DEAR DR. DONOHUE: What is pneumococcal sepsis? My wife and I cannot get answers explaining why my 41-year-old daughter died of it. She lived in an apartment with her 13-year-old daughter and 9-year-old son. My daughter and granddaughter both had pneumonia. My granddaughter went to the hospital and recovered. My daughter went to the ICU and died four days later. Can you shed any light on this? – F.

ANSWER: The pneumococcus (NEW-moe-KOK-us) germ is a common bacterium found in the nose and throat of 10 percent of healthy adults and up to 40 percent of healthy children. On occasion, it can turn lethal when it escapes to other body sites, especially when it does so in infants younger than 2, adults older than 65 or people whose immune systems are not up to snuff.

In your daughter’s and granddaughter’s cases, the germ found its way into their lungs and brought on pneumonia. In your daughter’s case, the germ escaped from her lungs and entered her bloodstream – that’s sepsis, and it is often a fatal infection.

I can’t tell you why this sequence of events occurred. It happens, even to very healthy people. Until recent times, penicillin controlled almost all pneumococcal infections. Now some pneumococcal strains have become resistant to penicillin and require other antibiotics. Perhaps your daughter and granddaughter had a resistant strain.

There is a vaccine for the pneumococcus germ, and it is now given to all babies. It is also highly recommended for those over 65. Popularly it is called the pneumonia vaccine. In addition, it should be given to people of any age with illnesses that make them susceptible to pneumococcal infection. That includes people with diabetes, liver and kidney disease, heart failure and those who do not have a spleen.

I have no words to console you for such an unexpected tragedy. I have no words to ease the loss your grandchildren face with the death of their mother. Be assured you have my and my readers’ sympathy.

DEAR DR. DONOHUE: I am enclosing a candy wrapper that says “sugar free.” On the list of ingredients there appears “sugar alcohol.” Is this false advertising, as it appears to be to me, or is it just grossly misleading? – B.C.

ANSWER: “Sugar alcohol” is a source of confusion to everyone. These substances aren’t sugars, and they aren’t alcohol. They got the designation because their chemical structure looks similar to the structures of sugars and alcohols. The term is misleading. Someone should come up with a substitute.

Sugar alcohols are used as artificial sweeteners, and the foods they are added to can be legitimately and truthfully labeled as being sugar-free.

Sugar alcohols have fewer calories than does sugar. They raise blood sugar slightly and slowly.

They have no alcohol effect at all.

Mannitol, xylitol, sorbitol and isomalt are common sugar alcohols. You can find them in many products. Overdoing their use can bring on diarrhea.

DEAR DR. DONOHUE: The doctor at the Veteran’s Administration has prescribed felodipine for my high blood pressure.

My private doctor recommends I take Toprol XL.

Toprol XL is expensive, and the VA does not carry it. Your opinion, please? – R.S.

ANSWER: Costly blood-pressure medicine is not necessarily the best blood-pressure medicine. The best medicine for an individual patient is the one that lower pressure with the fewest side effects and the least expense.

Felodipine, brand name Plendil, is a calcium-channel blocker. It stops minute amounts of calcium from entering the tiny muscles that surround arteries. When calcium enters those muscles, they constrict, narrow the vessel and raise blood pressure.

Toprol XL is the brand name for metoprolol, a beta-blocker medicine. It dilates arteries too but in a way different from felodipine.

If your pressure is controlled with felodipine, then you don’t need the more expensive medicine. If it isn’t, then you do need a medicine change. There are many to choose from.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.