Pneumonia remains the leading infectious cause of death globally, affecting all ages. With mortality rates not declining significantly over the past 60 years, it killed more than 2.5 million people worldwide in 2019 alone (the latest date for which data is released).
In terms of national data, according to the latest national epidemiological bulletin, from January to October 2023, a total of 148,571 cases of pneumonia were reported nationwide, which is similar to the 147,967 cases in the same period in 2022. Although medical advances, particularly in the treatment of pneumonia, have improved outcomes, the increasing age of the population and the increasing incidence and severity of pneumonia in older adults have diminished this positive effect.
What is pneumonia?
Pneumonia is an acute respiratory infection that affects the lungs. They are made up of small sacs called alveoli, which fill with air when a healthy person breathes. In pneumonia patients, the alveoli fill with purulent secretions and fluid, which can make breathing difficult and limit the oxygenation of blood in the lungs. The disease can be caused by viruses, bacteria, fungi or parasites.
Viruses are an important cause of pneumonia (23%), as we saw with the SARS-CoV-2 pandemic and the 2009 H1N1 influenza epidemic. Among the bacterial causes of pneumonia, Streptococcus pneumoniae, also known as pneumococcus, is the most common bacterium. On top of that, it causes a variety of diseases, manifesting as upper respiratory tract infections (e.g. acute otitis media and/or sinusitis) or in invasive forms (meningitis, bacteremia, abscesses), the latter with higher mortality disease. In addition to pneumococci, there are other bacteria that can cause pneumonia, although they are less common.
How does it spread?
Pneumonia can be spread in many ways. The underlying pathogen may be in the air we breathe, from a sick person, or colonized by a virus such as influenza or respiratory syncytial virus, or from bacteria commonly found in the nose or throat that can multiply. Lungs after inhalation.
Who has the most exposure?
Adults over 65 years of age.
Patients with chronic respiratory, heart, liver, kidney disease and changes in spleen function or surgical removal of the spleen.
Immune compromise for a variety of reasons.
What are the main symptoms?
Symptoms of pneumonia can be general, such as fever, chills, and general malaise, or they can be more specific, such as a cough with mucus or purulent discharge, chest pain, or shortness of breath. Many times, patients are diagnosed while in the hospital, which is why prevention is key to avoiding severe cases.
For children: Maintain breastfeeding at least until infant is 6 months old and stay up-to-date on your vaccination schedule to reduce health complications and mortality from respiratory infections.
Adults: Dispose of tissues properly, cover your mouth and nose when coughing or sneezing, do not smoke, avoid overcrowding and wood heating, and ventilate homes and workplaces frequently.
All ages: There are two vaccines available for children and adults that are given at different times: the flu vaccine and the pneumococcal vaccine. Adults can also receive the two vaccines mentioned above, which have been included in the national vaccination plan for adults over 65 years old and adults with heart disease, lung disease, kidney failure, liver disease, diabetes and other diseases.
Pneumonia and its complications are preventable through vaccination, early diagnosis, and appropriate treatment, especially in children and older adults. Regardless, vaccination rates are low, so it is important to emphasize the importance of influenza and pneumococcal vaccination, which are the leading vaccine-preventable causes of pneumonia.
It is important to emphasize that the annual influenza vaccine and pneumococcal vaccine are included in the national vaccination calendar and are free of charge at the country’s vaccination centers and public hospitals for people with any of the above indications.
Recommendation: Dr. Laura Pulido (MN 127115), Coordinator of the Infectious Diseases Section of the Argentine Association of Respiratory Medicine.