Pneumonia, deadly but preventable

Pneumonia is a form of acute respiratory infection that affects the lungs. Scientists say the lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. “However, when an individual has pneumonia, the alveoli are filled with pus and fluid, causing cough with phlegm or pus, fever, chills and difficulty breathing. It makes breathing painful and limits oxygen intake,” says General Practitioner, Dr. Abiola Lanre-Iyanda.

The World Health Organisation notes that pneumonia is the single largest cause of death in children worldwide.

Mode of contact

Lanre-Iyanda says one can be infected with pneumonia anywhere and at any time, including in the office, school, or the hospital. “In short, wherever there are humans, the possibility of getting the infection is there,” the physician warns.

Lanre-Iyanda says there are bacteria and viruses that live in the nose, sinuses, or mouth, but that they may spread to the lungs. “You may breathe some of these germs directly into your lungs. If this happens when you are immunocompromised, then you may end up with pneumonia,” she says

An individual is said to be in “immunocompromised” state when his ability to fight infection is greatly reduced because of a weakened immune system.

People whose immune system is not working well are less able to fight off germs, experts say. “Because of this state, they are more likely to become infected by germs that typically do not cause disease in healthy people. They are also more vulnerable to the usual causes of pneumonia, which can affect anyone,” Lanre-Iyanda adds.

Again, she says, bacteria may also spread via air-borne droplets from a cough or sneeze. “And that’s why it’s advisable to have clean handkerchiefs on hand whenever you are in public places, so that you can cover your nose and mouth when people around you cough or sneeze,” she counsels.

In addition, the physician warns, pneumonia may spread through blood, especially during and shortly after birth. “This is another reason why pregnant women must not neglect antenatal visits, so that these issues can be taken care of as soon as they are detected,” Lanre-Iyanda says.

What weakens immune system

Experts say the immune system may be weakened as a result of many factors, including when one undergoes bone marrow transplant or chemotherapy. Again, HIV infection, leukaemia, lymphoma, and other conditions that harm the bone marrow may provide the leeway for pneumonia, physicians say.

Again, they warn, certain medications — including steroids, and those used to treat cancer and control autoimmune diseases — can weaken the immune system. And those who have undergone organ transplant — including kidney, heart, and lung — may suffer weakened immunity and thus be susceptible to pneumonia infection.

Causes

The American Lung Association says pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. Physicians say pneumonia caused by bacteria tends to be the most serious kind. “In adults, bacteria are the most common cause of pneumonia,” the association enthuses.

It explains further, “The most common agents of pneumonia are Streptococcus pneumonia, which is the most common cause of bacterial pneumonia in children; Haemophilus influenzae type b (Hib) — the second most common cause of bacterial pneumonia; respiratory syncytial virus — the most common viral cause of pneumonia.

“In infants infected with HIV, Pneumocystis jiroveci is one of the commonest causes of pneumonia, responsible for at least one quarter of all pneumonia deaths in HIV-infected infants.”

Presenting features

The presenting features of viral and bacterial pneumonia are similar, scientists say. However, the symptoms of viral pneumonia may be more numerous than the symptoms of bacterial pneumonia.

“In children under five 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 their chest moves in or retracts during inhalation,” Paediatrician and Public Health Specialist, Dr. Rotimi Adesanya explains.

Adesanya adds that wheezing is more common in pneumonia that is due to viral infections. He also warns that infants that are severely ill as a result of pneumonia attack may be unable to feed or drink; while they may become unconscious, or experience hypothermia and convulsions.

The online portal, webmd.com notes that symptoms of pneumonia caused by bacteria usually come on quickly and they may include cough, accompanied by mucus that is rusty, green or tinged with blood. The victim may also have fever, fast breathing and feeling short of breath.

Shaking and teeth-chattering chills, as well as chest pain that often feels worse when you cough or breathe in, may also be experineced.

As time goes on, experts warn, the patient may experience extreme tiredness, nausea and vomiting, diarrhoea, lower than normal body temperature in people older than age 65, and in people with poor overall health or weakened immune systems.

Worse still, the patient may experience fatigue and muscle aches, headache, and excessive sweating and clammy skin

Adesanya says newborns and infants may not show any sign of the infection; or they may vomit, have a fever and cough. “They may also appear restless or tired and without energy, or have difficulty breathing and eating,” he adds.

Lanre-Iyanda says older people who have pneumonia sometimes have sudden changes in mental awareness, though they may have different, fewer, or milder symptoms.

“They may not have a fever. Or they may have a cough but not bring up mucus. The main sign of pneumonia in older adults may be a change in how well they think. Confusion or delirium is common. Or, if they already have a lung disease, that disease may get worse,” she says.

She advises that those who have certain health conditions, such as diabetes and asthma, should get vaccinated against the flu and bacterial pneumonia.

Risk factors

Experts say while most healthy children can fight the infection with their natural defences, children whose immune systems are compromised are at higher risk of developing pneumonia. Such children include those whose immune system has been weakened by malnutrition or undernourishment, especially infants who are not exclusively breastfed.

“Pre-existing illnesses, such as symptomatic HIV infections and measles, also increase a child’s risk of contracting pneumonia,” experts say.

Environmentalists also add that certain environmental factors increase a child’s susceptibility to pneumonia. And they include indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung), living in crowded homes and smoking by parents.

Save yourself

Experts say if you are 65 or older, if you smoke, or have a heart or lung problem, you should get a pneumococcal vaccine. “It may not keep you from getting pneumonia, but if you do get pneumonia, you probably won’t be as sick,” they counsel.

You can also lower your chances of getting pneumonia by staying away from people who have the flu, colds, measles, or chickenpox.

More important, wash your hands often, as this helps prevent the spread of viruses and bacteria that may cause pneumonia.

Experts also advise against smoking, as it damages the lungs and increases the chance of infection.