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Friday 30 November 2012

Enemy of the lungs

20 November 2012 | last updated at 11:12PM
By Nadia Badarudin | nadia@nst.com.my

In conjunction with World Pneumonia Day on Nov 12, Nadia Badarudin finds out about the disease that can be lethal to children and senior citizens

You are gasping for air and it is just not enough. Your lungs feel constricted. The body has the chills. You have a headache and, sometimes, chest pains. The whole episode started with a flu and cough so you expect all to wane in a few days, but it doesn’t.

Pneumonia is an infection of the lungs caused by microbial pathogens such as virus, bacteria, mould or other micro-organisms.

.
ASK someone who has suffered from pneumonia and
he or she will tell you of the ordeal associated
with the simplest of acts — breathing.
Despite vaccinations and improvements in treatment, the World Health Organisation reports that worldwide, pneumonia is the leading cause of death in children. It “kills an estimated 1.4 million children under the age of 5 every year — more than AIDS, malaria and tuberculosis combined”.

The International Union Against Tuberculosis and Lung Disease states that “a child dies of the illness every 20 seconds around the globe, with 98 per cent of these deaths reported in developing nations.”

According to the Health Ministry’s hospitals’ discharge diagnosis 2009-2011, pneumonia is among the Big Four in lung diseases that affect Malaysians. The other three are asthma, chronic obstructive pulmonary disease and tuberculosis.

UNDER-REPORTED

Babies and children (from 6 months to 5 years) the elderly (65 to 80) as well as individuals with vitamin deficiency or a weak immune system are most vulnerable to the disease.

Pantai Hospital Kuala Lumpur consultant respiratory physician Dr P. Ravindran Menon explains:
“Pneumonia can be severe and can cause death. However, it is often under-reported because the symptoms are just like those of the flu (influenza). Only a chest X-ray can confirm whether a person is infected with the disease.

“Besides children, senior citizens and people with an impaired immune system (those with HIV or systemic diseases, or on chemotherapy), there is also an increase in cases among pregnant women.” Smokers and alcoholics are also prone to the disease.

COMMON CASES

Dr P. Ravindran says there are several classifications of pneumonia, but the most common are community-acquired, hospital-acquired and aspiration pneumonia, mainly triggered by bacteria.  
He explains that community-acquired pneumonia is when a person gets infected from public or crowded places, while hospital-acquired pneumonia is when a person gets the infection from hospital (while getting treatment for other illness).

You can get pneumonia in crowded places
You can get pneumonia in crowded places

He says aspiration pneumonia is common among children and senior citizens, particularly those who suffer from dementia or stroke, or wear ill-fitted dentures.

“Aspiration pneumonia is an infection that develops after foreign objects such as pieces of food get lodged, or accidently inhaled into the lungs.

“Some of the patients don’t even know that the objects are stuck in the lungs. Among the objects that we’ve retrieved are pieces of meat, coins and saga seeds.”

Dr Ravindran adds that individuals infected by pneumonia will experience either typical or atypical symptoms that differ between age groups or the type of pneumonia.

“Typical symptoms are a high fever, cough, runny nose or shortness of breath. Children may look lethargic, irritable or don’t feed well if they are infected, while confusion is an important sign of infection in senior citizens,” he says.

 Symptoms that don’t conform to classical ones are called atypical symptoms and include diarrhoea, muscle pain or a skin rash. “Such symptoms are more apparent in severe or unusual types of pneumonia,” he says.

X-RAY TEST IS CRUCIAL

Most pneumonia cases don’t require hospitalisation and can be cleared up in two or three weeks. Dr Ravindran says an individual who experiences the symptoms but is not feeling better despite taking antibiotics should go for an X-ray examination.

“After four to six weeks, patients should also go for follow-ups to make sure that their lungs are clear. If they are not, doctors will look for other severe complications such as lung cancer.”

He says vaccinations are available for children, the elderly or people in the high risk group (those with systemic diseases, heart diseases, asthma, COPD, bronchitis or HIV) to prevent pneumonia.

“Vaccinations are also available for travellers, healthcare workers and people who want to go on pilgrimage,” he adds.

Big threat

PNEUMONIA was once regarded as the “captain of the men of death” in the 19th Century by father of modern medicine Sir William Osler. The disease overtook tuberculosis as the leading cause of death during his time.

What gets in the lungs

AMERICAN actress and singer Brittany Murphy died at 32, on Dec 12, 2009 due to a combination of pneumonia, anaemia and prescription drug intoxication.

Pneumonia and anaemia were also cited as the causes of death of her husband, Simon Monjack, who died five months later at their Hollywood Hills residence.

It was reported that Murphy’s mother, Sharon, believed that the toxic mould in the couple’s home had caused their illnesses and deaths.

According to the Illinois Department of Public Health (as reported in a 2011 report by The Huffington Post), exposure to mould can lead to pneumonia, but it is rare.

Prevention tips

HERE are Dr P. Ravindran Menon’s tips to prevent pneumonia:
1. For the elderly: Take good care of dental hygiene and don’t wear ill-fitting dentures.
2. Get vaccinated if you are travelling across continents.
3. Avoid frequenting crowded places or other potential hazards (e.g. haze, cigarette smoke) if you’re in the high risk group.
4. Ensure clean and good ventilation at home. Service the air-conditioners in your house or in your car frequently.
5. Get your pets vaccinated from bacteria that can trigger pneumonia.
6. If you’re infected, use good hand-washing techniques, and cover your nose and mouth when coughing or sneezing.

http://www.nst.com.my/life-times/health/enemy-of-the-lungs-1.173653