Pneumococcal Strain Linked to US Pink Eye Outbreak
Thu January 30, 2003 03:01 PM ET
By Paul Simao
ATLANTA (Reuters) - A strain of the sometimes deadly pneumococcus bacteria has been linked for the first time to an outbreak of conjunctivitis among young children in the United States, the Centers for Disease Control and Prevention said on Thursday.

A study published in the CDC's weekly morbidity and mortality report concluded that a type of streptococcus pneumoniae was responsible for a flurry of conjunctivitis infections last autumn at an elementary school in Maine.

Conjunctivitis, commonly known as pink eye, is an infection of the outer layer of the eye. A number of bacteria can cause the infection, and there are viral and allergic forms as well. The bacterial form of the disease is typically marked by stringy discharge, swelling, redness and itching. Outbreaks of the pneumococcal form of conjunctivitis had been identified previously, but never in young children. A CDC epidemiologist said it was possible the strain was a common, but previously unrecognized, cause of conjunctivitis in children. 

Most cases of bacterial conjunctivitis are easily cured with antibiotic eye drops. But the highly contagious nature of the disease allows it to spread quickly from person to person, usually through contact with eye secretions.

Federal health officials say this is what likely occurred in late September and early October at an elementary school in Westbrook, Maine, where more than 100 kindergarten and first and second graders developed conjunctivitis or its symptoms.

Swab cultures on more than two dozen children were positive for the  pneumococcal strain, the same one that had caused an outbreak of conjunctivitis among college students in New Hampshire earlier in the year.

A further investigation revealed that the outbreak in Maine had widened to include family members of those infected as well as kids attending other schools and child care centers in the northeastern state.

"We have seen outbreaks before of this particular strain, but never in young kids," said Brendan Flannery, an epidemiologist with the CDC's National Center for Infectious Diseases. Flannery, however, cautioned that the outbreak did not signal a serious new health problem because the strain responsible for the outbreak appeared to be confined to the eyes.

None of the infected kids in Maine became seriously ill.

"This strain is not very good about infecting either the lungs to cause pneumonia or to get into the bloodstream to cause invasive disease," Flannery said. Various forms of pneumococcus kill about 1.2 million children around the world each year, according to estimates from the World Health Organization. In the United States, it is the most common cause of bacterial meningitis. The CDC said conjunctivitis transmission could be prevented in schools if children and teachers frequently washed their hands with soap and water and limited the sharing of objects in classrooms.

Health experts also advise parents and family members of those infected with the disease to avoid the sharing of towels, washcloths or handkerchiefs at home.
 

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      Posted on Fri, Feb. 07, 2003  
    
      U MEDICAL STUDY: Pneumonia vaccine not as effective as thought
      BY TOM MAJESKI
      Pioneer Press

      The pneumonia vaccine booster shot normally given to frail and elderly people five years after their initial immunization does not protect them for life as was previously thought, researchers at the University of Minnesota have found.  The discovery is important because more than 60,000 Americans a year die of pneumonia, making it one of the top five killers of people 65 and older.

      The study published in today's Journal of the American Geriatrics Society raises the possibility that patients most at risk of contracting and dying from pneumococcal infections should be vaccinated every year or every other year.  "A lot of people haven't even had a primary vaccination, and a lot of patients aren't aware of the need for a booster,'' said lead investigator Thomas Lackner, a clinical professor in the university's College of Pharmacy. "Our elderly population is growing week by week, so it's affecting more people.''

      However, no one knows yet whether it's safe to give high-risk patients annual pneumococcal shots, so Lackner and his colleagues plan to study the question. He also said researchers should develop a more effective vaccine. Until more is learned, Lackner said elderly patients and others at high risk should talk to their doctors about getting a vaccination or a booster. The shots are normally offered at the same time as the annual flu vaccinations.

      Besides causing most pneumonias, pneumococcal bacteria can trigger various blood infections, including meningitis, a disease that kills 80 percent of its elderly victims. Many such bacteria have become resistant to antibiotics, making treatment difficult.  When the vaccine was introduced in the 1980s, experts thought one shot would protect a patient for life. Later studies showed that was not true, so high-risk patients were advised to get booster shots five years after the first vaccination.

      But even that strategy offers no lifetime guarantee against pneumonia, Lackner and his colleagues discovered in their study of 67 patients at six Twin Cities nursing homes.  All had received their initial dose of the pneumococcal vaccine. Once antibody levels were measured, the researchers gave each participant a booster shot. They then measured the antibody levels at one month, six months and one year later.

      Patients showed a significant rise in their protective antibody levels one month after the booster shot. But by the end of the year, the antibody counts had dropped to levels equal to or below the starting points, indicating the vaccine no longer protected them.  Lackner said patients in the study tolerated the booster shots well. The only side effects were a little tenderness and warmness at the injection site that disappeared in a couple of days.