Tamil Nadu - Chennai

Nip this child killer in the bud

Chennai: This condition needs attention particularly from parents of children less than 5 years. That is because while anyone can contract pneumonia, it is the leading killer of children under five years.

Indian and international experts have urged governments to take immediate steps to control and prevent pneumonia, which besides leading to death also has a profound impact on the quality of life of the child.

Pneumococcal disease describes a group of illness caused by the bacterium Streptococcus pneumoniae, which rests in the upper respiratory tract – primarily nose and throat. It strikes when the person’s defences are at a low. Symptoms may include high fever, severe headache, nausea, vomiting, sudden shaking, chills, cough, fever, chest congestion, ear ache and muffled hearing, apart from sinusitis. It causes a number of severe invasive pneumococcal diseases, including bacterial infection in the blood, and membrane of the spinal cord and brain. Acute inflammation of the middle ear, infection of the sinuses and inflammation of the lungs are also common.

Doctors say if left untreated, pneumococcal disease can lead to hearing loss, learning disabilities, speech delays, paralysis and death.

T.L.Rathnakumari of the paediatrics and neonatology department of Madras Medical College and secretary of the Indian Association of Paediatrics (IAP), Chennai, says the recent conference held in Chennai attempted to discuss the changing face of pneumococcal diseases and arrive at a consensus on the need for a vaccine. It was jointly organised by the Asian Strategic Alliance for Pneumococcal Disease Prevention – India (ASAP) and IAP.

At the conference, Institute of Child Health officials led by its director Sarada Suresh said 2,000 to 2,500 children get admitted with pneumonia every year. In a retrospective analysis, it was found that the maximum affected are children less than five years (95 per cent) and infants (60 per cent).

As many as 60 per cent of pre-school children are carriers of pneumococcus, statistics show. Therefore, children who attend day care are much more likely to become infected due to increased exposure in their day care setting, according to a report published by the Centres for Disease Control, Atlanta, in 2005.

Doctors generally use antibiotics to treat children with pneumonia, but at the conference, paediatricians raised questions about the increasing incidence of drug-resistant pneumococcus.

Kurien Thomas, microbiologist, Christian Medical College, Vellore, stressed this aspect and flagged off other options for treatment or prevention.

Indeed prevention is possible. The best way is to ensure that the child’s defences are up – that the baby is in the pink of health. This means ensuring good nutritional supplements for the child and satisfactory levels of hygiene, Dr. Rathnakumari advises. It is also prudent to avoid crowded places to avoid exposure to the bacteria.

For parents who can afford the cost (approximately Rs.12,000 for the course) vaccines are available. Two vaccines are available in the market and some doctors believe that they have great effect.

Nitin Shah, of ASAP-India says, “Half of all severe cases of pneumonia and pneumonia deaths are caused by pneumococcus and almost 40 per cent of the deaths – nearly one lakh under five deaths – are preventable by using the pneumococcal conjugate vaccine in the National Immunisation Programme.”

It is the stand of ASAP-India that routine pneumococcal vaccination in countries such as the US and Canada has proven to be a cost-effective way for achieving significant improvement in public health.

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