• Experts explain what you may not know about this respiratory infection

Ogechukwu Agwu

Pneumonia, a respiratory infection that inflames the air sac, affects the lungs. Indeed, both lungs could be affected, depending on the severity. The infections could be bacterial, viral or fungal. To say the lease, it is a deadly disease, especially for children in developing countries.
When the lungs are inflamed, the air sacs may be filled with fluid, resulting in cough, chills and fever. In most cases, such sufferers usually experience difficulty in breathing.
It must, however, be stated that cold weather or getting wet does not cause pneumonia. Respiratory infection causes pneumonia. However, a bad or worsened cold or flu could turn into pneumonia, as it “irritates the lungs, creating an environment where it’s easier for pneumonia germs to move in and start an infection.”
Cold or flu could worsen existing cough. Therefore, those who have a cold, pneumonia or bronchitis , must know that being out in the cold could make you cough.
According to the World Health Organisation (WHO), nearly 1.6 million children under the age of 5 die from the pneumonia infection annually. Ninety-eight per cent of these children, who die, live in developing countries. Incidentally, in 2008, 177, 000 of children, from the 16 million who die from pneumonia, are from Nigeria.
It is in order to underline the importance of preventing and fighting pneumonia that November 12 was set aside as World Pneumonia Day.
Dr. Chiemeziem Okwara, a house surgeon at the Usman Danfodiyou University Teaching Hospital, Sokoto, said this of pneumonia: “It is an acute, lower respiratory tract infection associated with a recently developed pulmonary shadowing (areas of infection seen on a chest X ray) and whose risk factors include smoking, alcohol, upper respiratory tract infections, corticosteroid therapy, old age, HIV and indoor/outdoor pollution by infected individuals.”

How pneumonia is contracted
Pneumonia could be community acquired (CAP), hospital acquired (HAP) or through immunocomprised.
Dr. Okwara said the disease is community-acquired when those who have it spread it through droplets, from sneezing and coughing etc.
He said through sneezing and coughing, millions of microbes are released into the air.  When healthy people inhale these microbes, they usually come down with pneumonia. Some of these microbes include, streptococcus pneumonia (by far the biggest culprit responsible for more than 70 per cent cases of community-acquired pneumonia), mycoplasma pneumonia, legionella pneumonia, chlamydia pneumonia, hemophilus influenza, staph aureus and klebsiella pneumonia.
Aside from the bacterial agent, some viruses can cause CAP, influenza virus, parainfluenza virus, measles herpes, simplex, varicella and cytomegalovirus, said an expert.
According to Dr. Okwara, “clinical feature of community acquired pneumonia include systemic features, as fever, vomiting, loss of appetite, headache. Chest features such as breathlessness (short, shallow and fast breathing) and cough with expectation of yellowish foul smelling sputum.”

How to dictate pneumonia and treatment
Lab and radiological tests to confirm CAP include: chest x-ray (an opaque area appears in the affected part of the lung within 18 hours of onset of infection), full blood count (white blood cells are very high more than 20*10^ 9/L pulse oximetry, where oxygen saturation is usually below 93 per cent
Treatment of CAP include, admitting the patient, placing the patient on oxygen, if oxygen is below 93 per cent, administration of intravenous fluids, if patient has been coughing and losing fluids through excessive sputum production. This fluid will also help to reduce the thickness of the sputum, enabling the patient to breathe.
Antibiotics can be used as well, in the case where sputum culture has been used to identify the microbes responsible for the infection. Broad-spectrum drugs, like Cefuroxime or Cephotaxime are very effective.
Dr. Okwara said: “Hospital acquired pneumonia (HAP) also called nosocomial pneumonia, is a new episode of pneumonia occurring at least two days after admission into the hospital. In simple words, the person caught pneumonia courtesy of staying in a hospital environment.
“Factors predisposing to HAP include, reduced immune defences of the patient due to corticosteroid treatment, diabetes, malignancy, immobility or reduced consciousness level. Clinical features includes fever greater than 38c. Patient develops yellowish, purulent sputum.”
The severity of pneumonia symptoms depends on factors, like the causative agent, medical history, age and the strength of the immune system.
According to the American Lung Association,  people who have a history of lung damage, smoking or other respiratory problems have a higher risk of developing this infection. The first step to reducing the odds of developing pneumonia is to get rid of any voluntary risk factors that can increase the chances of catching bacterial infections or viruses in the first place.
An expert said: “When someone develops pneumonia, the symptoms are usually the same, no matter the causative agent. This infection usually presents itself with mild fever, cough, headache, muscle pains, troubled breathing and weakness of the body. One should expect feverish symptoms to get worse if the infection is bacterial in nature. Pneumonia is quite infectious and can be spread from person to person, having a strong immunity is one way to fighting it.”
Paper by Dr. Orin Levine posted on huffingtonpost.com stated thus: “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 hand washing (protection); immunising 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.”

Ways to overcome pneumonia
It’s possible to treat pneumonia with antibiotics, fever reducers and cough medicine. Despite the severity of pneumonia, a sufferer could completely recover within one to three weeks.
Where there’s no sure way to prevent pneumonia, there are number of steps you can take to overcome pneumonia. They include, getting plenty rest, drinking plenty of fluids to prevent dehydration, eating a healthy diet, avoiding alcohol, practice hand hygiene, disposing of used tissues that may have been used to dispose phlegm, covering one’s nose and mouth with a tissue or sleeve when coughing or sneezing, taking care of your cough if it is making it hard for you to rest and taking aspirins to reduce fever.
Antibiotics can be used to treat many forms of pneumonia, in the case of hospitalisation.
Dr. Levine said: “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, November 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.”