Vaccination stops pneumonia deaths

The difference between an ailing infant and a sick grown-up is that while the adult can complain and describe his symptoms to the physician and other
people around him, the child, who has yet to learn how to speak, is unable to explain how he feels. If the people around him do not take heed, a sick child’s condition can worsen before his caregivers realize that something is seriously amiss. And thus, it happens that more infants succumb to fatal infections.

One life-threatening illness that causes a disturbing number of infant deaths in the Philippines is invasive pneumococcal disease (IPD), an acute bacterial infection caused by Steptococcus pneumoniae. Aside from being the leading cause of pneumonia, the bacterium causes meningitis and sepsis or bacteremia. Pneumonia is a common infection characterized by the inflammation of the lungs; meningitis is a condition where the fluid-filled membranes that cover the brain and spinal cord become inflamed, and sepsis/bacteremia is the presence of bacteria in the blood.

Young infants aged 0-24 months old whose immune systems are not yet fully developed are particularly susceptible to infection. Without early and adequate medication, IPD is a potentially fatal affliction.

“Streptococcus pneumonia is a killer disease that is neglected and forgotten by many. But if you look at the number of children killed every day because of pneumococcal disease, there are staggering statistics,” says Dr. Lulu Bravo. “The burden of the disease in the very young cannot be overemphasized.”

Bravo heads the Asian Strategic Alliance for the Prevention of Pneumococcal Disease (ASAP), an organization of health experts that was convened and mobilized to fight the disease. “Our mission is to contain and control pneumococcal disease in the Asian region,” says Dr. Bravo. “That will be done through awareness, surveillance, advocacy, and vaccination.”

World Health Organization pegs IPD deaths at 1.6 million people each year. Of these, 700,000 to one million are children under five years old and over 90 percent of these deaths occur in developing countries. Pneumonia is a top killer in India, China, Nigeria, Pakistan, Bangladesh, Indonesia, and Brazil.

The Philippines is 10th in the list and 35 percent — or one out of three patients — succumbs to the disease. However, the real figures may still rise significantly. This is because pneumonia is not a reported disease, with any standard surveillance for it. Consequently, the actual statistics for pneumonia mortality may be considerably higher, especially since the disease is easily spread through droplet infection.

The symptoms of IPD are common enough, beginning with a severe chill followed by high fever, cough, and shortness of breath, rapid breathing, and chest pains. Certain patients may complain of nausea, vomiting, headache, tiredness, and muscle pain. Infants and young children may exhibit either increased irritability or lethargy and disinterest or difficulty in feeding. Although antibiotics are employed to treat infection, these are often expensive. In addition, resistant strains would require a longer hospitalization period or could even be fatal.

The good news is that there are vaccines that can prevent the disease. Currently, two vaccines against IPD are available commercially. These are the 23-valent unconjugated polysaccharide vaccine and the 7-valent pneumococcal conjugate vaccine (PCV-7). While both were shown to be effective, PCV-7 is licensed for use in children under five years old, including infants 12 months or younger — an age group that is greatly at risk for life-threatening pneumococcal disease.

The downside is that not many children are immunized despite the availability of the vaccine. “Although the disease is vaccine-preventable, PCV-7 is not included in the national immunization program of many countries, including the Philippines,” says Dr. Bravo.

The vaccines included in the Philippine expanded program of immunization of the Department of Health are BCG (against tuberculosis), DPT (diphtheria, pertussis, and tetanus), OPV (oral polio vaccine), measles, and hepatitis B vaccine.

Although the Philippine Pediatric Society, the Pediatric Infectious Disease Society of the Philippines and the Philippine Foundation for Vaccination recommends immunization with pneumococcal conjugate vaccine (PCV-7) to children six weeks to five years old, most mothers are unaware that the IPD vaccine is also important.

“Vaccination leads to better health for our children,” says Dr. Bravo who espouses the idea that awareness is necessary towards lowering morbidity (sickness) or mortality (death) from pneumonia. “If we are able to campaign and get a million signatures for political causes, I don’t see why we cannot mobilize and gather enough support for the protection of our children against IPD. Vaccination saves lives.”

Ask your doctor about the pneumococcal vaccine (PCV-7) that protects against invasive pneumococcal disease in children.