By Henrylito D. Tacio
Pneumonia may have lost its grip, but it is still deadly as ever.
In 2020, the number of pneumonia cases amounted to approximately 87.5 thousand in the Philippines, according to the Statista Research Department. This reflected a significant decrease compared to the previous year, which recorded over 312.4 thousand cases in the country.
Unfortunately, pneumonia is taking its toll. In 2020, it caused approximately 34.3 thousand deaths in the country, reflecting a year-on-year decrease from over 62.7 thousand. Pneumonia was the fifth leading cause of death among Filipino women in the same year.
“The Philippines is one of the 15 countries that together account for 75% of childhood pneumonia cases worldwide,” the UN World Health Organization (WHO) reports. “In children under 5 years, pneumonia is the leading cause of mortality.”
So much so that the international community launched World Pneumonia Day in 2009 to provide an annual forum for the world in the fight against pneumonia. It is observed every November 12.
Understanding pneumonia
Pneumonia is actually an infection of the lungs that involves the small air sacs (alveoli) and the tissues around them. But then, pneumonia isn’t a single illness but many different ones, each caused by a different microscopic organism.
As Donald and Diana Stroetzel explained in an article which appeared in Reader’s Digest: “Pneumonia is a catchall name for a number of look-alike conditions, some requiring different medications.”
“Pneumonia tends to be more serious for children under the age of five, adults over the age of 65, people with certain conditions such as heart failure, diabetes, or chronic obstructive pulmonary disease, or people who have weak immune systems due to HIV/AIDS, chemotherapy, or organ or blood and marrow stem cell transplant procedures,” the US National Heart, Lung, and Blood Institute (NHLBI) says.
Lifestyle habits, like smoking cigarettes and drinking too much alcohol, can also raise a person’s chances of getting pneumonia. “Smoking damages your body’s natural defenses against the bacteria and viruses that cause pneumonia,” the Mayo Clinic says.
Caused by bacteria
Medical science has established that bacteria and viruses are the most common causes of pneumonia. In adults, the most common causes are bacteria, such as Streptococcus pneumoniae, Staphylococcus aureus, Legionella, and Hemophilus influenzae.
Streptococcus pneumoniae is the most common bacterial cause. A person who has been infected with one of the 80 known types of pneumococci develops partial immunity to the others. Staphylococcus aureus causes only two percent of pneumonia cases acquired outside the hospital, but it causes 10% to 15% of those acquired in hospitals while people are being treated for another disorder.
Legionella accounts for one to eight percent of all pneumonias and about four percent of fatal pneumonias in hospitals.
Despite its name, Hemophilus influenzae isn’t the virus that causes flu, but is one of the bacterial causes of pneumonia. The Hemophilus influenza type b strains are the most virulent strains and cause many other serious diseases aside from pneumonia.
Viruses, fungi and atypicals
There are several viruses that cause pneumonia. In infants and children, respiratory syncytial virus (RSV), adenovirus, parainfluenza virus, and influenza virus are the most common causes. The measles virus also may cause pneumonia, especially in malnourished children.
In healthy adults, two types of influenza virus – called types A and B – cause pneumonia. The chickenpox virus can also cause pneumonia in adults. In elderly people, viral pneumonia is likely to be caused by influenza, parainfluenza, or RSV.
There are three types of fungi that commonly cause pneumonia: Histoplasma capsulatum, which causes histoplasmosis; Coccidioides immitis, which causes coccidioidomycosis; and Blastomyces dermatitidis, which causes blastomycosis. Most people who become infected have only minor symptoms and don’t know that they’re infected. Some become gravely ill.
There are so-called “atypical pneumonias,” which are pneumonias caused by organisms other than the typical bacteria, viruses, or fungi. The most common causes are Mycoplasma pneumoniae and Chlamydia pneumoniae. Both bacteria-like organisms are the most common cause of pneumonia in people ages 5 to 35. Mycoplasma epidemics reportedly occur in confined groups such as students, military personnel, and families.
“(Pneumonia) is a tough disease to diagnose,” says Dr. Marie Budev, a pulmonologist and the medical director of the lung transplant program at the Cleveland Clinic in Ohio. “Age makes a big difference, as well as a person’s immune system… and, of course, the symptoms themselves.”
Signs and symptoms
“The signs and symptoms of pneumonia may vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health,” the Mayo Clinic states. “Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.”
The Mayo Clinic adds that the signs and symptoms of pneumonia may include chest pain when you breathe or cough; confusion or changes in mental awareness (in adults age 65 and older); cough, which may or may not produce phlegm; fatigue; fever, sweating and shaking chills; lower than normal body temperature (in adults older than age 65 and people with weak immune systems); nausea, vomiting or diarrhea; and shortness of breath.
“Newborns and infants may not show any sign of the infection,” the Mayo Clinic says. “Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.”
Treatments
Pneumonia is generally treated with antibiotics. “The antibiotic of choice is amoxicillin dispersible tablets,” the WHO recommends. “Most cases of pneumonia require oral antibiotics, which are often prescribed at a health center. These cases can also be diagnosed and treated with inexpensive oral antibiotics at the community level by trained community health workers.”
Pneumonia often clears up in 2 to 3 weeks. But older adults, babies, and people with other diseases can become very ill. Hospitalization is recommended only for severe cases of pneumonia.
An ounce of prevention is better than a pound of cure, so goes the saying. “Preventing pneumonia in children is an essential component of a strategy to reduce child mortality,” the WHO says. “Immunization against Hib, pneumococcus, measles and whooping cough (pertussis) is the most effective way to prevent pneumonia.”
In 2013, the health department introduced the Pneumococcal Conjugate Vaccine as an addition to its free basic immunization program for children in the health centers across the country.
“Non-immunization is one of the definite risk factors that makes any child more vulnerable to pneumonia,” said Dr. Salvacion Gatchalian, past president of the Pediatric Infectious Disease Society of the Philippines.
You can also lower your chances of getting pneumonia by staying away from people who have the flu, colds, measles, or chickenpox. You may get pneumonia after you have one of these illnesses. Wash your hands often. This helps prevent the spread of viruses and bacteria that may cause pneumonia. – ###
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