Vaccine call for 'silent killer'

By Jane Elliott Health reporter, BBC News

Nayeem died from complications

When little Nayeem Hossain became sick at his home in a village in Bangladesh, his family were desperately worried.

Doctors at the local clinic said the five-month-old boy had a viral fever and needed paracetamol to reduce his temperature.

For eight days his parents tried to reduce his fever, but as he grew worse and started having convulsions they took him by bus from their home to the children's hospital in Dhaka.

Left paralysed

Fluid was taken from his backbone and doctors confirmed that Nayeem had advanced pneumococcal meningitis and there was nothing that could be done.

Nayeem's father and mother were determined not to give up hope and sold off the little property they had to pay off his hospital bills.

Despite doctors' efforts, Nayeem was left completely paralysed. He stayed in hospital for two weeks before his parents had to take him home, against medical advice, because they could no longer afford to pay for his care.

Until his death 18 months later from complications of the disease, his days were spent lying on the floor staring blankly at the ceiling.

Vaccination hopes

Experts warn that Nayeem's case is not unique, but say such tragic cases could be avoided with a global vaccination programme.

Now there are calls, from the UK All-Party Parliamentary Group (APPG) on pneumococcal disease prevention in the developing world, to have the disease given equal standing with HIV, malaria and TB.

Monica, Nayeem's twin continued to thrive

Medics say that diseases caused by serious pneumococcal infections kill more children than any other illness - more than Aids, malaria and measles combined.

Between 800,000 and one million children die from pneumococcal infections, mainly pneumonia and meningitis - at least one child every minute.

In developing countries, pneumococcal meningitis alone kills over 40% of the children who get the disease.

The impact is so devastating because of the lack of vaccination programmes and resources.

Speedy access

A vaccine to protect children against pneumococcal meningitis is credited with saving hundreds of lives since its introduction in the UK in February 2006.

But getting the vaccine into developing countries is slow.

Dr Orin Levine, executive director of PneumoADIP, a dedicated team working from John Hopkins Bloomberg School of Public Health in the US, supported by a $30m grant from the Global Alliance for Vaccines and Immunization (GAVI), aims to help vaccinate children in developing countries.

"Pneumococcal disease is probably the biggest killer that nobody ever hears about," said Dr Levine.

"We can do a lot to prevent these deaths.

"Vaccination is a proven, safe and effective solution to the global burden of this deadly disease.

"If you are fortunate enough to be born in the UK your risk of dying in your first year of life is less than 1%, and you have access to a healthcare system and all the immunisations.

"But if you are born in Africa you probably have around a one in 10 risk of death before your first birthday and you probably live in an environment where there is very little healthcare, and generally of a less than high quality.

"Your access to immunisations is seriously constrained unless there is concerted aid to vaccinate.

"Tackling pneumococcal disease requires resources and sustained international commitment. But this effort pales in comparison to doing nothing."

Dr Des Turner, MP and chair of the APPG, said now was the time to do something.

"We have a responsibility to help reduce the global health problem of pneumococcal disease, which is under-recognised and, until recently, has had few dedicated efforts made to tackle it."