Pneumonia

Pneumonia can affect anyone. Symptoms of pneumonia, like chest pain, cough, fatigue and difficulty breathing, can require hospitalisation. There are over 77,5001 pneumonia hospitalisations in Australia each year, and the average stay rises with age – from 6 days for those under 65 to 13 days for those 65+2. Know pneumonia and how to protect yourself by reading on.

What is it?

Pneumonia is a common and potentially fatal lung infection that should not be underestimated. It can be caused by viruses, bacteria or fungi. During normal respiration, air travels through the lungs to the alveoli or air sacs. Pneumonia results when air sacs in the lungs fill with secretions and fluids that obstruct normal air flow. There are many types of pneumonia, one of the most common and life threatening types is Pneumococcal Pneumonia.

Who is at risk?

Anyone of any age can contract pneumonia, but those at a higher risk are:

• People 65+ years young
• People with medical conditions such as diabetes, cancer or a chronic disease affecting the lungs, heart , kidney or liver
• Tobacco smokers
• Indigenous Australians
• Infants aged 12 months and under3

It’s important to remember that no matter how healthy and active you are, your risk for getting pneumonia increases with age. This is because our immune system naturally weakens with age, making it harder for our bodies to fight off infections and diseases.

Causes ­

Pneumonia can be spread through inhaling infected droplets in the air from a cough or sneeze of an infected person. The infection can also be spread through blood (e.g. during birth).4 It can be triggered by a cold or bout of the flu, which allows germs to grow in the air sacs of the lungs.5 The infection can develop in just 1 – 3 days.6

Types

The types of pneumonia include:

Bacterial pneumonia: One of the most severe and potentially life-threatening forms of pneumonia is pneumococcal pneumonia, which is caused by the bacterium, Streptococcus pneumoniae (S. pneumoniae).1,4 This bacterium is responsible for approximately 1.6 million deaths each year, world-wide.7 Healthy people may carry S. pneumoniae bacteria in their nose and throat.4 While most of the time this does not cause any illness, vulnerable groups such as those of the age of 65, infants, people with a chronic illness etc. may develop pneumococcal disease.1

Viral pneumonia: caused by various viruses, including influenza. It is thought that around half of pneumonia cases are attributed to this type of pneumonia.

Mycoplasma pneumonia: caused by the bacterium Mycoplasma pneumoniae. This type of pneumonia can have some different symptoms and physical signs such as white phlegm, nausea and vomiting. Pneumonia caused by mycoplasma organisms is generally mild, but recovery takes longer.

 Other pneumonias: There are other less common pneumonias that may be caused by other infections including fungi.

Symptoms

The symptoms of pneumonia depend on the age of the person, the cause and severity of the infection, and any existing problems with immunity. Some of the symptoms may include:

Rapid breathing

Difficulty breathing

Cough

Fever

Fatigue

Chest pain

If you or your child or the person you are caring for seems to be recovering well from a cold or flu, but then gets worse, pneumonia may be the cause. See your doctor immediately, since pneumonia can be life threatening to babies, young children and people aged 65 and over.

Diagnosis

A doctor can often diagnose pneumonia based on your symptoms and by examining your chest, but sometimes it can be difficult to tell whether you have pneumonia or another kind of chest infection.

General examination

Chest x-rays

Blood tests.

Treatment

Treatment for pneumonia depends on the age of the individual and the type of infection, but can include:

  • hospital admission for babies, young children and people over 65 years old
  • plenty of fluids taken orally or intravenously
  • antibiotics to kill the infection, if bacteria are the cause
  • medications to relieve pain and reduce fever
  • rest: sitting up is better than lying down. 8

The mean duration of hospital stay for pneumococcal pneumonia rises with age, ranging from six days for those under 65 years of age, to 13 days for those aged 65 or above2.

Prevention

One of the most common types of bacterial pneumonia is pneumococcal pneumonia, caused by infection with Streptococcus pneumoniae. There are vaccines against this strain that reduce the risk of infection.

You can take steps to protect yourself against pneumococcal pneumonia by:

  • Practicing good hand and home hygiene to minimise the spread of germs.
  • Making your life a smoke-free zone by quitting smoking and/or reducing your exposure to second hand smoke.
  • Having the vaccination which is free under the government’s National Immunisation Program (NIP) for all Australians aged 65 and above, Indigenous Australians aged 50 years and over, Indigenous Australians aged 15 to 49 years who are medically at risk, and infants under 12 months. A second dose of vaccine is also available to some Australians, a minimum of five years following their first dose. The vaccine is also subsidised on the PBS for those aged under 65 who are considered at increased risk for contracting pneumonia, for example if they are immune-compromised.

Influenza is a common preceding viral infection. Being vaccinated against influenza can also help prevent that infection and the pneumonia which may complicate it.

Support

Lung Foundation Australia is here to help.  We develop a large range of patient resources and support programs for people with lung disease.  For further information, call us on 1800 654 301.

References

  1. Lung Disease in Australia, 2014, Woolcock Institute of Medical Research.
  2. Australian and New Zealand Society for Geriatric Medicine. Position Statement – Immunisation of older people. Australas J Ageing 2016: 35(1); 67-73
  3. NHMRC, The Australian Immunisation Handbook, 10th Edition, 2013 (updated June 2015) Chapter 4.13. Available at http://www.immunise.health.gov.au/internet/immunise/publishing. nsf/Content/7B28E87511E08905CA257D4D001DB1F8/$File/Aus-Imm-Handbook.pdf [last accessed Feb, 2017].
  4. World Health Organization (WHO). Pneumonia fact sheet. WHO. Available at [last accessed May, 2018].
  5. State Government of Victoria – Better Health Channel. Pneumonia. Last modified June 2015. Available at [last accessed May, 2018].
  6. Centres for Disease Control and Prevention. Pneumococcal disease. Available at https://www.cdc.gov/pneumococcal/clinicians/clinical-features.html [last accessed March, 2017].
  7. World Health Organization (WHO). Pneumococcal disease. WHO. Available at [last accessed March, 2018].
  8. State Government of Victoria – Better Health Channel. Pneumonia. Last modified June 2015. Available at [last accessed May, 2018].