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Prevention really is better than cure

Why a vaccination against pneumococcal infections can save the lives of a child or an elderly person

Ashleigh Langoulant was just six months old when she fell sick with meningitis, an often fatal disease caused by Streptococcus pneumonia bacteria.

The little girl survived but developed cerebral palsy. Today, at 23, she's still unable to walk or talk and her dad, Bruce, chairman of the non-profit Australian Meningitis Centre and president of the Confederation of Meningitis Organisation (COMO), travels the world to try and persuade both authorities and parents of the urgency to put the vaccine against the disease on the schedule of compulsory vaccinations for children.

Langoulant told Ashleigh's story again during the recent Asia Pneumococcal Disease conference in Hong Kong.

Pneumococcal infections are caused by the bacteria Streptococcus pneumoniae, also known as pneumococcus. Pneumococcal disease (PD) affects society's most vulnerable groups, in particular infants and children under 5 years of age, the elderly (adults over 65) and people with underlying medical conditions.

The most common types of infections caused by this bacteria include otitis media (middle ear infections), pneumonia, bacteraemia (a relatively mild infection of the blood), septicaemia (a more serious blood infection), sinusitis and meningitis.

The bacteria are spread through contact between persons who are ill or who carry the bacteria in their throat. Transmission is mostly through the spread of respiratory droplets from the nose or mouth of a person with a pneumococcal infection.

Pneumococcal bacteria are common inhabitants of the human respiratory tract but cause danger to the body when immunity is weakened.

The incidence is highest in young children aged under five and in the elderly.

Pneumonia, bacteraemia, and meningitis are all invasive pneumococcal infections caused by the same bacteria, but have different symptoms.

As they arrive along with the rainy season, those not alert to the threat may discount the symptoms, which include fever, chills, chest pain, cough, shortness of breath and weakness, as flu and fail to seek treatment.

"Understanding of pneumococcal disease is limited not only among the public but also among general practitioners," says Infectious Diseases specialist, Dr Wichai Techasathit.

Since pneumonia is caused by different types of microorganisms, including bacteria, viruses, and fungi, so it creates different types of the illness and in different degrees.

In Asia, one child under the age of five dies every two minutes from pneumococcal disease. More than half of pneumococcal disease episodes and deaths occur in Asia alone.

Mortality rates have approved in the Western world, where the pneumococcal vaccine is generally included in the child vaccination programme.

Dr Wichai adds that the pneumococcal disease is also commonly found in the elderly, with a fatality rate of 34 per 100,000 people.

But with 10 per cent of Thailand's population already past retirement age and growing by the year, increased risk from the disease is cause concern.

Dr Wichai adds that the disease also strikes those whose immunity has been weakened by large intakes of alcohol and cigarettes, which puts elderly Thais at even more risk.

Though antibiotics are the treatment of choice, antibiotic resistance has become a major problem, and no more so than in Thailand.

"One problem is that Thai people can buy antibiotics over the counter, leading to improper antibiotic intake and a build-up of resistance," he says.

Vaccination can help control the growing problem of antibiotic-resistant PD as vaccination reduces the need for antibiotics resulting in lower rates of resistant bacteria.

After years of providing vaccines against pneumococcal disease in children, Pzifer is now helping the world's greying population lead healthier lives.

Just last year, the US FDA approved a vaccine for adults 50 years and older to help prevent pneumonia. The vaccine protects against 13 strains of pneumococcus.

Thailand has also approved the vaccine and the health authorities are recommending men and women over the age of 50 to have the jab. The vaccine for adults is now available in US and most European countries, while Thailand is the second country in Asia that has received approval from FDA. It is a conjugate vaccine, meaning that it's more effective in helping the body's immune system recognise the bacteria and has a longer lasting immune response time

Like any vaccine, the shot should be given while you are feeling healthy. The immune response takes around two weeks.

"It's useless to have the vaccine when the symptoms have already started," says Dr Wichai.

The vaccine is also recommended for those with weakened immunity, such as diabetics, those who have been through surgery to remove the spleen, heavy drinkers and smokers and those with HIV.

The pneumococcal vaccine for adults is typically given only once.

The Education Brief Meeting on Pneumococcal Disease was organised

in Hong Kong by Pfizer.




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