With pneumonia no one can breathe easy
Pneumonia coughs up some shocking statistics. Worldwide, approximately 450-million people develop this inflammatory condition every year, resulting in four million deaths, which are mostly children under the age of five and adults over the age of 75, as well as those suffering from underlying chronic illness.
Pneumonia occurs about five times more frequently in developing than in developed countries and 95% of the deaths it causes occur in developing countries.
South Africa falls squarely into this category. In the past 20 years the country has experienced an alarming increase in deaths caused by pneumonia. Between 300 000 and 500 000 people are infected every year and between 5% and 10% of those will die as a result.
A high proportion of those contracting pneumonia are people infected with HIV, which strains our public sector healthcare resources because even though HIV-infected patients make up only 10% to 15% of our population they account for up to 80% of all hospital admissions related to pneumonia.
Many HIV-infected people, both adults and children, die from pneumonia because they are predisposed to bacterial infections, including tuberculosis, because of their weakened immune systems.
Pneumonia is an inflammation of one or both lungs owing to infection, which can be caused by a virus, bacteria, fungi or parasites.
When any of these organisms settle in the air sacs and passages inside a lung, it multiplies quickly. In the immune system’s effort to ward off the infection that area of the lung fills with fluid and pus. This is what causes a distinct crackling sound (called “crepitations”) when a doctor listens to your chest through a stethoscope.
Often the condition is spread by infected people when they cough or sneeze, which releases tiny droplets that contain the culpable organisms. At times people literally infect themselves through bacteria or viruses that are present in the mouth or nasal passages finding their way down to the lungs.
If people are in a weakened state because of illness they are at a higher risk of developing pneumonia. Those most at risk are those who have suffered recent viral infections, lung disease, heart disease, a stroke or a seizure. Other high-risk categories are people with swallowing problems, as well as those who abuse alcohol or drugs, as gastric contents can be aspirated into the lungs after a bout of vomiting.
As we get older it’s natural for both our immune system and swallowing mechanism to become impaired, which also increases the risk of pneumonia.
The signs of pneumonia start off the same as a bad cold: sneezing, coughing and a sore throat. These are it is followed by a high fever and a cough which produces sputum that is often bloody. The infection impairs the level of oxygen in the bloodstream resulting in cyanosis—when a sufferer’s skin colour takes on a purplish hue. Shortness of breath is also perceptible.
A dangerous aspect of pneumonia is that in some cases there is a slow onset of the symptoms, especially in babies, children and the elderly, which allows the infection to be established.
Effective treatment depends on the initial cause of the infection. If it is bacterial, a course of antibiotics needs to be prescribed. There is no medication for viral pneumonia, only supportive treatment comprising bed rest, plenty of liquids and treatment for the coughing, including supplemental oxygen and physiotherapy if the infection is severe.
Prevention is always better than cure. High- risk groups can be vaccinated to protect them against the most commonly acquired pneumonia.
Pneumonia will be the topic of Bonitas House Call on SABC2 on July 23 at 9am