Pneumococcal Disease (includes pneumococcal pneumonia, pneumococcal meningitis and pneumococcal bacteremia)
Last Reviewed: January 2023
What is pneumococcal disease?
Pneumococcal disease is caused by bacteria. It can lead to pneumonia, arthritis, ear infections, endocarditis, and invasive blood (bacteremia) or brain infections. It can also infect and inflame the coverings of the brain and spinal cord (meningitis). Pneumococcal disease causes moderate to severe illness and can sometimes lead to death.
Anyone can get pneumococcal disease. Some people are at higher risk. This disease occurs more often if you smoke or have:
- A weak immune system
- Chronic heart, lung, liver and kidney disease
- Cochlear implants
- Cerebrospinal fluid leak
- No spleen
Children who are Alaskan Natives, African Americans, Navajo and White Mountain Apache American Indians, and childcare attendees are also at higher risk.
What are the symptoms?
Symptoms appear suddenly -- about one (1) to three (3) days after a person is infected. They may differ based on what type of infection you have. Symptoms may include:
- Fever and chills
- Chest pain
- Cough, often with rusty sputum
- Difficulty breathing (pleuritis)
- Weakness and feeling very ill
- Stiff neck (meningitis)
- Ear pain (middle ear infections)
How is pneumococcal disease spread?
It spreads from person to person by coming into contact with fluids like the saliva, respiratory droplets, or mucus of someone who is sick. Many people, especially children, can have these bacteria in their nose or throat without being ill and can still transmit the disease to others.
Is there treatment?
Pneumococcal disease is treated with antibiotics. Some strains of pneumococcal disease are becoming resistant to antibiotics. Patients often need to be cared for in a hospital.
If my child or another family member is exposed, what should I do?
Talk with your health care provider about the risk to you and your family, and when you should be vaccinated.
What are the complications?
- Pneumonia: Many people in the U.S. who get pneumococcal pneumonia need to be cared for in the hospital. About five (5) to seven (7) percent of people with this type of pneumonia will die. The elderly have a higher risk of death.
- Blood infections: As many as 20% of people who get a blood infection from this disease die. The death rate may be as high as 60% for the elderly.
- Bacterial meningitis: Pneumococcal meningitis infections cause more than 50% of all bacterial meningitis cases in the U.S. About 8% of children and 22% of adults with pneumococcal meningitis will die.
- Middle ear infections. This is the most common reason for visits to a pediatrician in the U.S. Complications of these ear infections can lead to meningitis. It can also cause infection in a bone behind the ear.
What is the best way to prevent pneumococcal disease?
The single best way to prevent this disease is to be vaccinated.
- Children should be vaccinated with a pneumococcal conjugate vaccine (PCV13) at two (2), four (4), and six (6) months. They also need another shot, or booster, at 12 to 15 months of age.
- Adults 65 years and older should be vaccinated with the PCV20 or PCV15. If PCV15 is used this should be followed by one (1) dose of pneumococcal polysaccharide vaccine (PPSV23) vaccine at least one (1) year after the PCV15 dose.
- Adults who are 19 to 64 years of age with certain health risks should be vaccinated. These risks include the following: diabetes, smoking, alcoholism, asthma, chronic heart, liver, lung or kidney disease, cochlear implant, sickle cell disease, a spleen that doesn't work, cerebrospinal fluid (CSF) leak, solid organ transplant, cancer or other diseases that affect the immune system. Talk to your doctor about which pneumococcal vaccines are right for you.
What is the difference between the PCV20 and PCV15 vaccines and the PPSV23 vaccines?
While both vaccines help to protect against the bacteria that cause the types of blood infections and meningitis that are included in the vaccines, the PCV13 offers protection against pneumonia, too.
What are the pneumococcal vaccine requirements for school attendance?
Your children in day care, Head Start or nursery school should have received one (1) to four (4) doses of pneumococcal vaccine, depending on their age. Please refer to the school attendance requirements at: Child Care Programs, Schools and Post-Secondary Institutions.
What should I or my family members do if we travel out of the country?
- Pneumococcal disease occurs around the world. It is more common in developing countries. You may be at higher risk if you spend time in crowded settings or come in close contact with children in countries where pneumococcal vaccine is not routinely used. Make sure that you are vaccinated according to the recommendations above.
- Wash your hands often with soap and water. If soap and water aren't available, use hand sanitizer. Avoid touching your eyes, nose or mouth. Cover your mouth when you cough or sneeze. Also, avoid close contact and sharing cups or eating utensils with people who are sick.