Pneumococcal disease can occur in multiple organ systems, causing pneumonia, meningitis, bacteraemia/sepsis, sinusitis, bronchitis and middle ear infection. Pneumococcal pneumonia in particular is a major public health concern for children globally. The presenting features of viral and bacterial pneumonia are similar. However, the symptoms of viral pneumonia may be more numerous than the symptoms of bacterial pneumonia. In children under 5 years of age, who have cough and/or difficult breathing, with or without fever, pneumonia is diagnosed by the presence of either fast breathing or lower chest wall in-drawing where the chest moves in or retracts during inhalation (in a healthy person, the chest expands during inhalation). Wheezing is more common in viral infections. Very severely ill infants may be unable to feed or drink and may also experience unconsciousness, hypothermia and convulsions.