would pneumonia vaccine included in routine immunisation time line?

Otitis media is commonly known as runny ear - it kills between three and five children every year and leaves another 15 permanently deaf.

The condition is more prevalent among Aboriginal children than in any other group in the world.

"Programmes stressing exclusive breast-feeding for the first six months of life can protect children from pneumonia," said paediatrician Jagadish Dhekne, president of IAP, Pune branch. "Similarly, immunisations against pneumonia can prevent pneumonia deaths. Vaccines against pneumococcus and Hib should be added as soon as possible," he added.

Pneumonia caused by these two bacteria is largely preventable through vaccination, said Nitin Shah, chairperson of the India chapter of the Asian Strategic Alliance for Pneumococcal disease prevention (ASAP). "Awareness levels about pneumococcal disease, which kills more children than AIDS, malaria and measles combined, is very low in India," he added.

Shah welcomed the Indian health ministry's move to introduce a pentavalent (five-in-one) vaccine which includes haemophilus influenzae type B (Hib), one of the two bacteria causing pneumonia and meningitis.

"The government should follow this up with the introduction of pneumococcal conjugate vaccine (PCV) which immunises children against pneumonia and other diseases caused by Streptococcus pneumoniae," said Shah. "India cannot achieve the Millennium Development Goal 4 of reducing child mortality by two-thirds unless we tackle the pneumonia burden (and the diarrhoea burden) in the country."

Dhekne said that the bacterium Streptococcus pneumonia can also cause other serious infections such as bacteria septicemia (blood infection), meningitis (infection of the coverings of brain and spinal cord), sinusitis (infection of the sinuses) and otitis media (middle ear infection).

"These diseases are collectively called pneumococcal disease and, besides causing acute illness and sufferings can also lead to long-term sequelae like brain damage, paralysis, learning disabilities, speech delays and at times death," added Dhekne.

Paediatrician Shishir Modak, vice-president, IAP, Pune branch, said that the main cause of pneumococcal disease is a weak immune system, lack of hygiene and living in overcrowded areas. The symptoms include high fever, breathlessness and grunting and pain in the chest in older children.

"Half of all severe cases of pneumonia and deaths under five years of age are preventable and this can be done by using the pneumococcal conjugate vaccine," said Modak. More than five lakh children in India under the age of five die every year because of pneumonia, he added.


Quick facts:

* Pneumonia kills more than 4 million people every year half of these deaths occur among children under age 5.

* Pneumonia is a disease responsible for the largest number of deaths in children under 5 world-wide

* Most children who die of pneumonia live in developing countries

India accounts for almost 40% of world-wide childhood pneumonia cases

* A study shows that for Indian children that survive Hib meningitis, about 30% suffer from major disabilities



Who is at risk?

* Children under 5, especially those under 2 years of age

* Children and adults with infections

* Children with weakened immune systems

* Persons exposed to tobacco smoke and other indoor air pollution

* AIDS victims