Pneumococcal Vaccine Overview and Impact
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Questions and Answers

When was Streptococcus pneumoniae first isolated, and by whom?

in 1881 by Pasteur

What type of bacteria is Streptococcus pneumoniae?

gram positive, facultative anaerobe, common inhabitants of respiratory tract

How many known serotypes of Streptococcus pneumoniae are there?

more than 90

What is an important virulence factor of Streptococcus pneumoniae?

<p>polysaccharide capsule</p> Signup and view all the answers

What are major clinical syndromes of Pneumococcal Disease?

<p>Pneumonia, Bacteremia, and Meningitis</p> Signup and view all the answers

What are the clinical features of Pneumococcal Pneumonia?

<p>Abrupt onset, fever, shaking chills, pleuritic chest pain, productive cough, dyspnea, tachypnea, hypoxia</p> Signup and view all the answers

What are the consequences in the population due to Pneumococcal Pneumonia?

<p>about 400,000 hospitalized cases per year; responsible for up to 1/2 hospital acquired pneumonias and 1/3 of community acquired pneumonias; case fatality rate 5%-7%, but higher in elderly; common bacterial complication of influenza</p> Signup and view all the answers

What are the conditions that increase risk for invasive pneumococcal disease?

<p>decreased immune function; asplenia; chronic heart, pulmonary, liver or renal disease; cigarette smoking; cerebrospinal fluid leak</p> Signup and view all the answers

What are the consequences in the population due to Pneumococcal Bacteremia?

<p>12,000 cases per year in the U.S.; occurs in about 25-30% of patients with pneumococcal pneumonia; rates higher among elderly and very young infants; case fatality rate of about 20%, 60% in elderly</p> Signup and view all the answers

What are the stats on Pneumococcal Meningitis?

<p>estimated 3,000-6,000 cases per year in the U.S.; case fatality rate about 30%, up to 80% in elderly; neurologic sequelae common among survivors; increased risk in persons with cochlear implant</p> Signup and view all the answers

Pneumococcal disease is a common cause of what in children?

<p>acute otitis media and bacterial meningitis in patients less than 5 years old</p> Signup and view all the answers

What is the reservoir for Pneumococcal Disease?

<p>human carriers</p> Signup and view all the answers

What is the transmission for Pneumococcal Disease?

<p>Respiratory droplets, autoinoculation</p> Signup and view all the answers

What is the temporal pattern of Pneumococcal Disease?

<p>winter and early spring</p> Signup and view all the answers

What is the contagious stage of Pneumococcal Disease?

<p>unknown, but probably as long as the organism is in respiratory secretions</p> Signup and view all the answers

Although pneumococcal outbreaks are not common, where do they usually occur?

<p>in crowded environments like jails and nursing homes</p> Signup and view all the answers

What significant event happened in Pneumococcal Vaccine history in 1977?

<p>a 14 valent polysaccharide vaccine was licensed</p> Signup and view all the answers

What significant event happened in Pneumococcal Vaccine History in 1983?

<p>a 23 valent polysaccharide vaccine named Pneumovax (PPSV23) was licensed</p> Signup and view all the answers

What significant event happened in Pneumococcal Vaccine History in 2000?

<p>a 7 valent polysaccharide conjugate vaccine named Prevnar (PCV7) was licensed</p> Signup and view all the answers

What significant event happened in Pneumococcal Vaccine history in 2010?

<p>a 13 valent PCV (conjugate) named Prevnar 13 (PCV13) was licensed</p> Signup and view all the answers

The Pneumococcal Polysaccharide Vaccine (PPSV 23) is made up of _______________________________________ antigen.

<p>purified capsular polysaccharide</p> Signup and view all the answers

How is the pneumococcal polysaccharide vaccine (PPSV 23) administered?

<p>either IM or SQ</p> Signup and view all the answers

In the pneumococcal polysaccharide vaccine (PPSV 23), _____ polysaccharide antigens account for ____________ of bacteremic pneumococcal disease.

<p>23, 60%-76%</p> Signup and view all the answers

When receiving the pneumococcal polysaccharide vaccine (PPSV 23), how long after this vaccination does it take to start developing antibodies?

<p>2-3 weeks</p> Signup and view all the answers

What is the efficacy of the pneumococcal polysaccharide vaccine (PPSV 23)?

<p>not effective in children less than 2 years of age, 60-70% effective against invasive disease, less effective in preventing pneumococcal pneumonia</p> Signup and view all the answers

What is the brand name for pneumococcal polysaccharide vaccine (PPSV 23)?

<p>Pneumovax</p> Signup and view all the answers

What is the pneumococcal polysaccharide vaccine (PPSV 23) indicated for?

<p>prevention of pneumococcal disease</p> Signup and view all the answers

Study Notes

Pneumococcal Vaccine Overview

  • Streptococcus pneumoniae first isolated in 1881 by Pasteur.
  • Bacteria Characteristics: Gram-positive, facultative anaerobe, commonly found in the respiratory tract.
  • Over 90 known serotypes of Streptococcus pneumoniae.

Virulence and Clinical Syndromes

  • Major virulence factor: Polysaccharide capsule.
  • Major clinical syndromes include Pneumonia, Bacteremia, and Meningitis.

Clinical Features

  • Pneumococcal Pneumonia symptoms: Abrupt onset, fever, shaking chills, pleuritic chest pain, productive cough, dyspnea, tachypnea, hypoxia.

Population Impact

  • Annually about 400,000 hospitalizations due to pneumonia.
  • Causes nearly 50% of hospital-acquired and 1/3 of community-acquired pneumonias.
  • Case fatality rate ranges from 5%-7%, higher in the elderly.
  • Common complication of influenza.

Risk Factors for Disease

  • Increased risk for invasive pneumococcal disease with:
    • Decreased immune function.
    • Asplenia.
    • Chronic heart, pulmonary, liver, or renal diseases.
    • Cigarette smoking.
    • Cerebrospinal fluid leaks.

Bacteremia Statistics

  • 12,000 cases per year in the U.S., occurring in 25-30% of pneumonia patients.
  • Higher incidence in the elderly and infants.
  • Case fatality rate of about 20%, reaching 60% in elderly patients.

Meningitis Insights

  • Estimated 3,000-6,000 cases of pneumococcal meningitis annually in the U.S.
  • Case fatality rate around 30%, potentially up to 80% in elderly.
  • Neurologic sequelae are common among survivors.
  • Increased risk in individuals with cochlear implants.

Disease in Children

  • Pneumococcal disease is a leading cause of acute otitis media and bacterial meningitis in children under five years.

Transmission and Contagious Nature

  • Reservoir: Human carriers.
  • Transmission occurs through respiratory droplets and autoinoculation.
  • Temporal pattern peaks in winter and early spring.
  • Contagious stage is unknown, likely lasts as long as the organism is present in respiratory secretions.

Vaccine Development History

  • In 1977, a 14-valent polysaccharide vaccine was licensed.
  • 1983 saw the licensing of the 23-valent polysaccharide vaccine (Pneumovax, PPSV23).
  • 2000 introduced the 7-valent polysaccharide conjugate vaccine (Prevnar, PCV7).
  • In 2010, a 13-valent conjugate vaccine (Prevnar 13, PCV13) was licensed.

Pneumococcal Polysaccharide Vaccine (PPSV23)

  • Composed of purified capsular polysaccharide antigen.
  • Administered via intramuscular (IM) or subcutaneous (SQ) routes.
  • 23 polysaccharide antigens account for 60%-76% of bacteremic pneumococcal disease.
  • Antibodies develop 2-3 weeks post-vaccination.
  • Efficacy rate: 60-70% against invasive disease, lower efficacy in preventing pneumonia; ineffective in children under 2 years.
  • Commercially known as Pneumovax.

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Description

This quiz covers the key aspects of the pneumococcal vaccine, including the characteristics of Streptococcus pneumoniae, its clinical syndromes, and the impact on populations. It also discusses the virulence factors and risk groups associated with pneumococcal diseases. Test your knowledge on this critical public health topic.

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