Pneumococcal Disease: The Killer In Our Midst?

When Zura Raharudin’s 11-month-old toddler developed high fever and flu-like symptoms in June 2011, like most mothers, she thought it was teething pains cold or the common cold.  But his condition continued to deteriorate, to the point where he could not even recognize Zura even though she was breastfeeding him.

When she brought him to the hospital, she was told her baby had caught pneumococcal meningitis, a potentially fatal disease. Upon recovery, there are also high chances of physical or mental disability, many that do not manifest until many years later.

“I started shaking and crying then. It was so sudden. One minute he was playing and laughing and the next minute, I was on the verge of losing him, she recalls. She found herself wondering- ‘What is pneumococcal disease anyway? How come I’ve never heard of this condition when the doctor said it’s quite common among children under two?’

Her son spent 15 days in the hospital, 5 days in the Intensive Care Unit. The hospital bill came up to a whooping RM16,000, but for Zura, having her son back was priceless. Not all parents are so lucky though.

12 years ago, Heng’s son, 4-year-old Darryl, was also hospitalized for pneumococcal pneumonia. Within a week, his condition deteriorated drastically, he first became breathless and later developed lung complications.

The antibiotics didn’t help and various tubes were inserted into Darryl’s to remove the fluid build-up that kept developing in his lungs. Still, he later developed pneumothoraces (bursting of the lungs) and became too weak to continue treatment.

Darryl passed away after 21 days in the ICU, leaving his parents a hospital bill of RM35,000, even after heavy government subsidy and a lifetime of painful memories. What is more sobering is the fact that Darryl would probably suffer from a lifetime of disabilities if he had survived.

Bruce Langoulant should know. Father to 25-year-old Ashleigh who contracted pneumococcal meningitis when aged six months, Bruce’s family has today become a case study for families with pneumococcal all over the world.

The Chairman of the Perth-based The Meningitis Centre since 1992, Bruce is also President of the Confederation of Meningitis Organisations (CoMO) that has 33 members in 22 countries and is one of the authors of the book ‘Meningitis: A Tragedy By Instalments’.

WHAT IS PNEUMOCOCCAL DISEASE?

What makes pneumococcal disease so hard to understand is that it is not one disease but a group of diseases caused by the bacterium known as Streptococcuc pneumonia, also known as pneumococcus.

Pneumococcus can cause serious infections that can have severe implications in adults and children. However, the effect of these infections is usually severe in young children and the elderly because of their weaker immune systems.

There are more than 90 known strains of Pneumococcal bacterium, but only 10% are disease-causing. If the bacterium travels to the child’s brain, he will develop meningitis, whereas if it goes to his lungs, he will develop pneumonia.

If it goes into his bloodstream, the child develops septicemia or bacteriacemia, and if it goes to his ears, he is likely to get otitis media (middle ear infection). All four diseases are chronic and potentially fatal.

The problem is the easy transmission rates of the virulent strains, especially among young children in day-care centres. What is most frightening is that most of the time, the cause of transmission is not known.

“Around the world, pneumococcal disease is responsible for 1.6 million deaths every year. WHO statistics show that pneumococcal disease is the leading cause of vaccine-preventable deaths worldwide for children below 5,” says Bruce, who was in Kuala Lumpur recently for a parent workshop to better understand pneumococcal disease.

He explains that if the child survives the infection, there are high risks of long-term problems such as blindness, hearing loss and brain damage.  This leads to learning disabilities, cerebral palsy, speech delays and mental retardation.

Although not all children end up in the worst case scenario, Ashleigh, Bruce’s second daughter, has all the disabilities listed, which gives him the first-hand knowledge of how extreme it can get.

“We never expected it to be this bad when she recovered, and only found out later that she couldn’t walk, talk or function like a normal person as she grew. It was heart-breaking for the whole family,” he recalls.

Parents of infected children also suffer from loss of productivity, time spent taking care of hospitalised children, high hospital bills and high levels of anxiety and stress. The medical costs of pneumococcal disease infections come up to billions every year, not including the costs of work and productivity costs. Many more families end up falling apart from the pressure of caring for a special child.

IS YOUR CHILD AT RISK?

The pneumococcus bacterium is spread through contact with people who are ill or who carry the bacteria in their throat. The bacterium is transmitted from droplets from the nose or mouth of the infected person when they sneeze, cough or talk.

Some children may carry the bacteria in their throats without being sick. However, another person who gets transmitted may not be so lucky especially if their immune systems are not strong.

Your child is at higher risk if he is below 24 months old, attend childcare centre, have weak immunity, frequent ear infections or have had a recent course of antibiotics.

TREATMENT

For the last 30 years, pneumococcal disease is mainly been treated with antibiotics. However, the increase in prevalence shows that there are certain strains of the bacterium that are now resistant to antibiotics.

The current management method is to practise prevention with vaccine to avoid getting infected, as infection inevitably results in severe defects such as mental retardation or learning disabilities, even if the patient survives.

Discuss with your doctor to know more or visit www.abc4pneumococcal.com for the details.

Fast Facts

Pneumococcal disease is the leading cause of these potentially deadly diseases:

MENINGITIS

A serious infection of the lining of the brain or spinal cord that causes swelling in the brain tissues.

Warning signs: Fever and chills, lethargy, sensitivity to light, refusal to feed, drowsiness, nausea and vomiting, stiff neck or legs, delirium, high-pitched cry (in babies)

BACTERAEMIA

Blood poisoning that disrupts the blood circulatory system, reducing the amount of oxygen that is transmitted to the vital organs and tissues, resulting in severe organ damage.

Warning signs: High fever and chills, pale skin, cold hands and feet, irritability, rapid breathing, low blood pressure, spotting on the skin, confusion

PNEUMONIA

A severe infection of the lungs

Warning signs: High fever or chills, cough, shortness of breath, rapid breathing, chest pains, nausea or vomiting, fatigue, muscles aches

OTITIS MEDIA

Middle ear infection that affects hearing and possibly language and speech development

Warning signs: Ear ache, fever, temporary hearing loss, flu-like symptoms, lethargy, poor feeding, frequent tugging at the ear

TAKE ACTION!

1)      Seek medical attention if your child has fever more than three days.

2)      Don’t send your child to nursery or school if he is ill.

3)  Have young children vaccinated to protect them from meningitis, pneumonia, bacteraemia or otitis media.

4)      Have a sibling or friend with young children? Help pass the word along.

5)      Pledge your support to have all children protected against pneumococcal disease www.abc4pneumococcal.com in Malaysia. You have nothing to lose but the anxiety.

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