Streptococcus pneumoniae (the pneumococcus) is a leading cause of otitis media (OM), community-acquired pneumonia, bacteremia, and meningitis. The pneumococcus is a human-specific pathogen which colonizes the nasopharynx and spreads between hosts through aerosols and potentially through the contamination of objects with mucosal secretions if the bacteria is living within a biofilm (1 - 3). Rates of carriage vary from 5 to 10% of healthy adults to 20 to 40% of healthy children. However, these numbers can vary widely based on where the samples are collected (4 - 7). Risk factors associated with higher rates of carriage include race (particularly Australian Aboriginals and Native Americans) (8 - 12), infancy (13, 14), season, with higher carriage during winter months (13), and crowded areas such as childcare centers, with estimates suggesting that 40 to 60% of children who attend childcare are colonized (15). Duration of colonization decreases with age and varies from 2 weeks to 4 months (14, 16, 17). The introduction of pneumococcal conjugate vaccines has reduced carriage rates for serotypes covered by the vaccine, while nonvaccine serotypes have emerged to occupy this empty niche (18). Nasopharyngeal colonization is usually asymptomatic (19).