After the pandemic, this infection is on the rise

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The latest annual report for 2022 shows that the number of invasive cases of bacterial pneumonia is only slightly lower than the record year of 2019. Therefore, maintaining vaccination protection according to Austria’s vaccination recommendation is essential, the Austrian Vaccine Association warned in a release Wednesday.

The decline in invasive pneumococcal disease (IPE) has been temporary due to hygiene measures. With 562 reported IPE cases, we have almost returned to pre-pandemic levels. In 2018, 611 cases were registered, and in 2019, 615. The steadily increasing trend recorded since the national surveillance system began registering invasive pneumococcal disease in 2006 is likely to continue. This applies not only to the number of invasive illnesses but also to the number of deaths. Again, 49 people died due to pneumococcal infections in 2022. Other infectious diseases, such as influenza and respiratory syncytial virus (RSV), resurged after Corona measures ended.

Men are affected slightly more often than women
People over 80 years of age were the most likely to contract IPE, and people over 75 years of age were the second most likely. However, the third most at-risk group is already found in babies under one year. “You can see here that the two ends of the age spectrum are disproportionately at risk,” said Bernd Lamprecht, head of the University Department of Internal Medicine and Pneumology at Kepler University Hospital Linz. “In babies, the immune system is inexperienced and has not yet learned to deal with such germs. On the other hand, in the elderly, the immune system no longer functions optimally.” As in previous years, men were slightly more likely to be affected than women.

“Overall, when you look at these numbers, you have to keep in mind that this is just the tip of the iceberg,” Lamprecht pointed out. “Non-invasive pneumonia or even pneumococcal-triggered middle ear infections are not included in this data and are many times more common. They, too, are a significant burden for those affected, with potentially long-lasting consequences.”

100 different pneumococcal serotypes
More than 100 different pneumococcal serotypes are known, 34 of which were detected in Austria in 2022. Serotypes 3, 19A, 8, 6 C, 22 F, and 11A were found most frequently. No change in serotypes was detected.

Pneumococcal vaccines have been available for many years. According to the Austrian Vaccination Plan, the recommended vaccination schedule for persons 60 years of age and older includes two vaccinations with different vaccines one year apart. “Unfortunately, pneumococcal vaccinations in Austria are also among those that are not particularly well received by the population,” Lamprecht said. “There is a good chance that more people would have received vaccinations, preventing a serious illness or possibly death.”

Healthy people are still recommended to be vaccinated starting at age 60, and people at higher risk are recommended to be vaccinated starting at age 50, with a one-time repeat vaccination series after at least six years from age 60.

Timely treatment is important
In principle, antibiotics can treat pneumococcal infections well, provided treatment is given promptly. However, antibiotic resistance was also first detected in 2022. “Also, antibiotics take time to start working,” the pulmonologist explained. “By then, the patient’s condition may have deteriorated significantly.” Therefore, he emphasized, “The important thing would be to prevent it from getting that far in the first place, so we don’t end up in the situation of having to use antibiotics. The best prevention is to be vaccinated against pneumococcus at age 60, when the performance of the immune system begins to decline. For children, pneumococcal vaccination is included in the free childhood immunization program anyway and should definitely be taken advantage of as well.”