For an average mother, the term pneumococcal disease may sound like a virulent offence which may have some relevance only in remote far-off lands, the understanding of which lies in the realms of rocket-science graduates. Unfortunately, when the scientific name is translated into more understandable language, the illnesses caused by the bacterial pathogen pneumococcus are the viciously familiar pneumonia, meningitis and bacteraemia (blood poisoning), killing mainly children under the age of five. Other common, but less threatening, infections include middle-ear infections (also known as otitis media), sinusitis and bronchitis. The danger of the disease, accountable for 1.6 million deaths annually worldwide, is real and present also in the very advanced Western world we inhabit.

According to the World Health Organisation (WHO) - the reliable authority whose reputation has been built on its consistent commitment to safeguard the world population's well-being, fighting and keeping life-threatening diseases at bay - pneumococcal disease is the number one vaccine-preventable cause of death in children younger than five years of age worldwide. Now, it has not only acknowledged its serious threat to the youngest newcomers to life, but it has also taken a stand to prevent the disease from taking over the health of our loved and dearest ones by recommending the inclusion of a pneumococcal conjugate vaccine (PCV) in national immunisation programmes worldwide.

The recommendation was made in a recent position paper by the organisation in its Weekly Epidemiological Record, designed for use mainly by national public health officials and managers of immunisation programmes.

"Streptococcus pneumoniae is the leading cause of bacterial pneumonia in humans beyond the first few weeks of life and is a major cause of serious illness, substantial morbidity and even death worldwide," says Prof. Paul Cuschieri, a consultant medical microbiologist in the Health Division.

"It also is an important cause of acute otitis media, which if left untreated may lead to more serious diseases such as mastoiditis and pneumococcal meningitis. In this light, WHO's position paper is a valued recommendation in helping to protect infants and young children from common paediatric illnesses caused by streptococcus pneumoniae."

At least 16 countries worldwide already incorporated the pneumococcal conjugate vaccine in their routine national childhood immunisation programmes. These include Belgium, France, Germany, Greece, Italy, the Netherlands, the United States and the United Kingdom. The vaccine is now licensed in more than 70 countries. WHO's Strategic Advisory Group of Experts (SAGE) says that in view of its demonstrated efficacy, the vaccine - available in Malta for parents choosing to administer the vaccine privately but not yet included in the national immunisation schedule - can help substantially reduce mortality and morbidity.

To this effect, WHO considers the pneumococcal conjugate vaccine's inclusion in national childhood immunisation programmes a health priority. Reducing the burden of pneumococcal disease is a vital step towards achieving the United Nations' Millennium Development Goal of reducing child mortality by two-thirds by 2015.

A World Economics Study on the Value of Vaccination highlights the full impact of vaccination in a community. It shows that there is an established link between improved health and a country's economic growth, with benefits in education, labour, savings and demography. It also establishes that vaccination not only protects the individual from the disease, but also against the long-term effects of that illness on their physical, emotional and cognitive development.

Who and the United Nations Children's Fund (Unicef) also developed a Global Immunisation Vision and Strategy (GIVS) with the aim to immunise more people, from infants to seniors, with a greater range of vaccines. Its chief goal is to reduce illness and death due to vaccine-preventable diseases by at least two-thirds compared to 2000 levels, by 2015 or earlier.

According to the WHO, out of the 1.6 million deceased by pneumococcal disease annually worldwide, between 700,000 and a million are children under five years of age, mostly living in developing countries. On the other hand, those most susceptible to the disease in industrialised countries are children under two and the elderly. As the world organisation highlights, the vaccine's urgency is also dictated by the worrying reality of an increased resistance of the bacterial pathogen pneumococcus to frequently used anti-biotics.

The recommended PCV-7 vaccine offers protection against 65 to 80 per cent of the bacterial strains associated with invasive pneumococcal disease in industrialised countries' young children. Another vaccine which covers 23 different serotypes is also available but not approved to be given to children under the age of two, who are incidentally considered to be the most vulnerable age group for whom the PCV-7 vaccine is recommended.

According to the WHO's document, the recommended PCV-7's safety profile makes it very well tolerated and is highly effective in all age groups but its administration is currently only authorised in children under the age of five, including newborns and infants under 12 months. The first of the three recommended doses may be administered as early as the sixth week of life.

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