Pneumococcus Disease and the Prevnar Vaccine
Jul 08 '00
Pneumococcus. I have been sitting here in front of my computer screen trying to decide how I am going to tell you about this nasty nasty bacteria, and for the life of me I am tongue tied. I have told my story in “real life” about 20 times now, but actually writing this mess down is quite difficult. My daughter had such a scary battle with this bug; I hate not to share it with you, in hopes that it will keep you or your children from having to fight this bug also. I know this editorial is long, but please take your time and read this information I have gathered for you. This is not a plea for you to read and rate my epinion. I just want to get this information into parent’s hands.
First I am going to give you a little information about the bug.
Pneumococcus disease are also found in these diagnosis’s pneumococcal pneumonia, pneumococcal meningitis and pneumococcal bacteremia. Pneumococcal disease is a severe bacterial infection caused by Streptococcus pneumoniae also called pneumococcus. It may cause pneumonia, meningitis or a blood stream infection (bacteremia). It is spread by airborne or by direct contact with respiratory droplets. The incubation periods vary, but generally they are one to three days. There are approximately 90 strains of the pneumococcus bacteria, seven of them being the most common causing 80% of invasive disease in infants.
Sounds like a common cold more or less doesn’t it. Far, far from that, in fact.
This bug is treated with antibiotics, as it rears it’s ugly head in the form of ear infections for the most part. The scary part of this bug is that some strains of it are becoming antibiotic resistant. In several parts of this country there are pneumococcal bacteria that are resistant to penicillin and cephalosporine antibiotic. These two forms of antibiotics make up most of the options of drugs to kill nasty bugs like this one. We may not have to worry about Lyme disease in East Tennessee, but we do have to worry about antibiotic resistant strains of the pneumococcus bacteria.
Now for my story.
My 10-month-old daughter came down with a cold on a Wednesday. On that Friday on our way to a major theme park, she decided to show me how miserable she was. As the day progressed at this theme park I realized she had much more than “your average cold”. She was either sleeping or crying…not her typical behavior. We decided to leave, and on the way home she started running a fever. Upon returning home and doing a quick temperature check (it was 102.5), I decided to head to the doctor. Diagnosis? Ear infection, sinusitis and conjunctivitis. Therapy? A shot of Rocephin (cephelasporine) antibiotic and a 10 day treatment of Augmentin (penicillin)
Ok, she starts feeling better about an hour after the shot and seemed completely cured after the 10 treatment of Augmentin. Not 48 hours after her last dose of Augmentin she spikes a 103 fever. Of course it is at 9 p.m. at night and we decide to wait it out till morning and take her to our pediatrician. At 9 am we are informed that her ear infection is worse and they are concerned it has moved into her blood stream. After blood has been taken it reveals her white blood cell count is double of what it should be, meaning her body is fighting a major infection. Long story short, she has to have a more complete blood test done culture it, her eardrum punctured and the pus drained and cultured and another shot of Rocephin. Of course it takes 48 hours to get a culture back and we are on a wait and see course of action. Upon returning to the pediatrician's office on Saturday, they decided to proceed with another shot of Rocephin and a double antibiotic course of treatment. Augmentin AND Amoxicillin…both penicillin. The doctor also throws in some antibiotic eardrops called Floxin just for good measure.
Upon returning to the Dr on Monday morning, my daughter’s ear was no better, but her fever was staying down and she was not sickly acting, as she was before. The labs were in! This nasty bug was resistant to cephalosporine AND penicillin antibiotics! This is a very serious situation. There are not many oral antibiotics left that have been approved for children under 1 year of age. The only thing keeping this bug at bay was the eardrop, which it was not resistant to. My doctor informed us we had two choices left, or as he said…”we are moving up the food chain”. We had one oral antibiotic left to try on my daughter…Cleocin. We had to get another culture of the bug to make sure it was not resistant. If it was resistant our final choice was hospitalization and an IV of big gun antibiotic called Vancomycin. The only antibiotic left. Luckily the strain was not resistant to Cleocin and after a 10 day round of it along with another 10 days of Floxin eardrop, her bug had been squashed!
Now your probably wondering why the heck I have chosen immunizations to post this editorial. Because there is an underutilized vaccine out there which can combat the seven most common strains of pneumococcus!
Yeah, I had no idea either. Wished I had.
Prevnar.
Prevnar is a pneumococcal 7-valent Conjugate Vaccine. Yeah, whatever that means. It is the first multivalent conjugate pneumococcal vaccine for children under the age of two. It targets the most common seven strains of pneumococcus that account for approximately 80% of invasive disease in infants. This new vaccine is great news for parents and their children because now for the first time, doctors have a highly effective way to prevent a major cause of meningitis, pneumonia, serious blood infections, and some ear infections in the most susceptible children—those under two years of age.
The Prevnar vaccine should be given to any child under two years of age. Routine scheduling would be at the age of 2,4,6 and 12-15 month visits…or a total of 4 vaccinations. Children who should not get the vaccine are those who are less that six weeks of age, children over nine, children with Thrombocytopenia or any coagulation disorder and children with an allergy to any component of the vaccine.
Some mild problems associated with the Prevnar vaccine are soreness and/or swelling at the vaccination site, fever of less that 101 degrees and irritability and decreased appetite. Mild problems should be discussed with your physician.
After extensive consultation with my doctor, it had been explained to me that day cares, doctors, and wrongful use of antibiotics are the major contributors to antibiotic resistant pneumococcal. Doctors because they put children on unnecessary “routine” treatments of antibiotics. Daycares, because the spread of illness between masses of children are greater. The wrongful use of antibiotics because bugs are not totally killed during a treatment, therefore “mutating” into a different form of bug, causing antibiotics not to work.
This can happen to you.
It happened to me. I am a stay at home mom. I don’t use day care. My daughter has never been on antibiotics before. She was breastfed. She has never had an ear infection. I do use church nursery twice a week though. It happened to me and it can happen to you too. Don’t think that just because you don’t use daycare or your child is never sick that it can’t happen to them. It absolutely can.
My doctor’s course of long term treatment?
Keep my daughter out of any childcare situation until she is two and get the Prevnar vaccine.
Immunizations are a very personal choice. However, the chance of your child getting Pneumococcus disease is far greater than the chance of them getting mumps or measles. If you are “anti” immunization, or have never heard of this disease, or vaccine, I recommend at least contacting your pediatrician about and getting more informed and educated.
I got my facts and figures from a handout from my Dr.’s office and this website http://www.health.state.ny.us/nysdoh/consumer/pneu.htm
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