Pneumonia
Pneumonia is a lung disease that can be caused by a variety of viruses, bacteria,
and sometimes fungi. The U.S. Centers for Diseases Control and Prevention (CDC)
estimate nearly 90,000 people in the United States died from one of several
kinds of pneumonia in 1999. In the United States, pneumonia is the fifth leading
cause of death. Rates of infection are three-times higher in African Americans
than in whites and are 5- to 10-times higher in Native-American adults and
10-times higher in Native-American children
On an international scale, acute respiratory infection ranks as the third
most frequent cause of death among children less than 5 years old and was
responsible for approximately 3.5 million deaths in 1998.
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Pneumococcal pneumonia is an infection in the lungs caused by bacteria called
Streptococcus pneumoniae. S. pneumoniae, also called pneumococcus, can infect
the upper respiratory tracts of adults and children and can spread to the blood,
lungs, middle ear, or nervous system. CDC estimates S. pneumoniae causes 40,000
deaths and 500,000 cases of pneumonia annually in the United States. The yearly
incidence of pneumococcal pneumonia is twice as high in African Americans than
in whites and is responsible for 3,000 cases of meningitis (inflammation of
spinal cord membranes), 50,000 cases of bacteremia (bacteria in the blood),
and 7 million cases of otitis media (inner ear infection).
According to the World Health Organization, S. pneumoniae is the leading
cause of severe pneumonia worldwide in children younger than 5 years old,
causing more than 1 million deaths in children each year.
Pneumococcal pneumonia primarily causes illness in children younger than
2 years old and adults 65 years of age or older. The elderly are especially
vulnerable to getting seriously ill and dying from this disease. In addition,
people with certain medical conditions such as chronic heart, lung, or liver
diseases or sickle cell anemia are also at increased risk for getting pneumococcal
pneumonia as are people with HIV infection or AIDS or people who have had
organ transplants and are taking medicines that lower their resistance to
infection.
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The noses and throats of up to 70 percent of healthy people contain pneumococcus
at any given time. It is spread from person to person by coughing, sneezing,
or close contact. Researchers don't know why it suddenly invades the lungs
and the bloodstream to cause disease.
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Pneumococcal pneumonia may begin suddenly, with a severe shaking chill usually
followed by
- High fever
- Cough
- Shortness of breath
- Rapid breathing
- Chest pains
There may be other symptoms as well.
- Nausea
- Vomiting
- Headache
- Tiredness
- Muscle aches
In an otherwise healthy adult, pneumococcal pneumonia usually involves one
or more parts of the lungs, known as lobes. Thus, it is sometimes called
lobar pneumonia. The remainder of the respiratory system is comparatively
not affected. In contrast, infants, young children, and elderly people more
commonly develop a relatively mild infection in other parts of the lungs,
such as around the air vessels (bronchi) causing bronchopneumonia.
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A doctor or other health care provider diagnoses pneumonia based on
- Symptoms
- Physical examination
- Laboratory tests
- Chest x-ray
Because a number of bacteria, viruses, and other infectious agents can cause
pneumonia, if you have any of the symptoms, you should get diagnosed early
and start taking the right medicine if you have any of the symptoms. The
presence of S. pneumoniae in the blood, saliva, or lung fluid helps lead
to a diagnosis of pneumococcal pneumonia.
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Health care providers usually prescribe antibiotics, such as penicillin, to
treat this bacterial disease. The symptoms of pneumococcal pneumonia usually
subside within 12 to 36 hours after treatment has begun. Bacteria such as S.
pneumoniae, however, are resisting and fighting off the powers of antibiotics
to destroy them. Such antibiotic resistance is increasing worldwide because
these medicines have been overused or misused. Therefore, if you are at risk
of getting pneumococcal pneumonia, you should talk with your doctor about taking
steps to prevent it.
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The pneumococcal vaccine is the only way to prevent getting pneumococcal pneumonia.
Vaccines are available for children and adults.
The CDC National Immunization Program (NIP) recommends that you get immunized
against pneumococcal pneumonia if you are in any of the following groups.
- You are 65 years old or older.
- You have a serious long-term health problem such as heart disease, sickle
cell disease, alcoholism, leaks of cerebrospinal fluid, lung disease (not
including asthma), diabetes, or liver cirrhosis.
- Your resistance to infection is lowered due to HIV infection or AIDS;
lymphoma, leukemia, or other cancers; cancer treatment with x-rays or drugs;
treatment with long-term steroids; bone marrow or organ transplant; kidney
failure; nephrotic (kidney) syndrome; damaged spleen or no spleen.
- You are an Alaskan-Native or from certain Native-American populations.
In February 2000, the U.S. Food and Drug Administration approved a pneumococcal
vaccine for use in toddlers and children. It is the first pneumococcal vaccine
approved for children younger than 2 years old. NIP recommends that all children
ages 2 to 23 months old get this vaccine.
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According to CDC, in 25 to 30 percent of people with pneumococcal pneumonia,
the bacteria invade the blood stream from the lungs. This causes bacteremia,
a very serious condition. Pneumococcal pneumonia also can cause other lung
problems and certain heart problems.
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The National Institute of Allergy and Infectious Diseases (NIAID) supports
research on more effective prevention and treatment approaches to control pneumonia
and its causes. These include
- Developing and licensing vaccines and treatments for the disease-causing
microbes (pathogens) that cause pneumonia
- Stimulating research on the structure and function of these pathogens
- Developing better and more rapid diagnostic tools
- Understanding the long-term health impact respiratory pathogens have
in various populations
- Examining the effect of vaccines in high-risk populations
- Determining how pneumococcus becomes resistant to antibiotics
The recently approved pneumococcal conjugate vaccine for children is partially
the result of crucial NIAID research in the early development of the vaccine.
This vaccine helps prevent pneumococcal diseases in babies and toddlers and
is the latest advance in developing vaccines against common bacterial infections.
This effort was led in large part by NIAID for more than 30 years.
NIAID supports studies to develop improved pneumococcal conjugate vaccines
for children worldwide. In one such study, NIAID researchers are working
with The Gambia Government and scientists from several international research
institutions to test a pneumococcal conjugate vaccine in The Gambia, West
Africa. Health care experts have consistently identified pneumococcus as
the most common cause of bacterial pneumonia in The Gambia. In a pattern
typical of many developing areas, infant and child mortality rates in The
Gambia are high, acute respiratory infections are a leading cause of death,
and pneumococcus is the most common cause of these infections.
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National
Institute of Allergy and Infectious Diseases
U.S.
National Library of Medicine
U.S.
Food and Drug Administration
The
American Lung Association
National
Foundation for Infectious Diseases
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AAT Deficiency
