Pneumonia particularly threatens those who are more vulnerable, such as children, the elderly or people whose immune system is weakened by a chronic disease, such as chronic obstructive pulmonary disease (COPD).
In addition, according to the World Health Organization (WHO), pneumonia is the world’s leading cause of death among newborns and children under 5 years of age.
Pneumonia is a severe respiratory infection in which there is both infection and inflammation of the lungs, especially the alveoli. The alveoli are comparable to small bunches of grapes at the end of each bronchus whose role is to allow oxygen to enter the bloodstream. During pneumonia, some of the alveoli fill with purulent liquid, preventing air from entering. Pneumonia is most often caused by bacteria, but it is also possible that a virus, such as the flu virus, is responsible for the infection.
Pneumonia can be described as lobar or bronchial, depending on its extent:
Lobar pneumonia: It is localized in one part of the lung only (in one lobe). It can become multilobar if it affects more than one lobe.
Bronchial pneumonia or bronchopneumonia: It affects the entire lung, i.e. the bronchioles and alveoli.
There are more than 100 microorganisms that can cause pneumonia, but only a few of them are responsible for most cases. There are three varieties of pneumonia depending on the agent involved:
Bacterial pneumonia is the most common pneumonia. It affects people with weakened immune systems (illness, old age, malnutrition or generalized weakness), alcoholics, smokers, children and people with respiratory problems or viral infections.
Pneumococcus is the bacterium most responsible for bacterial pneumonia. It is the only pneumonia that can be prevented by a specific vaccine, the pneumococcal vaccine. Vaccines will be discussed in the “Prevention” section.
Half of all pneumonia is viral in origin. Viruses cause more or less common upper respiratory tract infections that can lead to pneumonia, especially in children. Most viral pneumonias are localized and not widespread. They are often less severe than bacterial pneumonia.
However, viral pneumonia caused by the Influenza virus is a serious infection that can lead to complications. This form of pneumonia often affects pregnant women and people with cardiovascular or respiratory diseases.
Bacterial pneumonia can even result from viral pneumonia. In this situation, the sick person may have a combination of viral and bacterial pneumonia symptoms. A good way to protect yourself from viral pneumonia is to get the annual influenza vaccine.
Mycoplasma pneumonia is caused by pathogenic micro-organisms that are smaller than bacteria and viruses. The course and symptoms of this form of pneumonia are quite different from that of pneumococcal pneumonia. It is more common in children and adults with immune problems such as HIV.
Aspiration pneumonia occurs when fluid, usually from the stomach, enters the lungs and causes severe inflammation. Swallowing problems (difficulty swallowing), gastric reflux, sedation, neurological and cognitive disorders, and unconsciousness are all conditions that are conducive to inhaling the irritating fluid that causes this type of pneumonia.
Signs and symptoms
Although the mode of transmission of pneumonia varies according to the pathogen involved, it is usually transmitted through contact with infected respiratory secretions.
If you suspect that you may have pneumonia, it is necessary to consult a doctor so that he or she can prescribe the necessary treatment for this respiratory infection.
The doctor will diagnose pneumonia based on several factors:
- Corresponding symptoms;
- Medical history of pneumonia;
- History of contact with people with pneumonia;
- Physical examination;
- Chest X-ray;
- Blood or sputum analysis;
- Other tests may be done to rule out other health problems.
While there is a multitude of elements or microbes that can cause pneumonia, factors such as age, early diagnosis, the nature of the infection, and whether or not there is any other illness affecting recovery.
In most cases, pneumonia does not require hospitalization. To get better, you just need to stay well hydrated, get plenty of rest and take the treatment recommended by your doctor.
Your doctor will prescribe medication specific to the germ that caused pneumonia. Antibiotics are normally prescribed if it is a bacterial infection, while antivirals are useful in the case of a viral infection.
However, antivirals are rarely used because to be effective, they must be administered within 48 hours of the onset of the first symptoms. In both cases, the drugs bring the fever down in one to two days and provide rapid relief of other symptoms.
However, if symptoms worsen or if people with pneumonia are at risk, hospitalization is often required. Treatment for pneumonia may also include inhaled medication or oxygen for people with breathing difficulties. Sometimes people who are extremely ill may be admitted to the intensive care unit because their lives are truly life-threatening.
Although after 48 hours of antibiotic therapy, the risk of contagion greatly diminishes, complete recovery can take 7 to 10 days and relapses are always possible. In the elderly, recovery may take longer because symptoms are much more persistent than in younger people.
Tips and preventions
Prevention is key given the aggressiveness of this disease.
Here are some simple things you can do to reduce your risk of pneumonia:
- Quit smoking since tobacco smoke reduces your body’s ability to fight infections;
- Wash your hands properly and often;
- Throw away your tissues after use;
- Do not share your glass or utensils with someone who is sick;
- Avoid contact with sick people, especially those with severe coughs, or ask them to wear a mask;
- Get a flu shot every year;
- Ask your doctor if the pneumococcal vaccine is right for you.
YOUR BEST DEFENCE: VACCINATION
In addition to the influenza vaccine available each fall, there are specific vaccines for pneumonia. The “Pneumovax” vaccine (pneumococcal polysaccharide vaccine) and the “Prevnar 13” vaccine (pneumococcal conjugate vaccine) are used to prevent pneumococcal infections, but only “Prevnar 13” protects effectively against pneumococcal pneumonia.
These vaccines increase your ability to defend yourself against pneumococcal infection by incorporating small amounts of bacteria into your body. These vaccines stimulate the production of your antibodies (cells that protect you from infection) that will stay in your body, ready to protect you from future bacterial infections.
Who should receive pneumococcal vaccination?
The people who are most vulnerable to infections and who should be vaccinated include:
- People aged 65 and up.
Other groups at increased risk are children under 2 years of age and adults who have one or more of the following risk factors:
- Cardiovascular, pulmonary or renal disease;
- Diabetes, alcoholism, absence or dysfunction of the spleen;
- Certain types of anemia;
- HIV infection or other diseases related to a deficiency of the immune system;
- People recovering from a serious illness;
- People living in a long-term care hospital centre.
Ask your doctor for more details about the availability of the vaccine and its recommendation based on your situation.
Since 2004, the Quebec Ministry of Public Health has added the pneumococcal vaccine to its vaccination schedule. Young children, therefore, receive a dose at 2, 4 and 12 months of age to ensure good protection against pneumococcal infections. These vaccines not only protect children but also reduce the transmission of these infections to people at risk.
What to do if you have symptoms of pneumonia
It is also important to get treatment for respiratory infections that last more than a few days. These infections often cause pneumonia. If you have the symptoms of pneumonia, it is recommended that you:
- Seek medical attention immediately. Early diagnosis and treatment make it easier to recover.
- Follow the doctor’s advice carefully. Get plenty of rest, drink plenty of water, and take all medications prescribed by your doctor to help your recovery.
- Be patient. Pneumonia is a serious illness. Give yourself every chance to recover.
Did you know that
The Quebec Lung Association offers direct services to the population. For more information, visit our Patient Resources section.
Revision June 2019