Pneumo what?

POSITIVE PARENTING
By Datuk Dr MUSA MOHD NORDIN

Understand pneumococcal disease, and learn how you can safeguard your child from it.

THERE are many threats to our children’s health. The figures say it all. The World Health Organisation (WHO) states that approximately 10 million children under five die each year from various diseases and infections.

Infectious diseases contribute significantly to this number. Amongst the many infectious agents that wreak havoc in our children’s bodies, Streptococcus pneumoniae is one that has much significance.

The bacterium, also known as pneumococcus, causes pneumococcal disease. This is a disease that can involve many organ systems. Invasive pneumococcal infections include meningitis (inflammation of the covering of the brain), pneumonia (inflammation of the lungs), and bacteraemia (blood infection). Among the common non-invasive manifestations are otitis media (ear infections) and sinusitis (sinus infection).

In this issue, we will look at meningitis, which is one of the more severe consequences of pneumococcal infection, and how you can protect your child against it.

What is meningitis?

Meningitis is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. It is usually caused by bacteria or viruses that infect the skin, gastrointestinal tract, or respiratory tract. These harmful pathogens then travel to the meninges through the bloodstream and cerebrospinal fluid (fluid that circulates in and around the spinal cord), causing inflammation of the meninges.

Bacterial meningitis can have serious consequences, such as brain damage, hearing loss, blindness, and even death. It also progresses quickly, making early diagnosis and treatment very important. Today, S. pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.

Meanwhile, it is also vital for the doctor to determine if meningitis is caused by a virus or bacterium as the severity of illness and treatment differs depending on the cause.

Is your child at risk?

Most cases of meningitis occur in children younger than five years of age. Children who attend day care centres and other childcare facilities are also at an increased risk of meningitis.

This is because meningitis is contagious and spreads through coughing, sneezing, or sharing eating utensils or a toothbrush.

The symptoms of meningitis can easily be mistaken for the common cold or flu. The flu-like symptoms can be similar in both viral and bacterial meningitis. Since meningitis can be fatal, it is better not to take chances. Bring your child to the doctor right away if he displays any of the symptoms. The sooner you detect it, the better the chances of a recovery without severe complications.

The common symptoms of meningitis are:

High fever
Headache
Photophobia (eye sensitivity to light)
Stiff neck
Confusion
Vomiting
Babies with meningitis may not display the symptoms above. Instead, they may simply have a fever and become extremely irritable. You may find it difficult to comfort them, even when you pick them up and console them.

What to do

If you suspect that your child has meningitis, bring him to the doctor immediately. The doctor will most likely conduct a lumbar puncture (spinal tap) to collect a sample of fluid from his spine. This fluid is then analysed for any signs of inflammation, as well as to identify the virus or bacteria causing the infection. Treatment depends on the cause of the meningitis

If bacterial meningitis is diagnosed, the doctor will most likely begin intravenous (IV) antibiotics as soon as possible. Your child will also be watched carefully to prevent serious problems such as brain damage.

Protect your child

Meningitis is typically associated with contagious infections. As such, good hygiene can help prevent meningitis. Try taking these steps below:

· Teach your child to wash his hands often, especially before he eats, and after he uses the toilet.
· Make sure your child gets enough rest, stays active, and eats a healthy and well balanced diet.
· Prevent your child from sharing eating utensils with other children.
· Ensure all toys are kept clean.

Get your child vaccinated

The best way to protect your child from meningitis is through immunisation. Vaccines are effective in stimulating the body to produce antibodies against pathogens that cause meningitis. There are different vaccines that protect against a range of organisms.

· Haemophilus influenzae type b (Hib) vaccine. Studies have shown that the Haemophilus influenza type b (Hib) virus is the leading cause of viral meningitis in Malaysia. Since 2002, the Hib vaccination has been made compulsory for all babies in Malaysia.

· Pneumococcal conjugate vaccine (PCV). The PCV protects against a number of strains of pneumococcal bacteria. These strains are responsible for most severe pneumococcal infections in children. Currently, the PCV is an optional vaccine in Malaysia and can be obtained in private hospitals or clinics.

· Quadrivalent meningococcal vaccine. The bacterium Neisseria meningitidis causes meningitis and can trigger epidemics of meningitis. This vaccine is currently optional in Malaysia.

Thanks to the increasing sophistication of medical technology, we are blessed with new innovations in vaccines. You can now look forward to the decavalent pneumococcal conjugate vaccine, which has the potential to prevent more invasive pneumococcal diseases. It offers coverage against more pneumococcal strains and is designed to protect children against both invasive pneumococcal disease and non-invasive diseases such as otitis media.

Immunisation can certainly go a long way to protecting your child against meningitis. So please ensure that your child gets all the standard immunisations recommended for children in Malaysia. Do not hesitate to seek advice from your doctor regarding optional vaccines as well.

By Datuk Dr Musa Mohd Nordin is a consultant paediatrician & neonatologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting Childhood Immunisation Campaign that is supported by an educational grant from GlaxoSmithKline. For further information, please visit