Traveller vaccination pneumococcal disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Although travellers are not at increased risk of acquiring pneumococcal disease, access to optimal healthcare may be limited during travel.

Disease cause

Many serotypes of the bacterium Streptococcus pneumoniae.

Transmission

Inhalation of respiratory droplets containing Streptococcus pneumoniae.

Nature of the disease

The most common non-invasive pneumococcal infections include diseases of the upper respiratory tract and non-bacteraemic pneumonia. Pneumonia with empyema and/or bacteraemia, febrile bacteraemia and meningitis are the commonest manifestations of invasive pneumococcal infection. Resistance of these bacteria to commonly used antibiotics is of increasing concern. Both nonbacteraemic pneumonia and invasive pneumococcal infections are associated with considerable mortality, in particular in young children, the elderly and immunodeficient individuals.

Geographical distribution

Worldwide.

Risk for travellers

Before travelling to countries with limited access to modern healthcare facilities, vaccination against invasive pneumococcal disease is advisable for children <2 years of age and for children and adults considered to be at particular risk of serious disease.

Vaccine

  • Conjugate vaccines that include 10 (PCV10) or 13 (PCV13) pneumococcal serotypes. These pneumococcal conjugate vaccines (PCVs) are safe and efficacious and may be used from the age of 6 weeks. PCV10 and PCV13 are licensed for immunization against invasive disease, pneumonia and acute otitis media caused by the respective vaccine serotypes of S. pneumoniae.
  • A pneumococcal polysaccharide vaccine that includes 23 serotypes (PPV23). This vaccine is licensed for individuals aged 2 years or older. It is safe and efficacious against invasive pneumococcal disease and pneumonia in healthy young adults, but shows limited efficacy in other age groups including elderly persons.