Pneumococcal disease: guidance, data and analysis

The characteristics, diagnosis, management, surveillance and epidemiology of pneumococcal disease.

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae (pneumococcus).

Infections are either non-invasive or invasive. Non-invasive diseases include middle ear infections (otitis media), sinusitis and bronchitis. Invasive pneumococcal disease (IPD) includes septicaemia, pneumonia and meningitis.

IPD is a major cause of disease and death globally and in the UK. It particularly affects:

  • the very young
  • the elderly
  • people with no spleen or a non-functioning spleen
  • people with other causes of impaired immunity and certain chronic medical conditions

There are more than 90 different pneumococcal types (serotypes) that can cause disease in humans. More than 5,000 cases of IPD are diagnosed each year in England. The number of cases peaks in December and January.

Diagnosis and management


Two different pneumococcal vaccines are routinely used in the national immunisation programme. These are the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPV23). Current recommendations for both vaccines can be found in the Green Book.


The UK Health Security Agency (UKHSA) undertakes enhanced surveillance of invasive pneumococcal disease. All isolates administered should be referred to the reference laboratory.

UKHSA routinely requires GPs and paediatricians to complete a surveillance questionnaire for all laboratory-confirmed invasive pneumococcal disease (IPD) to monitor the impact of the PCV13 (Prevenar 13®).

Published 31 July 2014
Last updated 30 April 2021 + show all updates
  1. Added 'Pneumococcal polysaccharide vaccine: change to the supply route from June 2021 letter'

  2. Added 'Pneumococcal disease: cases caused by strains covered by all serotyped IPD and cases caused by strains covered by Prevenar 13 vaccine'.

  3. First published.