The Decline of Pneumococcal Infections

Early in my career as a pediatrician, I would sometimes lie awake at night worrying about pneumococcus. Pneumococcus is a type of strep bacteria (different than the one that causes strep throat) which can cause serious infections such as meningitis, bloodstream infections, and pneumonia. Unfortunately, early in the course of an invasive pneumococcal infection, the symptoms can be the same as in a plethora of common, self-limited, viral infections, especially in young children.

This is what resulted in sleepless nights, wondering if I could have missed something serious hidden among the multitude of benign illnesses. As a result, we would obtain labs on some children with fevers who met certain criteria or even admit them to the hospital for observation or give them injections of antibiotics until we had final blood culture results available, usually in 48 hours. Most of those children did not end up having serious illnesses but, depending on the situation, waiting to see could have resulted in what are sometimes referred to euphemistically as “bad outcomes.”

The first pneumococcal conjugate vaccine was introduced in 2000 and there was a 76% decrease in invasive pneumococcal infections over the next seven years. In 2010, a new version of the vaccine containing more serotypes of pneumococcal antigens was released. A new study in JAMA Pediatrics reports a further 70% decrease in invasive pneumococcal disease in a population of children in New York City monitored since the introduction of the new vaccine.

I can’t remember the last time I saw an invasive pneumococcal infection. I sleep much better than I used to. And most importantly, children and their families are at much lower risk of these serious infections than they used to be.

The End of an Era

I will eventually get to medical topics on this blog but wanted to first pay tribute to a friend and colleague.

Dr. George T. Sproul has retired after 38 years of practicing pediatrics in Staunton. I had the pleasure of working with him for the last 18 of those years. During those years, he was first my physician manager, then my business partner, and finally an employed physician the past few years. In all of those roles I always found him to be a man of integrity. He is kind, honest, hard-working, and always did what he thought was best for patients.

He is a lover of nature as exhibited by the bird feeders that have always been around our offices, first on Commerce Road in Staunton and now in Verona. I have learned a lot about medicine from him through the years but he has also been a frequent recipient of my questions regarding local nature and history, astronomy, and science in general.

I recently have heard that some families refer to him as “The Baby Whisperer” for his calming manner when dealing with patients. At the old office, he could frequently be seen taking patients over to the edge of the parking lot towards the stream to show them what poison ivy plants look like. Over the past few months, as his retirement neared, I enjoyed hearing grandmothers of patients reminisce about bringing their children to see him and mothers of patients talk about when they used to be his patients.

I know pediatrics has changed a lot in the past 18 years so I can’t quite imagine how different things must have been 38 years ago. But doing our best to care for patients is one thing that should never change. Dr. Sproul’s legacy of compassion for patients combined with intellectual integrity is one I aspire to continue. His presence will be greatly missed.

Old Newspaper Column, New Blog

I formerly wrote a monthly column on pediatrics for the local newspaper. Writing is one of my hobbies and I found it enjoyable and I believe it was at least somewhat informative as well. Then life got crazy with family activities, frequent call nights running to the hospital, and all sorts of other things and it kind of fell by the wayside.

But I recently realized that I missed writing my column and have had enough people ask me about it to think that it must have been at least somewhat helpful. So I have decided to resurrect it as a blog (it is 2015, after all).

My intent is to cover topics related to the health and well-being of children and adolescents and their families based on published data as well as my experience as a practicing pediatrician and father. As with everything else in life, it seems that the more I learn and experience in medicine, the more I realize I do not know. So I tend to hold my thoughts and opinions a bit more loosely than at times in the past and I think this is a good thing. But I also think there are some things that I have learned that I hope you find interesting and useful.