The alarming mortality rate from pneumococcal disease in children was highlighted by Associate Professor, Doctor Pham Quang Thai of the Central Institute of Hygiene and Epidemiology. Speaking at a seminar on pneumococcal awareness, organized by the Vietnam Preventive Medicine Association in collaboration with Pfizer Vietnam on 24/6, Dr. Thai revealed that these figures, published in 2025, stem from a study of 274 invasive pneumococcal cases at the National Children's Hospital between 2019 and 2022. Out of these cases, 24 children died, primarily those under the age of 5.

Despite its severe impact, many parents underestimate the burden of pneumococcal disease, which remains a leading cause of dangerous invasive infections in young children. Data from Children's Hospital 1 and 2 further underscore this threat, indicating that pneumococcal bacteria are responsible for over 86% of bacterial meningitis cases in children under 5 years old.

The challenge of early detection is significant, as initial symptoms often mimic common cold and flu. Doctor, Grade 2 Specialist Nguyen Minh Tien, Deputy Director of Ho Chi Minh City Children's Hospital, recounted the case of an 11-year-old patient who was initially treated at home for what the family believed was a common cold, presenting with fever, cough, and runny nose. Within days, the child developed severe pneumonia and heart failure, necessitating extracorporeal membrane oxygenation (ECMO) to sustain life.

"The patient required ECMO for four weeks, followed by nearly one month of additional treatment before discharge, incurring costs of hundreds of millions of Vietnamese dong", Doctor Tien stated. He emphasized that pneumococcal infections frequently begin with mild, easily mistaken symptoms such as a cough, runny nose, and low-grade fever.

Pneumococcal bacteria are a common cause of pneumonia, otitis media, and sinusitis in young children. When these bacteria invade the bloodstream or central nervous system, they can lead to severe conditions like sepsis, meningitis, pleural empyema, and even multi-organ failure. According to Doctor Tien, children with chronic illnesses face a risk three times higher than healthy children for severe pneumococcal infection, while immunocompromised children have a risk up to 40 times greater.

Asymptomatic carriers pose a considerable risk for community transmission. A study published in 2026 revealed that approximately 33% of Vietnamese children under 18 years old carry pneumococcal bacteria in their nasopharynx without exhibiting symptoms, thereby becoming primary sources of infection within their families and communities.

Critically ill patient receiving intensive care. *Photo: Quynh Tran*

A major challenge in treating pneumococcal infections is the worsening issue of antibiotic resistance. At the National Children's Hospital, 75,3% of invasive pneumococcal strains have developed resistance to third-generation cephalosporins, and nearly 100% are resistant to erythromycin and clindamycin. Similarly, Ho Chi Minh City Children's Hospital reports resistance rates of around 80% to several common antibiotic groups. Experts attribute this growing resistance largely to the indiscriminate use of antibiotics within the community, which severely limits treatment options.

The success of vaccination programs in reducing other bacterial infections highlights the potential for pneumococcal prevention. Associate Professor Thai noted that after the Hib vaccine was introduced into the Expanded Program on Immunization, the incidence of purulent meningitis caused by Hib dramatically decreased by 60-70%, falling to about 6%. In contrast, pneumococcus has emerged as the dominant cause, now accounting for approximately 70% of purulent meningitis cases in children.

"In severe invasive pneumococcal cases, the mortality rate can reach 40-45%, nearly comparable to meningococcal disease", he explained. Even if children survive, many can suffer long-term sequelae, including deafness, reduced learning ability, motor disorders, or seizures.

Experts share information about pneumococcal bacteria at the seminar. *Photo: My Nguyen*

Professor, Doctor Phan Trong Lan, Director of the Central Institute of Hygiene and Epidemiology and President of the Vietnam Preventive Medicine Association, emphasized that delaying concern for certain diseases until hospitalization is often too late. Such delays can result in significant anxiety, high costs, and sometimes severe, lasting consequences for children. Pneumococcal disease serves as a prime example, being a leading cause of pneumonia, meningitis, and sepsis in children.

"The epidemiological landscape of pneumococcal disease is becoming more complex due to the combined effects of environmental pollution, urbanization, and the uncontrolled use of antibiotics", Professor Lan stated.

Associate Professor, Doctor Cao Huu Nghia, Head of the Department of Biomedical Sciences at the Pasteur Institute HCMC, pointed out that pneumococcal disease is not solely a threat to children under 5 years old. It can also cause severe illness in older children with high-risk underlying conditions. He stressed that correctly identifying risk groups across all age ranges is crucial for selecting appropriate preventive measures.

Experts advise parents to pay close attention if a child experiences prolonged fever, worsening cough, labored breathing, poor feeding, or lethargy after a seemingly recovered cold or flu. "Do not be complacent, as a seemingly mild runny nose can sometimes escalate into a severe emergency within just a few days", Doctor Tien warned.

Le Phuong