As one of the leading causes of hospitalization for both children and adults, it makes sense
that pneumonia is top-of-mind, especially during flu season.
We know that pneumonia is dangerous, especially for elderly people and people with other health
issues - but what actually is pneumonia?
We’ve all heard about pneumonia before, but if you’re not quite sure exactly what
it is, you’re definitely not alone!
Understanding pneumonia can be tricky, because it’s not just one disease, but a family
of diseases - there are many different types of pneumonia and the symptoms, treatment and
outcome for each type can be dramatically different.
No wonder it’s hard to pin down what exactly pneumonia is!
First, the name pneumonia comes from the Greek words pneumon, which means ‘lung’, and
ia, which means ‘disease’, and that’s exactly what pneumonia is - a disease of the
lungs.
During a pneumonia infection, the air sacs in the lungs - called alveoli - become inflamed
and can fill with fluid or pus.
This inflammation makes it hard for oxygen to make its way into the bloodstream.
Pneumonia is no joke - it’s a leading cause of hospitalization for both children and adults,
and flu-related pneumonia was the eighth leading cause of death in the US in two-thousand and
sixteen.
Sadly, pneumonia is the single leading cause of death among children under five years old
worldwide.
According to the World Health Organization, in twenty-seventeen pneumonia caused fifteen
percent of all deaths in children under five, killing more than eight-hundred thousand children
that year alone - that means more than two-thousand two-hundred children died of pneumonia every
single day.
It’s not just children who face the deadly consequences of pneumonia.
More than two and a half million people worldwide died from pneumonia in twenty-seventeen.
The death toll is highest in poorer countries - the twenty-seventeen death rate in Europe
was around ten deaths per hundred-thousand cases, while poorer countries in sub-Saharan
Africa experienced a much higher death rate of one-hundred deaths per one-hundred-thousand
cases - ten time higher than the European death rate.
Age is another huge factor in the mortality rate of pneumonia.
119 out of every 100,000 children under 5 with pneumonia will die.
The death rate is even higher for older populations - 261 of every 100,000 people over 70 who
are diagnosed with pneumonia will die each year.
Although these numbers have improved in recent decades, they are still incredibly high.
Although many cases of pneumonia are relatively mild and the chances of recovery are high,
especially in developed countries, the death rate for severe cases is staggering.
Up to 30% of severe cases that require intensive treatment will result in death.
On top of socioeconomic and age factors, there are other risk factors that can make some
people more susceptible to pneumonia and more likely to experience severe symptoms and complications.
Pre-existing health conditions, especially lung or heart issues like COPD or lung disease,
can increase the severity of the infection and the risk of complications.
Someone with a compromised immune system, like a cancer patient undergoing chemotherapy
treatments, will have a harder time fighting off an infection that could lead to pneumonia.
Just being in the hospital to be treated for another health condition can increase the
risk of developing pneumonia, especially if the treatment involved the use of a ventilator.
Difficulty swallowing, whether due to a past stroke, dementia, other health issues or even
intoxication, can put someone at a higher risk for pneumonia as fluid can be inhaled
into the lungs.
Other lifestyle factors can increase the risk of complications from pneumonia, including
smoking, air pollution and malnutrition.
Understanding pneumonia can be complicated because there are many different types of
pneumonia.
One of the main ways that healthcare professionals categorize pneumonia is by how it was acquired.
Community Acquired pneumonia is an infection that occurs outside of the hospital setting.
Although pneumonia itself is not contagious, the virus or bacteria causing the infection
can spread from person to person the same way most viral or bacterial infections spread
- through contact with infected people or surfaces, especially through respiratory droplets
released when an infected person coughs or sneezes.
It may also spread through blood, especially during and after birth, which is why pregnant
women are considered high-risk during flu outbreaks.
When the immune system is weak, it has a harder time fighting off these infections.
Even worse, the bacteria that already live in the respiratory system can start to grow
out of control and cause pneumonia.
Hospital Acquired pneumonia is an infection associated with previous healthcare, especially
ventilator use, or with hospitalization or residence in a nursing home where infections
can spread like wildfire.
Hospital Acquired pneumonia is usually much more serious than Community Acquired pneumonia
and has a much higher mortality rate.
Another way to differentiate between types of pneumonia is by whether it affects both
lungs, as in double pneumonia, or just one lobe, as with Lobar pneumonia.
Still more categories of pneumonia exist, including walking pneumonia, which is usually
a milder form of the disease that doesn’t require treatment in the hospital.
Aspiration pneumonia is caused by inhaling fluid into the lungs - if you aren’t able
to cough up the fluid, bacteria can take hold in your lungs and lead to infection.
Fluid can enter the lungs a number of ways, from accidentally inhaling your food instead
of swallowing it, to experiencing a near drowning, to even inhaling vomit - especially risky
for intoxicated individuals.
There are so many different kinds of pneumonia because there are nearly as many things that
can cause the inflammation of the lungs that is a trademark of pneumonia.
Pneumonia can be caused by bacteria, fungi or viruses.
All three are microorganisms that are too small to see with the naked eye, but they
are all very different.
Bacteria normally live all over our bodies, and many are harmless or even helpful.
Some bacteria can give off toxins as they reproduce which causes disease and symptoms.
Fungi are parasites that decompose and give off an enzyme that helps them absorb organic
matter.
Viruses need a host cell to be able to replicate, and as they insert their genetic material
into the cells, those cells can burst and die or turn malignant.
The most common type of bacterial pneumonia is pneumococcal pneumonia.
This type of pneumonia happens when the Streptococcus pneumoniae bacteria that normally makes its
home in our upper respiratory tract reproduces uncontrollable.
Legionnaires disease is a very dangerous type of pneumonia caused by the legionella pneumophila
bacteria, which is usually contracted from contaminated water from cooling towers or
even pools and whirlpools.
Although we can thank vaccines for all but eradicating tuberculosis from most developed
countries, the mycobacterium tuberculosis bacteria can still cause a rare form of tuberculosis
pneumonia that is highly resistant to treatment.
Bacterial pneumonia can occur on its own, or develop after a viral flu or cold infection.
It often only affects one lung, making it a Lobar type of pneumonia.
Fungi found in soil and bird droppings can also cause pneumonia, although this is most
common in those with chronic health issues or a weakened immune system.
Pneumonia can also be caused by viruses and the flu virus is the number one cause of viral
pneumonia, which is why we hear so much about pneumonia during flu season, especially during
particularly bad outbreaks.
As the virus invades the lungs and reproduces it causes pneumonia symptoms, but may not
show the same physical damage as bacterial pneumonia.
Most viral pneumonias are less severe than bacterial pneumonia, but flu-related pneumonia
can still be very serious and even fatal.
Viral pneumonia is most dangerous for people with pre-existing heart or lung issues and
pregnant women.
There’s also the risk that the viral infection could trigger a second bacterial pneumonia
invasion.
Bacterial pneumonia tends to cause the most severe symptoms and require the most medical
care.
The symptoms of bacterial pneumonia can come on suddenly or develop more gradually, but
symptoms of viral pneumonia usually develop over the course of several days.
Typical pneumonia symptoms include a fever and chills, a phlegmy cough, shortness of
breath and rapid, shallow breathing, chest pain, loss of appetite and fatigue.
Symptoms can be mild or severe, and not everyone experiences the same symptoms.
For example, very young children may also experience nausea and vomiting, and some elderly
people may not even have a fever, so confusion and mental changes may be the only way to
tell that something is going on.
There is no one-size-fits-all test to diagnose pneumonia.
Instead, doctors typically start with a physical exam, including listening to the patient's
lungs with a stethoscope.
They may also order a chest X-ray to measure inflammation in the lungs or a pulse oximetry
test to measure the oxygen level in the bloodstream.
Blood and mucus tests can be done to identify the particular germ responsible for the pneumonia
infection.
If symptoms are severe doctors may order a CT scan to check for complications, or perform
a bronchoscopy to look into the patient’s airways and see what’s going on.
Treatment for pneumonia depends on the type of pneumonia and the severity of the symptoms.
Bacterial infections can be treated with antibiotics, which work by stopping or slowing the growth
of the bacteria.
Although this seems like a simple treatment, it can be complicated to decide when to use
antibiotics.
Overuse of antibiotics can lead to antibiotic resistance, and many infections, including
pneumonia, are becoming more and more resistant to antibiotics, which is why the death rate
from pneumonia has not improved much over the last fifty years, despite the widespread
use of antibiotics.
Unfortunately, antibiotics do not work on viral infections.
Some antiviral drugs exist, but treatment for viral pneumonia is mostly about managing
the symptoms.
Symptoms like fever can be treated with medications like Aspirin and non-steroidal anti-inflammatory
drugs, or NSAIDs.
Drinking lots of fluids can help prevent dehydration, and warm beverages, hot baths and a humidifier
can help to open the airways.
Pneumonia sufferers should get plenty of rest and give themselves lots of time to fully
recover from the infection.
Most of the pneumonia symptoms will resolve after a few weeks, but some, like fatigue,
can persist for weeks or even months.
It can take six to eight weeks to fully recover from a case of pneumonia and return to normal
levels of functioning.
Even once the infection has passed, a bout of pneumonia can have long-lasting effects
like future lung disease.
Mild cases of pneumonia can usually be treated at home, but the more severe cases, especially
Hospital Acquired pneumonia, will require treatment in the hospital.
Healthcare professionals will provide intravenous fluids and antibiotics, oxygen therapy and
symptom management, while also keeping an eye out for complications.
Serious cases of pneumonia can quickly turn dangerous, which is why it’s so important
to be under the care of professionals in a hospital setting.
Severe pneumonia can cause dangerous and life-threatening complications.
The biggest danger is that the patient will go into respiratory failure and require ventilation
to help them breathe.
Acute respiratory distress syndrome, or ARDS, can occur after the lungs have experienced
trauma, like a pneumonia infection.
As fluid leaks into the lungs, they become smaller and stiffer and breathing becomes
very difficult, starving the body of oxygen.
There is no treatment for ARDS - all that medical professionals can do is help the patient
get enough oxygen with the help of a ventilator and give their lungs time to heal.
Other potentially serious complications from pneumonia include sepsis, which is uncontrolled
inflammation throughout the body that can cause multiple organ failure.
Lung abscesses can also be a concern, and surgery may be required to drain them of fluid.
Complications are more prevalent and more serious in patients who are very young or
very old, or have pre-existing health issues, especially heart and lung diseases.
Now that you know how serious pneumonia is, especially for the elderly and the sick, you
can do your part this flu season by washing your hands regularly, always covering your
mouth when you cough or sneeze, staying at home when you’re sick and maintaining distance
when you’re out and about.
Even if you think you’re strong and healthy enough to handle a bout of the flu or even
a case of pneumonia, remember that pneumonia is a serious infection and even young, healthy
people can be taken out by it.
Besides, it’s not just about you - the last thing you want is to be the reason someone’s
grandma ends up in the hospital on a ventilator!
If you thought this video was enlightening, be sure and check out our other videos, like
this one called “The Most Painful Illness Known to Man”, or perhaps you’ll like
this other video instead.