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03 April 2009
Australian first study aims to understand how to
prevent and treat rare complication of pneumonia
Experts at Sydney Children’s Hospital (SCH), Randwick have undertaken an
Australian first study to determine how effective the universal pneumococcus
vaccine is in protecting Australian children from empyema, a rare complication
of pneumonia which has become more prevalent in Australian children over the
past 15 years.
Preliminary findings – based on 60 out of a total of 170 children hospitalised
with empyema across Australia - indicate that the current vaccine needs to be
broadened to include more strains of the bacteria Streptococcus Pneumoniae - the
family of bacteria which most commonly causes meningitis and pneumonias.
Of the 60 children involved in the study, 30 were infected with a strain of the
Streptococcus Pneumoniae bacteria. Of those 30 children, 91 per cent were
infected with a strain of the bacteria not covered by the vaccine.
Associate Professor Adam Jaffe, Head of the Respiratory Department at SCH and
lead investigator, says that while the existing vaccine has proven effective in
significantly reducing the incidence of meningitis and pneumonia, work needs to
be done to safeguard children from the emerging bacterial strains causing
empyema.
"Since the 7-valent pneumococcal vaccine was introduced in 2005 there has been
up to a 78 per cent decrease in the number of Australian children infected with
strains of the Streptococcus Pneumoniae bacteria covered by the vaccine," said
Associate Professor Jaffe.
"While the vaccine is an absolutely essential part of Australia’s vaccination
program, there are always improvements that can be made.
"Our preliminary results indicate that the vaccine could better protect children
through the inclusion of an additional number of strains of the Streptococcus
Pneumoniae bacteria, strains we have identified to be the cause of many cases of
childhood empyema in Australia.
"While our results are based on 60 children with empyema across Australia, once
the remaining 110 samples are fully analysed, we expect the results will follow
the same trend."
Associate Professor Jaffe commenced the study two years ago after a recorded
increase in the number of children hospitalised with empyema both nationally and
internationally.
With the financial support of GlaxoSmithKline, Associate Professor Jaffe and his
team established a research network across 13 major paediatric centres across
the country, with blood and fluid samples from 170 children with empyema
collected and sent to Sydney for highly accurate and advanced laboratory
testing.
While empyema very rarely causes death in children, around one third of the 170
children involved in the study were admitted to a high dependency or intensive
care unit, with many requiring prolonged hospital treatment of up to three
weeks.
Associate Professor Jaffe hopes his team’s findings will assist in the
development of national guidelines for the diagnosis, prevention and management
of childhood empyema.
It is hoped the results may also influence a change to the current national
vaccine program.
Final study results will be analysed and released in approximately six months.
***Preliminary study results will be presented to health care professionals on
Monday, 6 April at the Thoracic Society of Australia and New Zealand Conference
in Darwin***
What is empyema?
- Empyema is a complication of pneumonia which is primarily caused by the
bacteria Streptococcus Pneumoniae.
- Typical symptoms of childhood empyema are similar to a severe case of
influenza and include fever, cough and shortness of breath. Following
medical tests, children with empyema typically have an elevated white blood
cell count, underlying pneumonia and fluid surrounding the lungs. It is
estimated that 0.7 per cent of children with pneumonia go on to develop
empyema, affecting 1 per 100,000 children in Australia.
- Around 20 per cent of adults with empyema will die from the disease.
- Empyema is typically treated by antibiotics and fluid drainage via a
chest drain insertion and/or surgery.
Media opportunities
Associate Professor Adam Jaffe is only available for interview on Wednesday 1
April and Thursday 2 April.
Limited phone interviews with Assoc Prof Jaffe available on Friday 3 April.
Former empyema patient and his parent available for media opportunity.
All media enquiries: Jessica Jaramillo (02) 9382 3571 or 0404 001 722.
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