Today the global health community recognizes the third annual World Pneumonia Day with the release of two new studies on pneumonia and events in more than 15 countries calling attention to the disease, which remains the world’s leading killer of young children. Yet despite renewed global attention and its dramatic toll, pneumonia remains one of the world’s least-understood conditions.
As we recommit ourselves to defeating this deadly disease on Nov. 12, let’s tackle a few of the leading myths head-on:
Pneumonia is really just a bad cold. In fact, it’s much worse. Pneumonia is an infection of your lungs that can require antibiotics or treatment in a hospital. A “common cold” usually lasts a few days or perhaps a week or two, and causes a runny nose, sore throat, sneezing and coughing. Pneumonia, on the other hand, kills more than 50,000 Americans and more than 1 million children worldwide each year.
The confusion exists because, at its start, pneumonia symptoms can be similar to those of a cold, including cough, fever and shortness of breath. Unfortunately, that’s where the similarities end. Left untreated, most colds will run their course as the body’s immune system naturally restores health. In contrast, ignoring early signs of bacterial pneumonia can be a death sentence.
The good news is that pneumonia is preventable and treatable with a host of proven interventions, including exclusively breastfeeding infants in their first six months of life, ensuring an environment free of indoor air pollution and promoting frequent handwashing (protection); immunizing against pneumonia’s leading causes (prevention); and ensuring access to medical care and antibiotics when cases do emerge (treatment). That’s why we need to ensure these interventions are available in developing countries, where 98 percent of pneumonia deaths occur.
Pneumonia only affects old people. Here in the United States, we tend to think of pneumonia as a disease that only affects elderly individuals, hospitalized adults or people with weakened immune systems. A closer look at the statistics about those who are actually at the highest risk for pneumonia may surprise you. Worldwide, pneumonia takes the lives of more young children than any other disease, and is responsible for up to 18 percent of the world’s annual child deaths.
Infants and young children with weakened or compromised immune systems are at particular risk, often because their natural defenses against infection are not yet fully developed or might have been stripped away by disease, chronic illness or lack of adequate nutrition.
In developing countries, these circumstances are further compounded for children who become sick with pneumonia and don’t have access to proper medical care. According to a study published last month in the International Journal of Epidemiology, simply by providing care and managing cases of pneumonia in sick children with antibiotics at the community level, pneumonia-related child deaths could be reduced by 70 percent. Community health workers can be trained to assess signs of pneumonia, determine appropriate treatment and advise parents, administer antibiotics and provide home care. They can also refer sick children to a health facility if complications arise. When children suffering from pneumonia are treated promptly and effectively with antibiotics, their chances of survival increase significantly.
However, in wealthy countries like ours where health care is accessible, childhood nutrition standards are high and vaccines are in routine use, childhood deaths from pneumonia are extremely low. That being said, adults of all ages here in the United States and elsewhere can increase their protection against pneumonia by getting their influenza vaccines. Adults over age 65 and those with one or more risk conditions should get the pneumococcal polysaccharide vaccine, which is covered under Medicare Part B.
Pneumonia doesn’t affect healthy people. While serious illness and deaths from pneumonia are more common in individuals with weakened or compromised immune systems, pneumonia can affect anyone. Take Washington Redskins quarterback Rex Grossman as an example. Grossman, a healthy adult and professional athlete, was hospitalized with pneumonia recently after several days of escalating symptoms. Grossman received treatment and is now back home and recovering well, but his story underscores an important point: Anyone can get pneumonia.
The key difference between recovery and serious illness or death can be found in the steps taken after infection. If you ignore your symptoms and do not seek medical care or receive antibiotic treatment, things can quickly spiral out of control. That’s why seeking out an early diagnosis and following up with antibiotic care is so important.
Pneumonia only happens in cold places and cold seasons. While we’ve all heard the warning to wear a coat when it’s cold outside or we’ll risk catching pneumonia, air temperature actually has little impact on the ability of pneumonia-causing bacteria to spread from one person to the next. In fact, the majority of pneumonia infections occur in countries with tropical climates.
The root of the cold air myth most likely stems from the fact that we tend to spend more time gathered indoors during the cold winter months. When we’re together in closer quarters, pneumonia-causing bacteria can easily spread from person to person. Pneumonia can thrive in tropical countries not because of the weather but because nutrition is often poor, people tend to live in crowded environments and there is indoor air pollution from cooking fires.
Pneumonia can be treated but it can’t really be prevented. There is actually a host of ways to protect against, treat and, yes, prevent pneumonia. The best defense is a combination of these approaches. Treatment with antibiotics can resolve confirmed cases if they are caught early enough. Exclusively breastfeeding infants for their first six months of life, ensuring proper nutrition and hygiene and limiting exposure to smoke from cigarettes or indoor cookstoves and fires can help limit the risk of pneumonia.
In fact, the World Health Organization now cites indoor air pollution from household cooking stoves and fires as the leading environmental cause of death — killing more than 2 million people each year. Almost half of the world’s population — 3 billion people — live in poverty and use materials like wood, charcoal or even dung to fuel indoor fires for cooking or heating. These fires fill homes with dense smoke and cause pneumonia and chronic lung disease. Women and children are most commonly affected since they tend to spend the most time at home. Eliminating the threats posed by indoor air pollution is essential to curbing the pneumonia burden in developing countries.
Safe and effective vaccines prevent deaths from the leading causes of pneumonia in both children and adults. Since infants here in the U.S. began receiving routine pneumococcal vaccination in 2000, the U.S. has nearly eliminated childhood pneumococcal disease caused by the strains of bacteria covered by the vaccine. Similarly introducing routine pneumococcal vaccination in developing countries could help save the lives of millions of children over the next 20 years.
Thankfully, because of the work of the GAVI Alliance, donors and visionary country leaders, more children are getting vaccinated against pneumonia than ever before. On World Pneumonia Day, Nov. 12, Malawi became the 16th of the world’s poorest countries to introduce the same kinds of advanced pneumococcal vaccines we have in the U.S., and that number is expected to grow to 58 by 2015, representing a huge step forward in the global fight against child mortality.
At a time of tight budgets and tough economic decisions, World Pneumonia Day is an opportunity to remind our leaders that the lives of babies and children are too important to be discounted.
Follow Dr. Orin Levine on Twitter: