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The burden of pneumococcal disease in children—advances in the fight of this epidemic

Abstract Streptococcus pneumoniae, the most important cause of acute otitis media, pneumonia, septicaemia and meningitis worldwide, comes in 90 different serotypes. Only a few serotypes cause most of the serious disease. Different serotypes are distinguished by differences in the complex sugars that made up the bacteria's capsule that provide protection against the host's specific defenses. The burden of invasive pneumococcal disease in South Africa subjects is estimated to be 100–200 per 100 000. The conjugate pneumococcal vaccine has been shown to be effective in reducing invasive pneumococcal disease due to vaccine serotypes in all countries where it has been introduced. This benefit has extended to unvaccinated subjects. Reduction in penicillin resistant pneumococcus related to vaccine serotypes has been recorded. Replacement disease by non vaccine serotype has eroded the benefit of the vaccine. Industry, donors and governments need to interact to ensure accelerated implementation of this vaccine in developing countries.