. The identification of serotypes has varied according to geographic region, age and study period. It was established that 6 to 11 of the serotypes most common cause approximately 70% of all invasive infections in children in the world.
On the other hand, not all serotypes that circulate in children and adults are the same. According to data presented by the ANLIS Malbrán Institute at the XXIII Congress of the Argentine Society of Infectious Diseases (SADI) in 2023, in children under 5 years of age, In 2020-2021 the prevalent serotypes were 3, 19A, 23B, 24F, 8 and 15B.
While in the case of adults, the prevalent serotypes in people over 65 years of age, According to an analysis of the cases reported to the National Surveillance System from 2017 to 2021, they were 3, 8, 12F, 14 and 7F. The serotype 3 It is characterized by its high potential for invasivenesshigh rates of complicated pneumonia and risk of mortality, remains stable over the years.
