Pneumonia is a form of acute respiratory infection that affects lungs. The lungs are made up of small sacs called alveoli, which fill with air when a healthy person breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake. Pneumonia is a very common illness in kids. To know about the causes and prevention of pneumonia and what people should do, Rising Kashmir’s senior health correspondent, M Peerzada interviews senior pediatrician department of pediatrics GMC Srinagar, Dr Suhail Naik who talks about suggestions for parents to prevent children from falling prey to pneumonia and the way forward.
What is childhood pneumonia?
The infection of lung parenchyma is defined as pneumonia. The pneumonia is called as lobar pneumonia if it involves the lobe of the lung or interstitial pneumonia, when it affects interstitium of the lung. The term bronchiolitis is used when there is viral infection of lungs in children less than 2 years of age.
Pneumonia is the most common cause of mortality in children less than 5 years of age. The under 5 [U5] deaths due to pneumonia are preventable as well as treatable if diagnosed at the right time.
What are its symptoms?
Depending on the severity of the pneumonia, signs and symptoms may include acute onset high grade fever, cough, breathing difficulty, vomiting, chest or abdominal pain, sweating and shaking chills, fatigue, nausea, or diarrhea. These symptoms may be associated with upper respiratory catarrhal like rhinorrhea and conjunctivitis.
Is there a pneumonia season?
Yes, pneumonia has seasonal variation and is common during rainfall and winter months. During these months due to increased circulation of different viruses, decreased local innate immunity and overcrowding, the respiratory tract infections increase exponentially, though cases are seen throughout the year.
What are its causes and remedial measures?
The pneumonia is caused by different viruses, bacteria and fungi in susceptible children. The susceptible children are young infants, infants on formula milk, malnutrition, immune deficient, post measles, overcrowding and smoke exposure. The manifestations of pneumonia depend on the causative organism and immune status of the child. The remedial measures are a healthy balanced diet, adequate hydration and vaccination.
Who is at higher risk to get pneumonia?
The under 5 children who are susceptible to pneumonia are young infants, infants on formula milk, malnutrition, measles, overcrowding and passive exposure to smoke. The six months of exclusive breastfeeding and vaccination are two important measures to prevent occurrence of severe pneumonia.
What are the different types of pneumonia?
The different types of pneumonia are lobar pneumonia, lobular pneumonia, Bronchopneumonia, Bronchiolitis, Interstitial Pneumonia, Atypical pneumonia, Tuberculous Pneumonia and fungal pneumonia. These definitions are based on the involvement of anatomical area in the lung and clinical spectrum.
Do children still die of pneumonia in Kashmir hospitals?
Pneumonia is a major cause of U5 mortality and millions of children die due to it across the globe. Pneumonia is not a major cause of death in Kashmir, the reason being health seeking behaviour of mothers or family, more 95 percent vaccination coverage, low incidence of malnutrition and strong health care delivery system.
So when should a patient call the doctor?
Ideally whenever mother feels the baby is not well, but particularly when child develops breathing difficulty, stridor, grunting, persistent vomiting, chest pain and low oxygen level at room air.
What is the treatment for pneumonia?
Pneumonia may be treated with antibiotics, if it is bacterial. The antibiotic of choice is amoxicillin dispersible tablets. Most cases of pneumonia require oral antibiotics, which are often prescribed at a health centre. These cases can also be diagnosed and treated with inexpensive oral antibiotics at the community level by trained community health workers. Hospitalization is recommended only for severe cases of pneumonia.
Does the treatment have any side effects?
When treatment saves lives, side effects are not important. Treatments are always based on evidence and cost-benefit analysis.
How is pneumonia transmitted in air or through blood?
Pneumonia can be spread in several ways. The viruses and bacteria that are commonly found in a child’s nose or throat can infect the lungs if they are inhaled. They may also spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. More research needs to be done on the different pathogens causing pneumonia and the ways they are transmitted, as this is of critical importance for treatment and prevention.
What are its risk factors?
While most healthy children can fight the infection with their natural defences, children whose immune systems are compromised are at higher risk of developing pneumonia. A child’s immune system may be weakened by malnutrition or undernourishment, especially in infants who are not exclusively breastfed. Pre-existing illnesses, such as symptomatic HIV infections and measles, also increase a child’s risk of contracting pneumonia.
How can people prevent children from getting pneumonia?
Preventing pneumonia in children is an essential component of a strategy to reduce child mortality. Immunization against Hib, pneumococcus, measles and whooping cough (pertussis) is the most effective way to prevent pneumonia.
Adequate nutrition is a key to improve children’s natural defences, starting with exclusive breastfeeding for the first 6 months of life. In addition to being effective in preventing pneumonia, it also helps to reduce the length of the illness if a child does become ill.
Addressing environmental factors such as indoor air pollution (by providing affordable clean indoor stoves, for example) and encouraging good hygiene in crowded homes also reduces the number of children who fall ill with pneumonia. In children infected with HIV, the antibiotic cotrimoxazole is given daily to decrease the risk of contracting pneumonia.
No disease kills more children aged less than five years than pneumonia. Why so?
Pneumonia is common because lungs are in direct contact with the external environment and breathing air in and out 30 times in a minute. The organisms live in air, therefore lungs are prone to get infected frequently and many times in a year.
What can people do to keep their lungs healthy?
Breastfeeding, vaccination, proper nutrition, exercise, and avoiding passive smoking.
What measures are needed on childhood pneumonia?
Pneumonia can be prevented by immunization, adequate nutrition, and by addressing environmental factors. Pneumonia caused by bacteria can be treated with antibiotics, but only one-third of children with pneumonia receive the antibiotics they need. Strengthening of rural health care delivery systems, universal immunization and strong campaigns against formula milk are some of the measures that would work better.
