2,5 million people die from pneumonia each year. Three groups of people are most affected by the disease

Proven content

Until a few decades ago, a doctor diagnosing a patient with pneumonia could only sympathetically nod his head. Inflammation of one of the organs supporting vital functions, in the absence of effective treatment, and even worse knowledge of the cause, was like a death sentence. Today, mortality from pneumonia is much lower, but it is still a fact.

1. 2,5 million people worldwide die from pneumonia each year
2. The disease can be fatal for people with weakened immunity, incl. young children and seniors
3. In severe cases of COVID-19, inflammation affects more than 50%. lung surface
4. Protection against pneumonia is primarily pneumococcal and influenza vaccinations
5. On November 12, we celebrate World Pneumonia Day
6. You can find more about the coronavirus on the TvoiLokony home page

Captain of the death squads

Pneumonia is not a disease of our time. The fact that our ancestors had already struggled with severe respiratory symptoms is evidenced by the meticulous records of the clinical picture of the disease, left over the centuries by great figures of medicine, such as Hippocrates or Moses Moimonides. And although the doctors of that time did not necessarily use the modern name of the disease, documents created until modern times link the description of its symptoms with high fever, persistent cough with purulent discharge, chest pain and shortness of breath, especially. The difference is not in the course, but in the effect of pneumonia. Until almost the middle of the XNUMXth century it was death. One of the greatest doctors of the last century is not without reason William Osler called pneumonia the “terrible plague”, “the captain of the death squads” and “friend to the elderly” – because they most often lost the fight with the disease.

The confirmation is the statistics, or actually – due to limited diagnostics – estimates of those who died then from pneumonia. At the beginning of the XNUMXth century, even tuberculosis was inferior to the disease in terms of mortality. One in three patients diagnosed with characteristic symptoms died of pneumonia, despite the discovery of one of the most common causes of inflammation – bacterial infection. From the determination of microorganisms responsible for most cases of the disease – diphtheria (Streptococcus pneumoniae) and pneumonia bacilli (Klebsiella pneumoniae) – however, several decades had to pass before an effective drug was discovered.

The breakthrough was the discovery of penicillin, and later – other drugs that inhibited the growth of bacteria. And viruses, because – as it quickly turned out – they also, attacking the body, could have contributed to the development of pneumonia. With the advancement of medicine, better and faster diagnostics and, above all, new methods of treatment and care for patients, the mortality rate from pneumonia has decreased significantly.

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Pneumonia – statistics

However, when we take a closer look at the numbers, it is hard to believe that today the disease is not a threat. According to data from the World Health Organization (WHO) 2017 million people died of pneumonia in 2,56 alone. Nearly one third (over 808) were children under 5 (15% of all deaths in this age group). This is a lot, though definitely less than at the end of the last century, when over 2 million children died of pneumonia each year.

Such a clear decrease in the deaths of the youngest is mainly due to the spread of preventive vaccinations. In Poland, vaccines protecting against infection with hemophilic bacilli type B (Haemophilus influenzae, HiB) and colic pneumonia are reimbursed and widely available. Their effectiveness is visible – in the first five years from the introduction of the vaccination obligation in the case of HiB (2007), there was a significant decrease in the number of the youngest patients requiring hospitalization. We have to wait about two more years for the effects of the pneumococcal vaccination (when all children under the age of 5 have completed the full vaccination course), but doctors are already paying attention to a lower number of severe courses of pneumonia caused by infection with this bacterium.

Unfortunately, in the remaining age groups, the mortality from pneumonia has not only decreased so drastically, but has remained at a similar level for decades. The highest rates are recorded among people over 70 years of age – Worldwide, over 1,1 million seniors die from pneumonia each year. The disease is taking the biggest toll in sub-Saharan Africa and South Asia, but the situation is not optimistic in our region as well. Across the European Union, inflammation in the lungs kills around 120 people each year. people, in Poland it is nearly 12 thousand. deaths annually.

An underestimated threat

Why is a disease whose causes are known and for which there is a remedy still fatal? According to the pulmonologist Dr. hab. Piotr Korczyński from the Department and Clinic of Internal Diseases, Pneumology and Allergology at the Medical University of Warsaw, practicing at the MD Clinic Multispecialist Outpatient Clinic in Warsaw, associate pneumonia as a disease that is relatively well treated with antibiotics.

– And in fact, in most cases it is successful, but it is also a serious disease and is one of the main causes of death of patients for a reason. Mortality may be directly related to pneumonia and may be due to respiratory failure or sepsis, but it may also be indirectly fatal, affecting the cardiovascular system or other chronic respiratory diseases such as COPD [chronic obstructive pulmonary disease – ed. ] – he explains, adding that Old age and other comorbidities, such as diabetes or a history of myocardial infarction, have a major impact on the severe course of the disease.

Another important factor is the belief that people die of other, “more serious” diseases, such as cancer or AIDS. Pneumonia – although known and common – is often confused with less severe conditions (e.g. a cold or flu), because its symptoms are not always clear-cut. As a consequence, the disease is underestimated, and the symptoms are consulted with a doctor only when the patient’s condition is serious and often requires hospitalization.

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Who Should Be Afraid of Pneumonia?

The “red lamp” should illuminate on at least three occasions. First, when we are in the age group where the morbidity and mortality from pneumonia are highest. Therefore, the parents of the youngest children, whose immune system is still insufficiently developed, and seniors, in whom it is not working so well, must pay attention to the disturbing symptoms. Secondly, if we are struggling with diseases of the respiratory system (including allergies), circulation, immune systems or chronic diseases, especially cardiac diseases. Thirdly, if we smoke cigarettes – actively or passively – because this addiction significantly weakens the work of the entire body, including the respiratory system.

Besides – whenever our condition worsens during infection, despite symptomatic treatment. The clinical course of pneumonia varies. Sometimes the disease takes a few days to develop, other times it takes several weeks. That is why it is so important to monitor your body. If the fever cannot be reduced and the dyspnoea worsens, hospitalization should be considered.

– We should be particularly concerned about disturbances of consciousness, dehydration and the emergence of respiratory failure, which can be assessed with a pulse oximeter. In such a situation, we will first go to the hospital ward, because the clinical condition may deteriorate further, signs of septic condition, worsening of respiratory failure and hypotension may appear. Treatment in intensive care centers is then necessary, often with the use of non-invasive or invasive ventilation and other elements of intensive care. Patients with pneumonia always require a very careful medical assessment – explains Dr. Piotr Korczyński.

Pneumonia and the coronavirus

Vigilance is especially recommended today, when we are struggling with an extremely contagious virus. Coronavirus infection is not only easier, but also has a more severe course than in the case of previously known viral infections. When the lungs become inflamed, the situation becomes very serious.

As explained by Dr. Piotr Korczyński, although infection with SARS CoV-2 in 81 percent. patients are relatively mild, the remaining 19 percent. these are very hard cases. In the case of 14 percent. In “covid” patients with dyspnoea and respiratory failure, inflammation takes over 50 percent. lung surface in radiological examinations. In the remaining 5 percent. patients develop acute respiratory distress syndrome, shock and multi-organ failure.

– Pneumonia caused by the SARS CoV-2 virus in a significant percentage leads to the development of severe respiratory failure. We treat it by administering large amounts of oxygen, using devices generating positive pressure in the respiratory tract or giving oxygen in a large flow. Nevertheless, some patients require pharmacological coma and the use of a respirator. Unfortunately, the results of such treatment are not successful anyway, he admits, adding that in good centers, the mortality rate in the group of the most severely ill (ventilated with a ventilator) is around 60%.

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The vaccine is not everything

Doctors do not yet have targeted, direct-acting drugs to deal with pneumonia caused by the new coronavirus. That is why prevention and minimizing the risk of disease is so important. In the case of COVID-19, it is obviously about keeping a distance, wearing a mask that covers the nose and mouth, and regular hand disinfection. But it is also worth protecting yourself against the consequences of infections, such as just pneumonia.

WHO, which supports technically the World Pneumonia Day, which is celebrated on November 12, first of all points to preventive vaccinations against influenza and pneumococci. According to research, about 15% of people with split pneumonia may be carriers. adults and up to 50 percent. children under 2 years of age. Anyone who comes into contact with them is potentially at risk of infection. Therefore, not only children should be vaccinated against pneumococci, but also people over 65 years of age, patients with chronic respiratory diseases and other chronic internal ailments.

The basic prophylaxis, however, is what each of us has a direct impact on. – Protection against pneumonia is primarily limited to lifestyle changes. People should stop smoking completely – indicates the pulmonologist.

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