What Should We Do to Prevent Pneumonia?

Pneumonia (pneumonia) is an inflammation of the lung tissue. It is caused by various microorganisms, especially bacteria. Pneumonia is one of the most common and leading causes of death in the world and in Turkey. It is the fifth leading cause of death in Turkey. In particular, pneumonia can be more fatal in infants, children, the elderly and people with other known diseases.

Worldwide, 10 to 12 million children under the age of 5 die from pneumonia each year. 90% of these deaths occur in developing countries. In our country, pneumonia is responsible for 48% of infant deaths aged 1-12 months. This rate is 42% in the one to four age group. Early diagnosis and treatment are extremely important in preventing deaths.

In some types of pneumonia, there is a risk of direct transmission from the sick person to healthy people. However, most often the disease occurs when germs from the patient's own mouth, throat or digestive tract reach the lungs. These germs, which do not cause disease in normal cases, cause pneumonia in people with weakened body defenses. Risk factors that break the body's resistance play a role in the emergence of pneumonia rather than infection. Influenza and similar viral respiratory infections that predispose to pneumonia are very contagious. They can be spread by sneezing and coughing, and can be passed on to other people through mouth and nose secretions and objects such as glasses, handkerchiefs, cutlery and door handles.

There are several risk factors that make it easier for a person to get pneumonia. If these can be avoided, pneumonia can be prevented. In adults; advanced age, chronic diseases: lung diseases (COPD, bronchiectasis, lung cancer), heart diseases, kidney diseases, liver diseases, diabetes, nervous system diseases, strokes, dementia, conditions that cause difficulty swallowing, immune system diseases (AIDS, blood and lymph gland cancers), smoking, alcohol intake, vomiting, prolonged surgeries, flu epidemics. In children; being under 2 years of age, low birth weight, premature birth, inadequate breastfeeding, inadequate nutrition, vitamin D deficiency, low socioeconomic level, crowded living conditions, presence of underlying chronic diseases, congenital heart, lung disease, diabetes, inadequate vaccination, ineffective application of measles and pertussis vaccines, air pollution, especially smoking, winter season, maternal age and education.

Symptoms of Pneumonia

Typical pneumonia usually presents suddenly with chills, fever up to 39-40°C, cough, dirty, purulent (green, yellow, rust-colored) sputum and side pain. In atypical forms, there is an insidious onset. Symptoms such as loss of appetite, weakness, joint and muscle aches, followed by dry cough, fever, nausea, vomiting and headache may persist for several days.

Symptoms of pneumonia in children may vary depending on the age of the child and the causative agent of pneumonia. Sometimes rapid breathing is the only symptom in children with pneumonia. When pneumonia affects the lower parts of the lungs near the abdomen, children may only complain of fever, abdominal pain and vomiting without any symptoms related to the respiratory system. Other symptoms include coughing, phlegm, rapid breathing, shortness of breath, the presence of pulling (the muscles under the rib cage and between the ribs pull in with each breath), chest pain, headache, muscle pain, decreased activity, loss of appetite in older children or inability to feed in younger children, vomiting, abdominal pain, and rarely bruising of the lips and nails.

A doctor should be consulted in cases of shortness of breath, rapid breathing, and a fever higher than 38.9°C, and higher than 38°C in children younger than 6 months.

If the patient's complaints are compatible with pneumonia, the diagnosis can usually be made by examination and findings on chest x-ray. Blood and sputum tests can be performed if necessary.

Pneumonia can sometimes be confused with diseases such as flu, colds and bronchitis. In such patients, if the fever rises with chills and chills and reaches up to 39-40°C, the general condition of the patient deteriorates, the disease is severe and lasts for a long time, accompanied by dark, bloody sputum and chest pain, the possibility of pneumonia should be investigated.

In many cases, pneumonia can be treated at home. Severe cases, elderly patients, patients requiring oxygen therapy or intensive care support require hospitalization. Treatment depends on the patient. When treatment is started early and in cases that can be treated on an outpatient basis, the results are favorable. However, the mortality rate is high in severe pneumonia cases with delayed diagnosis and treatment.

Pneumonia Prevention

To prevent pneumonia, negative factors that facilitate the development of pneumonia should be corrected. To this end, appropriate follow-up and treatment of chronic diseases, avoidance of stress, balanced nutrition and hygienic housing conditions, control of alcohol, tobacco and drug addiction, and reduction of risk factors that cause mouth and stomach contents to enter the respiratory tract (aspiration) are necessary. During influenza outbreaks, which can cause or facilitate pneumonia, it is recommended to reduce contact with crowds and use masks.

Pneumococcal vaccination and annual influenza vaccination to increase the immunity of high-risk individuals against pneumonia are also among the pneumonia prevention strategies. Vaccination of people who can transmit influenza, especially in high-risk groups, is recommended for prevention.

Inadequate nutrition is the most important factor that facilitates the development of pneumonia in children. In Turkey, less than 10% of babies are exclusively breastfed within three months of birth. Breast milk strengthens the immune system of infants and leads to a better response to vaccines. Therefore, adequate breastfeeding should be encouraged. Exposure of children to cigarettes increases the incidence of pneumonia, hospitalizations and deaths. Passive smoking (exposure to cigarette smoke) should be prevented in children.

Vaccination rates are very low in our country. Measles, whooping cough and tuberculosis are the most important causes of pneumonia in children. Therefore, vaccination against these diseases will reduce the incidence of pneumonia. It is also important to include the H. influenzae type b vaccine, which was developed against Haemophilus influenzae, a common bacterium among the causes of pneumonia in children, in the routine vaccination program in children.