Pneumonia, a forgotten killer

Monday September 13 2021
health01pix
By Abdul-Nasser Ssemugabi

Not so long ago, Hakim Muyanja suffered breathing difficulties for about six weeks. Quite often, he coughed heavily throughout the night but was hesitant to go to hospital, for fear of contracting Covid-19.

Besides, he thought, he would overcome the cough as he had done several times in his 28-year lifespan.

But on the insistence of his father, Muyanja underwent a diagnosis, and he tested positive for pneumonia. Ten days later, he died, because pneumonia had done irreparable damage to his lungs and partly compromised his kidneys. He had only quit smoking eight months back. 

Worse still, he had passed on the disease to his four-year old daughter.

Pneumonia is an acute respiratory infection that causes inflammation in the air sacs of the human lungs, filling them with fluid or pus, hence making breathing difficult. It is caused by bacteria, viruses and in some cases fungi.

According to the World Health Organisation (WHO), 2.56 million people die from pneumonia worldwide annually. Almost a third of all victims are children younger than five years, it is the leading cause of death for children under five.

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People aged 65 and above, those with medical complications like cancer, habitual smokers like Muyanja, alcoholics, and children aged five and below, are the most vulnerable to pneumonia.

According to a study published by PubMed in 2014, pneumonia is a leading cause of death among children under five years of age, causing roughly 1.6 million deaths per year. In Uganda, Unicef estimates that pneumonia kills up to 24,000 children under-five every year, many of whom were misdiagnosed with malaria.

 Signs and symptoms

Asia Nakitto, a medical officer at Pearl Medical Centre, in Kansanga, says pneumonia symptoms can vary according to one’s age and immunity but the commonest are: coughing that may produce phlegm (heavy mucus); shortness of breath or difficulty in breathing, or wheezing—even during normal activities or resting.

Chest pain worsened when coughing or breathing; fever, sweating or chills, fatigue, loss of appetite, nausea, headaches, among others.

She adds that the incubation period of the bacteria or virus is 48 hours in most patients, but for those with strong immune systems, the symptoms can be detected as early as 12 hours.

Covid pneumonia?

According to the World Health Organisation, the most severe cases of Covid-19 had severe pneumonia, which is called Covid-19 pneumonia.

Those with weakened immune systems due to comorbidities like cancer, high blood pressure, diabetes, kidney or liver disease, severe heart disease, asthma and other breathing disorders, stand high chances of catching Covid- Pneumonia.

Nakitto says such cases necessitate physicians to supplement the Covid treatment with antibiotics and oxygen to help the body fight off pneumonia.

Who is vulnerable?

Anyone can contract pneumonia, but as earlier mentioned, the most vulnerable groups include:

Children aged five and below; people aged 65 and above; those with weakened immune systems—mostly as a result of disease or use of medications, such as some cancer drugs; those with chronic medical conditions, like diabetes, asthma, and those born with lung defects like cystic fibrosis— a genetic condition that causes severe damage to the respiratory and digestive systems.

If you recently had flu or a cold; or had a stroke, you are also susceptible to pneumonia, just like habitual alcoholics and smokers like Muyanja.

Exposure to lung irritants, like pollution, fumes, and certain chemicals is another risk factor.

Physical effects

Although pneumonia is primarily a respiratory disease, its complications can lead to body organ failure.

If one’s lungs are so inflamed they cannot take in enough oxygen or expel enough carbon dioxide, medics say, it can lead to hypoxia, when the oxygen levels in one’s blood is below normal.

Nakitto adds that if pneumonia reaches the bloodstream, it can cause septic shock, a medical emergency caused by very low blood pressure and a compromised blood flow to the body’s major organs, hence causing failure of the heart, kidney, and other life-threatening conditions.

She adds that if the damage tears the membranes that cover the spinal cord and the brain, it can cause pneumococcal meningitis—a serious disease that can cause death even with proper treatment.

 Prevention, treatment

Muyanja’s four-year old daughter was lucky.  She was vaccinated when she was two years old, and the pneumonia only manifested in mild fever, cough, and healed in about three weeks of taking antibiotics.

But the Unicef/WHO report cited by the 2014 Ugandan study mentioned above, shows that only about one in every five caretakers can tell the signs and symptoms of pneumonia like fast breathing and difficult breathing.

The study also shows only about half of the children sick with pneumonia receive proper medical care and, less than 20 per cent of children with pneumonia receive antibiotics.

Meanwhile, scientists have developed Prevnar 13 and Pneumovax 23, Flu vaccine and the Hib vaccine to reduce the severity of pneumonia-related complications.

Health practitioners also suggest preventive measures like regular washing of hands with soap and water; covering one’s coughs and sneeze; promptly disposing used tissues; quitting smoking and maintaining a healthy lifestyle—resting enough, taking a healthy diet, and exercising regularly—to boost one’s immune system.

Nakitto also encourages exclusive breast feeding of babies for up to six months and maintaining proper hygiene.

“By Ugandan standards, a well-ventilated average size room should not be occupied by more than three children.”

If antibiotic treatment fails to clear the lungs of the unwanted fluid, a surgery may be required to remove it.

Five  myths about Pneumonia and the real truth

Myth: Pneumonia is just a bad cold.

Truth: The common cold is caused by a virus and typically does not require urgent medical care. In fact, self-care may be enough. Pneumonia is a bacterial infection in the lungs, which is more serious and requires treatment.

Myth: You can get pneumonia if you don’t wear a coat outside when it’s cold.

Truth: Pneumonia is caused by bacteria, viruses, or possibly fungi.

Myth: Standing near a drafty window or going out with wet hair can give you pneumonia.

Truth: When you are cold, your body may possibly be less able to fight off infection and other illnesses, but the weather is not a direct cause of pneumonia.

Myth: Pneumonia is an infection within one person. It’s not contagious.

Truth: You can catch pneumonia sometimes, but it depends on what kind of pneumonia it is. Bacterial and viral infections can be spread from person to person, but fungal pneumonia cannot.

Myth: Pneumonia only affects older individuals.

Truth: Pneumonia can affect people of any age. However, older age is a significant risk factor, which is why people over the age of 65 are considered to be at higher risk. The lung infection may also be more serious in seniors because the immune system may be less effective. Infants and young children also are at high risk of getting pneumonia.

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