Friday, March 20, 2009

The Pneumoccocal bug is not to be trifled with!

I have been very affected by an email which I received from a distraught parent last week. She recounted that she had just lost her 2 year old son who succumbed to pneumococcal infection.

This pneumococcus bug can affect different parts of the body. Most commonly it can infect the brain, causing meningitis, the lungs (pneumonia), the ears (otitis media) or enter the bloodstream and cause widespread infection.

Having heard about this unfortunate case, I have been strongly urging every parent that comes to the clinic to consider vaccinating their kids from this disease. It was then that one parent also told me of another recent case of a pre-schooler who also died from the infection.

In retrospect, these tragedies might have been prevented if the kids had been given the pneumoccocal vaccination which has been available for the last few years. In Singapore it is not part of the list of compulsory vaccinations that all babies need to be given. So a lot of the time it is up to the doctors to inform their patients. In other countries like Australia for instance, all babies are required to be vaccinated from birth. I hope it is only a matter of time before the MOH adds this vaccine to the list of necessary vaccines for newborns.

In the meantime, it is up to you as parents to be aware and informed of the availability of the vaccine. A lot of information is already online, so I will not elaborate on the condition. However, I would like to let you know that these series of incidents has affect the way I look at this disease and so here are some of the things that I do now which I did not in the past:

1. Encourage parents to give the pneumoccocal vaccine from birth rather than let them wait till the age of two. The pneumoccoal vaccine is expensive, so at birth you need four jabs, but as the baby gets older, the number of jabs reduces till at two years of age, you only need one jab. I used to sympathize with parents concerning the cost of these jabs and so some parents decide to give later. However, I am now redoubling my efforts to educate and encourage parents to give it from birth.

2. In order to do this, I have decided to reduce the price of the vaccine to encourage parents to give it in the first year of life. So I have started to offer a package of 4 vaccines for $620 which works out to be $155 each. The normal price of the vaccine is $170. This price is nett so there is no GST or consultation charge if you only come to do the vaccination.

3. I am also now being extra vigilant in younger children who present with fever. There are some parents who are very resistant to the use of antibiotics and I agree that too much antibiotic use is not good. But we should also not go to the other extreme and let our children suffer from a prolonged fever. Pneumoccocal disease does respond to antibiotics, so a course of antibiotics given on suspicion of pneumoccocal disease does save lives and prevent severe disabilities. There was one instance of a 6 year old girl who did not present to the doctor until after 1 week of fever. By that time, the pneumococal bug had already got into the bloodstream and affected the kidneys. The girl is left with only 10% of kidney function and will need dialysis in the future. So as parents, a good general rule of thumb is to bring your kids to see the doctor if the fever lasts for more than three days or earlier if the child is really unwell.

So parents, if your child has not been vaccinated, please read up and be informed of the dangers of pneumoccocal disease and do let your friends know about it.

More info on pneumoccocal disease can be found here.

For info on other available vaccines, please click here.


Anonymous said...

question. my elder just recovered from her 1-week fever recently. she complained about headache a few days ago, and complained of another headache two days ago.

she is coming-to-3 years old, not sure if she understands what headache is. is there a need to bring her to see GP?

Anonymous said...

Hi Dr Tay,

Is there any TB vaccines for adults?

Dr Leslie said...

Yes and the best place to get one is SATA

Anonymous said...

Hi Doctor

My daughter is 12 years old with allergic rhinitis and asthma. Is she too old for the pneumococcal vaccine?

Also she has block nose for the past 3 months and one of her ear is block 2 days ago, when can I bring her for the vaccine if it is available to her,should I wait for the ear infection to clear up?Thanks.

Genny Tnay

Dr Leslie said...

This vaccine is for kids up to 9 years old.

You should have your child vaccinated against H1N1 and Seasonal Flu

Anonymous said...

Hi Doctor

How about the Pneumococal 23 vaccine that you mention somewhere, (since my daughter already 12 years old). Do you still have it at your clinic?

Genny Tnay