1. Streptococcus pneumoniae Adele Ricciardi

2. Pneumonia - inflammatory condition of the lung PNEUMONIA CAN BE CAUSED BY: VIRUSES FUNGI BACTERIA

3. Symptoms Diagnosis cough (often produces rust colored mucus) fever and chills shortness of breath chest pain fatigue Chest x-ray (in hospitals and clinics) Blood test Sputum culture physical examination CT scan

4. CHEST X-RAY

5. Streptococcus pneumoniae nasopharynx of healthy people Gram-positive bacteria Paired (diplococci) or appear in chains May also infect brain (pneumococcal meningitis) and blood stream (pneumococcus septicemia) Scanning Electron Micrograph of Streptococcus pneumoniae. Source: CDC/ R. Facklam, J. Carr

6. S. pneumoniae was first isolated in 1881, S. pneumoniae was first isolated in 1881, but it still remains the number 1 killer of children under 5 today. but it still remains the number 1 killer of children under 5 today

7. The Toll 4 million deaths every year half of these deaths - children under age 5 5,500 children die from pneumonia every day 98% of children who die of pneumonia live in developing countries contributes to the cycle of poverty

8. S. Pneumoniae -Virulence Polysaccharide capsule, > 90 serotypes Resistance to phagocytosis and antibiotics

9. Different serotypes

11. Pneumococci in intimate contact with lung cells show reduced capsular polysaccharide

12. Virulence- Pneumolysin Toxin Cholesterol-dependent cytolysin Cytokine synthesis Inflammatory response

13. Pneumococcal conjugate vaccine Elicits antibodies against the seven most common capsular types Sero-specific Problems: Expensive Alter serotype distribution Results: Decrease nasopharyngeal colonization Reduce disease of included serotypes

14. Use of pneumococcal conjugate vaccine is limited to parts of the developing world

15. Pneumonia will continue to kill Unless we do something about it…

16. Treatment Antibiotics, <$1/dose Amoxicillin – inhibit cell wall formation Erythromycin- inhibit protein synthesis 1 out of 5 children with pneumonia receives antibiotics

17. We can protect from pneumonia

18. Pneumonia suffers from scientific neglect

20. They may not be excited now... but they will be. This vaccine deal could save 900,000 lives by 2015.

22. References Bruyn, G.W, Zegers, B. M, R. van Furth. Mechanisms of Host Defense against Infection with Streptococcus pneumoniae. Clinical Infections Diseases 1992;14;251-62. Daniels, Briles, Mirza, Hakasson, Briles. Capsule does not block antibody binding to PspA, a surface virulence protein of Streptococcus pneumoniae. Microbial Pathogenesis. 40;2006;228-233. Alonsodevelasco, Verhuel, Verhoef, Snipe. Atreptococcus pneumoniae: Virulence Factors, Pathogenesis and Vaccines. Microbiological Reviews. Dec. 1995, 591-603. Hsieh, Lee, Shao, Chang, Huang. The Transforming Streptococcus Pneumoniae in the 21 st century. Chang Gung Med J Vo. 30 No. 2 2008;31:117-24 Hammerschmidt, Wolff, Hocke, Rosseau, Muller, Rohde. Illustration of Pneumonococcal Polysacharide Capsule during adherence and invasion of epithelial cells. Infection and Immunity. 2005; 4653-4667. Kadioglu, Weiser, Paton, Andrew. The role of streptococcus pneumoniae virulence factors in host respiratory colonization and disease. Nature. 2008;6. World Health Organization: The top 10 causes of death. October 2008. http://www.who.int/mediacentre/factsheets/fs310/en/index.html [2] Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86:408–16. World Health Organization. World health statistics 2009. Geneva: World Health Organization; 2008. http://www.who.int/whosis/whostat/EN_WHS09_Full.pdf Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86:408–16. World Health Organization. World health statistics 2006. Geneva: World Health Organization; 2006. http://www.who.int/whosis/whostat2006.pdf. World Health Organization. World health statistics 2006. Geneva: World Health Organization; 2006. http://www.who.int/whosis/whostat2006.pdf.. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86:408–16. Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H. Global estimate of the incidence of clinical pneumonia among children under five years of age. Bull World Health Organ. 2004;82:895–903.