Pneumonia Can Be Prevented – World Pneumonia Day
World Pneumonia Day is observed each year on November 12th. Globally, pneumonia kills nearly 1 million children younger than 5 years old each year. This is greater than the number of deaths from any infectious disease, such as HIV infection, malaria, or tuberculosis. Each year in the United States, more than 250,000 people have to seek care in a hospital due to pneumonia. Unfortunately, about 50,000 people die from the disease each year in the United States. Most of the people affected by pneumonia in the United States are adults.
Pneumonia - an infection of the lungs
Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Depending on the cause, doctors often treat pneumonia with medicine. In addition, vaccines can prevent some types of pneumonia. However, it is still the leading infectious cause of death in children younger than 5 years old worldwide. Common signs of pneumonia include cough, fever, and difficulty breathing.
Causes of Pneumonia
Viruses, bacteria, and fungi can all cause pneumonia. In the United States, common causes of viral pneumonia are influenza and respiratory syncytial virus (RSV). A common cause of bacterial pneumonia is Streptococcus pneumoniae (pneumococcus). However, clinicians are not always able to find out which germ caused someone to get sick with pneumonia.
Community-acquired pneumonia is when someone develops pneumonia in the community (not in a hospital). Healthcare-associated pneumonia is when someone develops pneumonia during or following a stay in a healthcare facility. Healthcare facilities include hospitals, long-term care facilities, and dialysis centers. Ventilator-associated pneumonia is when someone gets pneumonia after being on a ventilator, a machine that supports breathing. The bacteria and viruses that most commonly cause pneumonia in the community are different from those in healthcare settings.
Learn more below about the infections that commonly cause pneumonia:
About HMPV
Human metapneumovirus (HMPV) can cause upper and lower respiratory disease in people of all ages, especially among young children, older adults, and people with weakened immune systems. Discovered in 2001, HMPV is in the paramyxovirus family along with respiratory syncytial virus (RSV). Broader use of molecular diagnostic testing has increased identification and awareness of HMPV as an important cause of upper and lower respiratory infection.
Symptoms
Symptoms commonly associated with HMPV include cough, fever, nasal congestion, and shortness of breath. Clinical symptoms of HMPV infection may progress to bronchitis or pneumonia and are similar to other viruses that cause upper and lower respiratory infections. The estimated incubation period is 3 to 6 days, and the median duration of illness can vary depending upon severity but is similar to other respiratory infections caused by viruses.
Transmission
HMPV is most likely spread from an infected person to others through secretions from coughing and sneezing close personal contact, such as touching or shaking hands touching objects or surfaces that have the viruses on them then touching the mouth, nose, or eyes In the U.S., HMPV circulates in distinct annual seasons. HMPV circulation begins in winter and lasts until or through spring. HMPV, RSV, and influenza can circulate simultaneously during the respiratory virus season.
About Human parainfluenza viruses (HPIVs)
Human parainfluenza viruses (HPIVs) commonly cause respiratory illnesses in infants and young children. But anyone can get HPIV illness. Symptoms may include fever, runny nose, and cough. Patients usually recover on their own. However, HPIVs can also cause more severe illness, such as croup or pneumonia.
Symptoms and Illnesses
Human parainfluenza viruses (HPIVs) commonly cause upper and lower respiratory illnesses in infants, young children, older adults, and people with weakened immune systems, but anyone can get infected. After you get infected, it takes about 2 to 7 days before you develop symptoms.
Symptoms of upper respiratory illness may include:
- fever
- runny nose
- cough
Symptoms of lower respiratory illness may include:
- croup (infection of the vocal cords (larynx), windpipe (trachea) and bronchial tubes (bronchi))
- bronchitis (infection of the main air passages that connect the windpipe to the lungs)
- bronchiolitis (infection in the smallest air passages in the lungs)
- pneumonia (an infection of the lungs)
Other symptoms of HPIV illness may include:
- sore throat
- sneezing
- wheezing
- ear pain
- irritability
- decreased appetite
About Flu
Influenza (flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk of serious flu complications. There are two main types of influenza (flu) virus: Types A and B. The influenza A and B viruses that routinely spread in people (human influenza viruses) are responsible for seasonal flu epidemics each year.
Flu Symptoms
Influenza (flu) can cause mild to severe illness, and at times can lead to death. Flu is different from a cold. Flu usually comes on suddenly. People who have flu often feel some or all of these symptoms:
- fever or feeling feverish/chills
- cough
- sore throat
- runny or stuffy nose
- muscle or body aches
- headaches
- fatigue (tiredness)
- some people may have vomiting and diarrhea, though this is more common in children than adults.
It’s important to note that not everyone with flu will have a fever.
Flu Complications
Most people who get flu will recover in a few days to less than two weeks, but some people will develop complications (such as pneumonia) as a result of flu, some of which can be life-threatening and result in death.
Sinus and ear infections are examples of moderate complications from flu, while pneumonia is a serious flu complication that can result from either influenza virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle (myositis, rhabdomyolysis) tissues, and multi-organ failure (for example, respiratory and kidney failure). Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis, the body’s life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have flu, and people with chronic heart disease may experience a worsening of this condition triggered by flu.
People at High Risk from Flu
Anyone can get sick with flu (even healthy people), and serious problems related to flu can happen at any age, but some people are at high risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women and children younger than 5 years, but especially those younger than 2 years old.
About Legionnaires’ disease
Legionnaires’ (LEE-juh-nares) disease is a serious type of pneumonia (lung infection) caused by Legionella (LEE-juh-nell-a) bacteria. People can get sick when they breathe in mist or accidently swallow water into the lungs containing Legionella.
Causes and Common Sources of Infection
Legionella is a type of bacterium found naturally in freshwater environments, like lakes and streams. It can become a health concern when it grows and spreads in human-made building water systems like
- Showerheads and sink faucets
- Cooling towers (structures that contain water and a fan as part of centralized air cooling systems for building or industrial processes)
- Hot tubs that aren’t drained after each use
- Decorative fountains and water features
- Hot water tanks and heaters
- Large plumbing systems
Home and car air-conditioning units do not use water to cool the air, so they are not a risk for Legionella growth.
How It Spreads
After Legionella grows and multiplies in a building water system, water containing Legionella then has to spread in droplets small enough for people to breathe in. People can get Legionnaires’ disease or Pontiac fever when they breathe in small droplets of water in the air that contain the bacteria. Less commonly, people can get sick by aspiration of drinking water containing Legionella. This happens when water accidently goes into the lungs while drinking. People at increased risk of aspiration include those with swallowing difficulties. In general, people do not spread Legionnaires’ disease and Pontiac fever to other people. However, this may be possible under rare circumstances. Talk to your doctor or local health department if you believe you were exposed to Legionella and you develop symptoms, such as fever, cough, chills, or muscle aches. Your local health department can determine whether to investigate. Be sure to mention if you spent any nights away from home in the last 10 days.
About Mycoplasma pneumoniae
Mycoplasma pneumoniae is a type of “atypical” bacteria that commonly causes mild infections of the respiratory system. In fact, pneumonia caused by M. pneumoniae is sometimes referred to as “walking pneumonia” since symptoms tend to be milder than pneumonia caused by other germs. The most common type of illness caused by these bacteria, especially in children, is tracheobronchitis, commonly called a chest cold. Symptoms often include being tired and having a sore throat, fever, and cough. Sometimes can cause pneumonia, a more serious lung infection, which may require care in a hospital.
How It Spreads
M. pneumoniae spread from person to person. People without symptoms may carry the bacteria in their nose or throat at one time or another. People spread M. pnuemoniae by coughing or sneezing, which creates small respiratory droplets in the air that contain the bacteria. Other people then breathe in the bacteria. Most people who spend a short amount of time with someone who is sick with M. pneumoniae do not become ill. However, it is common for the bacteria to spread between people who live together. M. pneumoniae infections usually have long incubation periods (the time between breathing in the bacteria and developing symptoms). The incubation period is usually between 1 to 4 weeks. M. pneumoniae outbreaks occur mostly in crowded settings like schools, college residence halls, military barracks, nursing homes, and hospitals. During school-based outbreaks, if people in the community get sick it is usually family members of ill school children.
Signs and Symptoms
In general, illness caused by Mycoplasma pneumoniae is mild with symptoms that appear and get worse over a period of 1 to 4 weeks. These bacteria can cause several types of infections.
The most common type of illness, especially in children, is tracheobronchitis, commonly known as a chest cold. Common symptoms of a chest cold include:
- Sore throat
- Fatigue (being tired)
- Fever
- Slowly worsening cough that can last for weeks or months
- Headache
Experts have estimated that up to 1 in 10 people who get ill from M. pneumoniae get pneumonia. Common symptoms of pneumonia include:
- Cough that may produce mucus
- Fever and chills
- Shortness of breath
- Chest pain
- Fatigue
Children younger than 5 years old often do not run a fever when they have an illness caused by M. pneumoniae. Instead they may have signs that appear more like a cold than pneumonia. They sometimes wheeze, vomit, or have diarrhea.
About Pneumococcal Disease
Pneumococcal disease is an infection caused by bacteria, sometimes referred to as pneumococcus. Pneumococcus can cause many types of illnesses, including ear infections and meningitis. There are vaccines to prevent pneumococcal disease in children and adults.
Types of Infection
Streptococcus pneumoniae bacteria, or pneumococcus, can cause many types of illnesses. Some of these illnesses can be life threatening. Pneumococcus is one of the most common causes of severe pneumonia.Besides pneumonia, pneumococcus can cause other types of infections too, such as:
- Ear infections
- Sinus infections
- Meningitis (infection of the tissue covering the brain and spinal cord)
- Bacteremia (bloodstream infection)
Doctors consider some of these infections “invasive.” Invasive disease means that germs invade parts of the body that are normally free from germs. For example, pneumococcal bacteria can invade the bloodstream, causing bacteremia, and the tissues and fluids covering the brain and spinal cord, causing meningitis. When this happens, disease is usually very severe, requiring treatment in a hospital and even causing death in some cases.
Symptoms and Complications
There are many types of pneumococcal disease. Symptoms and complications depend on the part of the body that is infected.
Symptoms
Pneumococcal pneumonia (lung infection) is the most common serious form of pneumococcal disease. Symptoms include:
- Fever and chills
- Cough
- Rapid breathing or difficulty breathing
- Chest pain
Older adults with pneumococcal pneumonia may experience confusion or low alertness, rather than the more common symptoms listed above.
Pneumococcal meningitis is an infection of the tissue covering the brain and spinal cord. Symptoms include:
-
- Stiff neck
- Fever
- Headache
- Photophobia (eyes being more sensitive to light)
In babies, meningitis may cause poor eating and drinking, low alertness, and vomiting.
Pneumococcal bacteremia is a blood infection. Symptoms include:
- Fever
- Chills
- Low alertness
Sepsis is a complication caused by the body’s overwhelming and life-threatening response to an infection, which can lead to tissue damage, organ failure, and death. Symptoms include:
- Confusion or disorientation
- Shortness of breath
- High heart rate
- Fever, shivering, or feeling very cold
- Extreme pain or discomfort
- Clammy or sweaty skin
Pneumococcus bacteria cause up to half of middle ear infections (otitis media). Symptoms include:
- Ear pain
- A red, swollen ear drum
- Fever
- Sleepiness
Complications
Doctors consider some pneumococcal infections to be “invasive.” Invasive disease means that germs invade parts of the body that are normally free from germs.
Most pneumococcal infections are mild. However, some can be deadly or result in long-term problems, such as brain damage or hearing loss.
Meningitis is the most severe type of invasive pneumococcal disease. Of children younger than 5 years old who get pneumococcal meningitis, about 1 out of 15 dies of the infection. The chance of death from pneumococcal meningitis is higher among elderly patients. Others may have long-term problems, such as hearing loss or developmental delay.
Bacteremia is a type of invasive pneumococcal disease that infects the blood. About 1 out of 100 children younger than 5 years old with this bloodstream infection die of it. The chance of death from pneumococcal bacteremia is higher among elderly patients.
Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Complications of pneumococcal pneumonia include:
- Infection of the space between membranes that surround the lungs and chest cavity (empyema)
- Inflammation of the sac surrounding the heart (pericarditis)
- Blockage of the airway that allows air into the lungs (endobronchial obstruction), with collapse within the lungs (atelectasis) and collection of pus (abscess) in the lungs
About 5 out of 100 people with non-invasive pneumococcal pneumonia will die from it, but that rate may be higher among elderly patients. Doctors consider pneumococcal pneumonia non-invasive if there’s not bacteremia or empyema occurring at the same time.
Sinus and ear infections are usually mild and are more common than the more severe forms of pneumococcal disease. However, some children develop repeated ear infections and may need ear tubes.
About Pneumocystis pneumonia (PCP)
Pneumocystis pneumonia (PCP) is a serious infection caused by the fungus Pneumocystis jirovecii. Most people who get PCP have a medical condition that weakens their immune system, like HIV/AIDS, or take medicines that lower the body’s ability to fight germs and sickness. In the United States, people with HIV/AIDS are less likely to get PCP today than before the availability of antiretroviral therapy (ART). However, PCP is still a substantial public health problem. Much of the information we have about PCP and its treatment comes from caring for patients with HIV/AIDS.
Scientists have changed both the classification and the name of this organism since it first appeared in patients with HIV in the 1980s. Pneumocystis jirovecii used to be classified as a protozoan but is now considered a fungus. Pneumocystis jirovecii used to be called Pneumocystis carinii. When scientists renamed P. carinii to P. jirovecii, some people considered using the abbreviation “PJP,” but to avoid confusion, Pneumocystis jirovecii pneumonia is still abbreviated “PCP.”
Symptoms
The symptoms of PCP include:
- Fever
- Cough
- Difficulty breathing
- Chest pain
- Chills
- Fatigue (tiredness)
In people with HIV/AIDS, PCP symptoms usually develop over several weeks and include a mild fever. In people who have weakened immune systems for reasons other than HIV/AIDS, PCP symptoms usually develop over a few days, often with a high fever. Contact your healthcare provider if you have symptoms that you think are related to PCP.
About RSV
Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. In fact, RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States. It is also a significant cause of respiratory illness in older adults.
Symptoms
Symptoms of RSV infection usually include:
- Runny nose
- Decrease in appetite
- Coughing
- Sneezing
- Fever
- Wheezing
These symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties. RSV can also cause more severe infections such as bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs. It is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age. Almost all children will have had an RSV infection by their second birthday. People infected with RSV usually show symptoms within 4 to 6 days after getting infected.
RSV Transmission
RSV can spread when an infected person coughs or sneezes. You can get infected if you get droplets from the cough or sneeze in your eyes, nose, or mouth, or if you touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands. Additionally, it can spread through direct contact with the virus, like kissing the face of a child with RSV.
People infected with RSV are usually contagious for 3 to 8 days. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks. Children are often exposed to and infected with RSV outside the home, such as in school or child-care centers. They can then transmit the virus to other members of the family.
RSV can survive for many hours on hard surfaces such as tables and crib rails. It typically lives on soft surfaces such as tissues and hands for shorter amounts of time.
People of any age can get another RSV infection, but infections later in life are generally less severe. People at highest risk for severe disease include:
- premature infants
- young children with congenital (from birth) heart or chronic lung disease
- young children with compromised (weakened) immune systems due to a medical condition or medical treatment
- adults with compromised immune systems
- older adults, especially those with underlying heart or lung disease
In the United States and other areas with similar climates, RSV infections generally occur during fall, winter, and spring. The timing and severity of RSV circulation in a given community can vary from year to year.
Lower Your Risk with Vaccines
In the United States, vaccines can help prevent infection by some of the bacteria and viruses that can cause pneumonia:
- Haemophilus influenzae type b (Hib)
- Influenza (flu)
- Measles
- Pertussis (whooping cough)
- Pneumococcal
- Varicella (chickenpox)
These vaccines are safe, but side effects can occur. Most side effects are mild and go away on their own within a few days. See the vaccine information statements for each vaccine to learn more about the most common side effects.Encourage friends and loved ones to make sure they are up to date with their vaccines.
Protect Your Health with These Healthy Living Practices
Try to stay away from sick people. If you are sick, stay away from others as much as possible to keep from getting them sick. You can also help prevent respiratory infections by:
- Washing your hands regularly
- Cleaning surfaces that are touched a lot
- Coughing or sneezing into a tissue or into your elbow or sleeve
- Limiting contact with cigarette smoke or quitting smoking
- Managing ongoing medical conditions (like asthma, diabetes, or heart disease)
Source:
- CDC
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