What are pneumococcal infections?
Pneumococcal infections are caused by the bacteria Streptococcus pneumoniae, which can cause infections such as pneumonia, bacteremia, meningitis, and otitis media. Severe infections are usually seen in patients who are at risk, such as persons over 65 years of age, residents of extended care and intermediate care facilities, and persons with impaired immunity or chronic illness. Over the past few months, however, there have been a higher than expected number of patients being admitted to St. Paul's Hospital with severe pneumonia and bloodstream infections. The increase in illness has been noted in persons with addresses in the Downtown EastSide (DTES) Vancouver, homeless, persons living with HIV, and history of drug misuse.
How is pneumococcal infection transmitted?
These bacteria can spread from the nose and throat of one person to another by close direct contact like kissing, coughing, or sneezing and through saliva when people share food, cups, water bottles, toothbrushes, etc. Currently, there is no evidence of nosocomial spread.
What Infection Control Precautions are required for patients with pneumococcal infection?
Standard Precautions are adequate to prevent the spread of this organism from the patient to patient and from patient to staff.
Standard Precautions:
Hand washing.
Appropriate use of Personal Protective Equipment (PPE) for contact with all blood and body fluids except sweat and tears.
Proper handling of needles and sharps.
When should I wash my hands?
Hands should be washed before and after every patient contact, as well as after touching potentially contaminated items in the environment (e.g., respiratory equipment). Hand washing with an alcohol hand gel (e.g., MicrosanTM) is appropriate for use if hands are not visibly soiled, but remember to let them air dry. Conventional handwashing with antiseptic soap and water is recommended for hands that are grossly soiled.
Standard Precautions: What PPE do I need?
Gloves - for direct to anticipated direct contact with all blood and body fluids (i.e., providing suctioning).
Gown or plastic apron - protection against splashes and sprays (i.e., intubation).
Face Protection - masks, goggles, face shield - during procedures that are likely to cause splashes or sprays of blood, body fluids or secretions (i.e., intubation).
Can pneumococcal infection be prevented?
Vaccination can prevent most serious pneumoccocal infections. The pneumococcal polysaccharide vaccine is recommended for and provided free to people who are at high risk of getting serious infections. This includes:
All those 65 years or older.
Residents of extended care and intermediate care facilities.
All people with:
Asplenia (removed or impaired spleen);
Weakened immune system such as HIV disease, haematopoietic stem cell transplantation; (HSCT), solid organ transplantation, certain cancers (leukemia, lymphoma, Hodgkins's Disease);
Conditions requiring ongoing high dose oral corticosteroid therapy; or
Chronic diseases such as heart disease, lung disease, liver disease, diabetes, alcoholism, cerebral spinal fluid leak, cochlear implant.
The VCH Public Health has also initiated a vaccination campaign in the DTES at a variety of locations, and would like to expand it to include patients in the SPH and VGH Emergency Departments.
Thank you very much for your help!
More information on Standard Precautions other infection control issues is available online on the PHC intranet at HYPERLINK "http://phcmanuals.phcnet.ca/Level2.asp?L1Heading=Standard+Precautions&LibCode=ICON" http://phcmanuals.phcnet.ca/Level2.asp?L1Heading=Standard+Precautions&LibCode=ICON
PHC Infection Prevention and Control (IPAC)
Pneumococcal Infection
Fact Sheet for Health Care Workers, Physicians and House Staff