World Pneumonia Day is observed on November 12th every year with the aim to spread awareness to prevent and treat pneumonia.
Pneumonia is one of the leading cause of morbidity and mortality in children under five years of age worldwide despite being easily preventable and treatable. According to the World Health Organization (WHO), it killed around 9,20,136 children under the age of five in 2015, accounting to 16% of all deaths of children all over the world. India accounts for around 36% of all the total cases of pneumonia in the South East Asia region. So this World Pneumonia Day, let’s focus on some of the key aspects of pneumonia including the risk factors, treatment, and prevention.
What happens in pneumonia?
Pneumonia is a condition that affects the lungs. It is a form of acute respiratory infection which causes inflammation of the alveoli (air sacs in the lungs). When a person suffers from pneumonia, the alveoli get filled with fluid or pus which makes it difficult to breathe and limits the intake of oxygen.
What causes pneumonia?
Pneumonia is caused by a number of infectious agents and is classified based on the organisms that cause the infections. The common causes and types of pneumonia include
-Bacterial pneumonia, caused by bacteria such as Streptococcus pneumoniae, Haemophilus influenzae type b (Hib) and Klebsiella pneumoniae.
-Viral pneumonia, caused by viruses such as the respiratory syncytial virus.
-Fungal pneumonia, caused by fungi such as Pneumocystis jirovecii.
-Mycoplasma pneumonia is caused by mycoplasms, organisms that have traits similar to bacteria and viruses but do not belong to either category.
Who can get pneumonia?
Anyone can get pneumonia, however certain people are at a high risk such as:
-Children till the age of five years.
-People with chronic disease such as COPD and asthma.
-People with a weakened immune system and those on medications for cancer.
-People who smoke or drink alcohol.
Most kids can fight the infection but kids whose immune system is compromised are at a higher risk of developing the infection. A child might have a weakened immune system due to malnutrition or undernourishment, especially in infants who are not breastfed exclusively for at least six months. Moreover, if kids are exposed to illnesses such as HIV infection or measles, the risk increased further. In addition to this, there are few environmental factors that can put a kid at risk of pneumonia. This include:
-Exposure to secondhand smoke
-Indoor and outdoor air pollution
-Living in crowded homes
-Poor sanitation and hygiene
-Exposure to already infected person/child (as infection can spread through coughing and sneezing)
How is pneumonia transmitted?
Pneumonia can spread via airborne droplets when a person coughs or sneezes. When the viruses and bacteria found in the droplets are inhaled, it can infect the lungs. It can also be transmitted through food, drink, saliva, and blood. In some cases, bacterial pneumonia can be acquired during hospital stay (known as hospital-acquired pneumonia) or outside anyy medical setting (known as community-acquired pneumonia).
Is pneumonia contagious?
Most types of pneumonia are contagious in nature. This is because both viral and bacterial pneumonia can be transmitted through inhalation of airborne particles when coughed and sneezed. However, fungal pneumonia doesn’t spread from person to person.
What are the signs and symptoms of pneumonia?
The signs and symptoms of pneumonia vary from person to person depending on the type of pneumonia, age and overall health. Some of the common pneumonia symptoms are:
-Cough with mucus or phlegm
-Shortness of breath
-Sweating and chills
Children with very severe pneumonia may show symptoms such as an inability to eat or drink, unconsciousness, hypothermia (dangerously lower than normal body temperature) and convulsions.
How is pneumonia diagnosed?
Based on your symptoms and clinical history, your doctor will perform a physical examination and may even order a chest X-ray and other investigations. Typically, pneumonia can be diagnosed with a physical exam and X-ray. However, depending upon the severity of the symptoms, your doctor may even order other tests such as:
-Blood test to confirm an infection
-Sputum test to identify the cause of the infection
-Pulse oximetry to know if the lungs are supplying enough oxygen into the bloodstream
-Urine test to identify certain bacteria causing the infection
-CT scan for a detailed view of the lungs
How is pneumonia treated?
The treatment for pneumonia depends on the type, severity, and overall health. In most cases, antibiotics, antiviral, or antifungal medications are prescribed to treat pneumonia based on its type along with other medications to treat symptoms like fever, cough, etc. Most cases can be treated at home by taking the prescribed drugs, taking enough rest, and drinking lots of water. However, if it’s not being managed at home, your doctor may advise hospitalization for appropriate treatment.
Most people respond to treatment and recover from the condition. However, in some cases, it can lead to worsening of the conditions you already suffer from such as diabetes, a weak immune system, or congestive heart failure. The common complications due to pneumonia include impaired breathing, acute respiratory distress (a severe form of respiratory failure), lung abscesses (pus in the lungs), bacteremia (bacteria in the blood), pleural effusion (fluid in the lungs) or even death.
Can pneumonia be prevented?
Pneumonia can be prevented in many cases. Getting vaccinated is one of the most effective preventive measures for pneumonia. The pneumococcal vaccine is indicated in special high-risk groups only such as people who underwent splenectomy, compromised immunity, diabetes and chronic organ failure. Pneumonia vaccination won’t prevent all cases of pneumonia, however, it can lead to a milder and shorter course of the disease and lower risk of complications. Apart from vaccination, quitting smoking, washing hands regularly, and maintaining a healthy lifestyle can help to boost immunity and prevent pneumonia.
The WHO and UNICEF integrated Global action plan for pneumonia and diarrhoea (GAPPD) aims to accelerate pneumonia control with interventions to protect, prevent, and treat pneumonia in children. The aim is to:
Protect children from pneumonia by promoting good health practices such as exclusive breastfeeding, adequate complementary feeding, and Vitamin A supplementation.
Prevent pneumonia with vaccinations, and regular hand washing with soap. It also aims at reducing household air pollution, preventing HIV prevention, and prophylaxis for HIV-infected and exposed children.
Treat pneumonia with proper antibiotics and medicines and provide appropriate care to every sick kid either from a community-based health worker or in a health facility, if the disease is severe.
(The article is verified by Dr. Lalit Kanodia, General Physician)
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