Risk Factors and How It Spreads

Anyone can get pneumococcal disease, but some people are at increased risk. Being a certain age or having certain medical conditions can increase a person’s risk for pneumococcal disease.

Children at risk for pneumococcal disease

Children at increased risk for pneumococcal disease include those younger than 2 years old and those with:

  • Chronic heart, lung, or kidney disease
  • Cerebrospinal fluid (CSF) leak (a health problem where fluid surrounding and protecting the brain and spinal cord leaks)
  • Cochlear implant (a small electronic device that is surgically implanted to help people with severe hearing loss be able to hear)
  • Diabetes
  • HIV infection, cancer, solid organ transplant, or another condition or taking medicine that weakens the immune system
  • Nephrotic syndrome (a kidney disorder)
  • Sickle cell disease, a damaged spleen, or no spleen

Adults at risk for pneumococcal disease

Adults 65 years or older are at increased risk for pneumococcal disease.

Adults of all ages are also at increased risk for pneumococcal disease if they have:

  • Alcoholism
  • Chronic heart, lung, kidney, or liver disease
  • Cochlear implant
  • CSF leak
  • Diabetes
  • HIV infection, cancer, solid organ transplant, or another condition or taking medicine that weakens the immune system
  • Nephrotic syndrome
  • Sickle cell disease, a damaged spleen, or no spleen

Adults who smoke cigarettes are also at increased risk for pneumococcal disease.

Chronic lung illnesses that increase an adult’s risk for pneumococcal disease include chronic obstructive lung disease, emphysema, and asthma.

If you’re at increased risk for pneumococcal disease, talk to your doctor about which pneumococcal vaccines you need and when.

illustration of two people, one transmitting particles through mouth

 How it spreads

People spread pneumococcal bacteria to others through direct contact with respiratory secretions, like saliva or mucus. Many people, especially children, have the bacteria in their nose or throat at one time or another without being ill. Doctors call this “carriage” and do not know why it only rarely leads to sickness.

Page last reviewed: September 1, 2020