Globally, pneumonia causes more deaths than any other infectious disease. However, it can often be prevented with vaccines and can usually be treated with antibiotics or antiviral drugs.

Every 20 seconds, somewhere in the world, a child dies from pneumonia. Many of these deaths are preventable through vaccination and appropriate treatment.

What Is Pneumonia?

Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Signs of pneumonia can include coughing, fever, fatigue, nausea, vomiting, rapid breathing or shortness of breath, chills, or chest pain. Certain people are more likely to become ill with pneumonia. This includes adults 65 years of age or older and children less than 5 years of age. People up through 64 years of age who have underlying medical conditions (like diabetes or HIV/AIDS) and people 19 through 64 who smoke cigarettes or have asthma are also at increased risk for getting pneumonia.

Pneumonia Essentials 2010

The Natural History and Relations of Pneumonia: Its Causes, Forms, and Treatment, a Clinical Study

Causes of Pneumonia

Encourage friends and loved ones with certain health conditions, like diabetes and asthma, to get vaccinated against the flu and bacterial pneumonia.

When bacteria, viruses or, rarely, fungi living in your nose, mouth, sinuses, or the environment spread to your lungs, you can develop pneumonia or other infections. You can catch the bacteria or viruses from people who are infected with them, whether they are sick or not.

Types of Pneumonia

You may have heard of community-acquired pneumonia (CAP). When someone who hasn't recently been in the hospital or another healthcare facility develops pneumonia, it's called community-acquired.

Pneumonia is associated with healthcare when someone gets the infection during or following a stay in a healthcare facility (like hospitals, long-term care facilities, and dialysis centers). These infections are labeled healthcare-associated pneumonias, which includes healthcare-associated pneumonia (HCAP), hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP).

In the U.S., the most common bacterial cause of pneumonia is Streptococcus pneumoniae (pneumococcus) and the most common viral causes are influenza, parainfluenza, and respiratory syncytial viruses. In children less than 1 year of age, respiratory syncytial virus (RSV) is the most common cause of pneumonia. Other common bacterial and viral causes of pneumonia in the U.S. include Staphylococcus aureus and adenovirus. Pneumocystis jirovecii, a fungus formerly known as Pneumocystis carinii, is a common cause of pneumonia in patients with AIDS.

Streptococcus pneumoniae. More than 90 serotypes exist; of strains causing invasive disease, 88% are serotypes included in the 23-valent polysaccharide vaccine. Before the new pneumococcal conjugate vaccine was introduced in 2001, over 80% of invasive isolates in children under 5 years old were included in the 7-valent vaccine. Streptococus is transmitted from person to person.

The clinical features include: Pneumonia, bacteremia, otitis media, meningitis, sinusitis, peritonitis and arthritis.

Persons at higher risk for infection are the elderly, children under 2 years old, blacks, American Indians and Alaska Natives, children who attend group day care centers, and persons with underlying medical conditions including HIV infection and sickle-cell disease.

The incidence among young adults and young children is decreasing, due to improved HIV therapy and to use of the new conjugate vaccine for children. Outbreaks have occurred in institutional settings and child care centers. In the United States, ß-lactam resistance is common and prevalence of strains resistant to multiple classes of drugs is increasing.

Ability to prevent infections could improve through expanded use of 23-valent polysaccharide vaccine among adults and through use of the conjugate vaccine for infants and young children. Campaigns for judicious use of antibiotics along with the new vaccine may slow or reverse emerging drug resistance.

Pneumocystis carinii (NEW-mo-SIS-tis CA-RIN- nee-eye) pneumonia, or PCP, is a severe illness found in people with HIV. PCP is not sexually transmitted. It is caused by a germ called Pneumocystis carinii. Most people infected with this germ don’t get pneumonia because their immune systems are normal. People whose immune systems are badly damaged by HIV can get PCP. People with HIV are less likely to get PCP today than in earlier years. However, PCP is still the most common serious infection among people with AIDS in the United States.

If you have PCP, you probably will have fever, cough, or trouble breathing. People with PCP may die if the infection is not treated quickly. See your doctor immediately if you have these symptoms. PCP can be diagnosed only by laboratory tests of fluid or tissue from the lungs.

Most scientists believe PCP is spread in the air, but they don’t know if it lives in the soil or some- place else. The PCP germ is very common. Since it is difficult to prevent exposure to PCP, you should get medical care to prevent PCP.

PCP can be prevented. The best drug for preventing PCP is trimethoprim- sulfamethoxazole (try- METH-o-prim - sul-fa- meth-OX-uh-sole), or TMP-SMX. TMP-SMX is a combination of two medicines. It has many different brand names, such as Bactrim, Septra, and Cotrim*. Adults and older children can take TMP-SMX as a tablet. You can also get TMP- SMX as a liquid.

The pneumonia vaccine protects you against another kind of pneumonia, but not against PCP. There is no vaccine for PCP.

You should have your blood tested regularly to check the strength of your immune system. Your doctor should prescribe TMP-SMX to prevent PCP if your CD4 cell count falls below 200. Your doctor may also put you on TMP-SMX if you show certain symptoms, such as having a temperature above 100°F that lasts for 2 weeks or longer, or if you get a fungal infection in the mouth or throat (commonly called “thrush”). Having thrush is believed to raise your risk for getting PCP.

TMP-SMX can make some people have a rash or feel sick. If the drug reaction is not severe, TMP-SMX should be continued because it works so much better than any other medicine to prevent PCP. If you have already had PCP you can get it again. TMP-SMX can prevent second infections with PCP. Therefore, you should take TMP-SMX even after you have had PCP to prevent getting it again.

Children with HIV or AIDS can also get PCP. To learn more about children and PCP, call the AIDS Treatment Information Service at 1-800- 448-0440.

Reduce Your Risk

Pneumonia can be prevented with vaccines. Following good hygiene practices can also help prevent respiratory infections. This includes washing your hands regularly, cleaning hard surfaces that are touched often (like doorknobs and countertops), and coughing or sneezing into a tissue or into your elbow or sleeve. You can also reduce your risk of getting pneumonia by limiting exposure to cigarette smoke and treating and preventing conditions like diabetes and HIV/AIDS.

In the U.S., there are several vaccines that prevent infection by bacteria or viruses that may cause pneumonia.

Based on data from the 2009 National Health Interview Survey, the percent of adults 65 years and over who received a pneumococcal vaccination was 61%.

For Vaccine information, see Vaccines & Preventable Diseases. These vaccines include:

• Pneumococcal,
• Haemophilus influenzae type b (Hib),
• Pertussis (whooping cough),
• Varicella (chickenpox),
• Measles, and
• Influenza (flu) vaccine.

National and Global Impact

In 2007, 1.2 million people in the U.S. were hospitalized with pneumonia and more than 52,000 people died from the disease. The percent of hospital inpatient deaths from pneumonia: 6.0%.

Globally, pneumonia kills more than one and a half million children less than 5 years of age each year. This is greater than the number of deaths from any other infectious disease, such as AIDS, malaria or tuberculosis. Access to vaccines and treatment (like antibiotics and antivirals) can help prevent many pneumonia-related deaths. Pneumonia experts are also working to prevent pneumonia in developing countries by reducing indoor air pollution and encouraging good hygiene practices.