By Dr Kizito Lubano
Pneumonia is an infection of one or both lungs and is caused by bacteria, viruses or fungi. Prior to the discovery of antibiotics, one-third of all people who suffered pneumonia died.
Currently, over one million Kenyans suffer from the disease every year. Over half a million of these people are admitted to the hospital. Although most people recover, about five per cent die. Pneumonia is the sixth leading cause of death in the country.
How do people catch pneumonia?
Some cases of pneumonia are gotten through breathing small droplets of pneumonia-causing organisms. These droplets are released into the air when an infected person coughs or sneezes. Pneumonia can also result when bacteria or viruses, which are normally present in the mouth, throat or nose enter the lungs.
Signs and symptoms
Majority of people who develop pneumonia initially have symptoms of a cold for example, sneezing, sore throat, or a cough. These are then followed by a high fever, shaking chills and a cough with sputum production. The sputum is usually discoloured and sometimes bloody. At times, the individual’s skin colour may change and become dusky or purplish — a condition known as cyanosis, because their blood is poorly oxygenated.
Chest pain may develop if the outer aspects of the lung close to the pleura are involved in the infection. This pain is usually sharp and worsens when taking a deep breath.
Children and elderly persons may not have any specific signs of a chest infection, but develop a fever, appear quite ill, and can become tired.
Diagnosis
A doctor will suspect pneumonia if they examine the patient and hears coarse breathing or crackling sounds when listening to a portion of the chest with a stethoscope.
There may be wheezing or the sounds of breathing may be faint in a particular area of the chest. A chest X-ray is usually ordered to confirm the diagnosis of pneumonia. Sputum samples can be collected and examined under the microscope. A blood test that measures white blood cell count may also be performed.
Treatment
Antibiotics are used to treat bacterial causing pneumonia while addressing that caused by fungal or viral infections depends on the specific agent. Other supportive measures are necessary in treating severely ill patients such as assisted ventilation and good nutrition.
Prevention
There are two vaccines available namely the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPV23; Pneumovax).
The pneumococcal conjugate vaccine is part of the routine infant immunisation in Kenya. It is recommended for all children below two years and children aged between two to four years who have certain medical conditions.
The pneumococcal polysaccharide vaccine is recommended for adults at increased risk for developing pneumococcal pneumonia, including the elderly, who have diabetes, chronic heart, lung or kidney disease, those with alcoholism, cigarette smokers and those people who have had their spleen removed.
This vaccination should be repeated every five to seven years, whereas the flu vaccine is given annually.
