Streptococcus pneumoniae (pneumococcus): infections, symptoms and vaccination in the UK

Streptococcus pneumoniae is the name of a bacterium, usually shortened to pneumococcus. In the NHS vaccine information it is the cause of what are called pneumococcal infections. Many people carry bacteria like this in the nose and throat without becoming ill, and problems arise when it spreads to places such as the lungs, bloodstream, brain coverings, ears or sinuses.

The illnesses it can cause range from fairly minor to life-threatening. The NHS describes the most serious as meningitis, which is an infection in the brain and spinal cord, sepsis, a life-threatening reaction to an infection, and pneumonia, an infection in the lungs. Less serious illnesses linked to pneumococcal vaccines include sinusitis and ear infections.

Because these illnesses can be caused by other germs too, a doctor cannot always say that pneumococcus is responsible from symptoms alone. Tests on samples such as blood, fluid or sputum are used in hospital to identify the cause and guide treatment.

The NHS pages on the main illnesses describe the signs that matter. None is specific to pneumococcus, but they are the reasons to seek medical help.

The NHS says you are at higher risk of getting seriously ill from pneumococcal infections if you have sickle cell disease, problems with your spleen or have had your spleen removed, a long-term condition that affects breathing such as COPD or cystic fibrosis, a long-term heart condition, chronic kidney disease, a long-term liver condition such as cirrhosis, diabetes, a weakened immune system due to a condition such as HIV or a treatment such as steroid medicine or chemotherapy, a cerebrospinal fluid leak or a cochlear implant. Some welders and metal workers exposed to metal fumes should also have the vaccine, and employers should make sure they are offered it.

The NHS meningitis page adds that meningitis is more common in babies and young children, teenagers and young adults, older people and people with a weakened immune system, and that it is usually spread by people who carry the bacteria or viruses but are not ill themselves.

Treatment depends on the site and severity of infection. For pneumonia caused by bacteria, the NHS says you will usually be given antibiotics, most people get better in 2 to 4 weeks, and you may need hospital treatment if you are over 65, have a cardiovascular or long-term lung condition, are very unwell or are not getting better on antibiotics. In hospital you may also receive steroids, oxygen, a chest X-ray and blood tests.

Bacterial meningitis needs to be treated in hospital, usually for at least a week, with antibiotics and fluids given into a vein and sometimes oxygen through a face mask, according to the NHS. It can cause long-term problems and can be fatal, which is why immediate medical help is advised if meningitis is suspected.

In the UK routine vaccination is the main way of preventing serious pneumococcal disease. The NHS says babies have a dose at 16 weeks and a booster at 1 year, and children can have the vaccine up until they turn 2. People aged 65 and over have 1 dose, and children and adults at higher risk have at least 1 dose, with some needing extra or regular doses. Your GP surgery will usually contact you if you are eligible; contact them if you have missed a dose.

The NHS says there are 2 types of pneumococcal vaccine given in the UK, one usually given to adults and children over 2 and the other to babies under 2. Most people can have the vaccine, including in pregnancy and breastfeeding, apart from those who have had anaphylaxis to a previous dose or an ingredient. Common side effects include swelling or pain where the injection was given, a high temperature, tiredness and loss of appetite. You usually have some protection by about 2 to 3 weeks after vaccination, and most adults need only 1 dose for long-term protection.

NHS vaccination is free for everyone who is eligible, and infections are treated through GPs, NHS 111 and hospitals. If you think you should be on the vaccination list but have not been contacted, the NHS advises speaking to your GP surgery.

Some private clinics and travel services offer pneumococcal vaccination outside the NHS criteria. Because the NHS schedule is designed around risk, it is worth checking with your GP whether you already qualify and keeping a record of any doses given elsewhere.