We are going through the season of increased respiratory infections, many of which lead to pneumonia.

Pneumonia is a serious infection, it can affect one or both lungs, it causes inflammation and fills the alveoli (the part of the lungs where gases, oxygen and dioxide are exchanged) with fluid. When the alveoli are filled with fluid (excretions), the air we breathe cannot reach them and give oxygen to the blood. This results in a problem with oxygenation and shortness of breath, so much so that it can lead the patient to the intensive care unit or even be fatal. It is a much more frequent and serious disease than we think, as Eurostat reports that in 2014, 118,000 deaths in Europe were due to pneumonia, while in the USA, annual cases exceed one million and deaths exceed 50,000.

Who does it concern and how is pneumonia recognized?

Everyone is at risk of pneumonia, but especially vulnerable groups are young children, older people and of course patients with chronic diseases, such as cardiac, respiratory, renal failure, immunosuppression, cancer, leukemia.

The symptoms of pneumonia usually start as in any respiratory infection: the patient has a fever, cough, usually with sputum, hears “boiling” and may have shortness of breath. When such symptoms are present and they are severe or persistent, a visit to the doctor and early diagnosis and treatment are essential. Pneumonia is usually microbial or viral, and often more than one pathogen coexists. For the diagnosis of pneumonia, an imaging test is necessary.

How is pneumonia treated?

Treatment includes antibiotics, antipyretics, plenty of fluids and rest, and these are usually enough to treat pneumonia. But when the pneumonia has greatly affected the lungs, when the symptoms are severe, or the patient is at high risk, based on the doctor’s opinion, it is safer to be admitted to a hospital so that there is close monitoring and IV treatment is given, or oxygen therapy. In even more serious cases, admission to the Intensive Care Unit and intubation are performed. It should be noted that the ventilator does not replace the alveoli, but it rests the patient and gives him time to recover. Pneumonia may resolve quickly, but may persist for two to four weeks. And unfortunately, sometimes it can even lead to death.

Can we prevent pneumonia?

In medicine, prevention is always very important and the most effective ways of prevention are vaccination, avoiding close contact and hand hygiene.

There are currently three vaccines to prevent respiratory infections and pneumonia: the flu vaccine, which is annual, the pneumococcal vaccine, and the coronavirus vaccine, which, like the flu, is now annual.

Internationally, the influenza vaccine is recommended for children older than 6 months, patients with asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes mellitus, heart disease, malignancies, immunosuppression, obesity, transplant recipients, pregnant and lactating women, caregivers of vulnerable individuals and healthcare personnel , as well as to people over 60 years of age.

The pneumococcal vaccine should be given to people over the age of 65, as well as to people over 18 who belong to vulnerable groups – chronic lung disease or heart disease, chronic kidney failure, chronic liver disease, alcoholism, smokers, patients who have immunosuppression, leakage of cerebrospinal fluid or cochlear implants. For pneumococcus, there are currently three different vaccines, PCV20, PCV13 and PCV23. The most up-to-date is PCV20 and a single dose of PCV20 is recommended in all groups that have an indication. If vaccination with a dose of PCV13 or a dose of PCV23 has been done, PCV20 should be administered at least 1 year later to complete vaccination. If there has been previous vaccination with both vaccines, i.e. both PCV13 and PCV23, no further dose is needed. However, especially for patients who have immunosuppression, leakage of cerebrospinal fluid or cochlear implants, vaccination with PCV20 is recommended 5 years after completion of the first vaccination.

Finally, the coronavirus is a virus that mutates rapidly, like influenza viruses, and the recommendation for annual immunization is strong, with the same indications as for influenza vaccination.

To protect ourselves and others around us from pneumonia, we cover our mouth and nose when we cough or sneeze, wash our hands often, get vaccinated, follow a healthy lifestyle with exercise and a good diet, avoid smoking and sex. And we visit the doctor promptly when we have symptoms that are severe or persistent.