The world pneumonia day (12th November 2021) provides an annual forum for the world to stand together and demand action in the fight against pneumonia- an acute respiratory infection of the lungs, leading to fluid filled lung alveoli causing breathing issues. India had the second highest number of child deaths due to pneumonia under the age of 5 in 2018, as per UN data. The UNICEF said, ‘In 2018 pneumonia claimed lives of >8,00,000 under 5 children- i.e., 1 child every 39 seconds, which was alarming.’ Most deaths occurred under the age of 2 and almost 1,53,000 within the first month of life.

Pneumonia doesn’t have one single cause – it can develop from either bacteria, viruses or fungi in the air or sometimes even due to aspiration, pollution, accidental toxin/chemical inhalation, etc. Children whose immune systems are immature (i.e., newborns) or weakened – such as by undernourishment or diseases like HIV – are more vulnerable to pneumonia.

The most common symptoms are fever, cough, increased respiratory rate and difficulty in breathing leading to distress, feeding difficulties, grunting, ultimately leading to respiratory failure in severe cases and death. It is contagious and can be spread through airborne particles (a cough or sneeze).  It is also observed that It can spread through other fluids, like blood during childbirth, or from contaminated surfaces. Risk factors like: over crowding, pollution, smoking, nutritional deficiencies, immunodeficiency disorders, congenital heart defects, recurrent aspirations (due to cleft palate, GERD, etc.) increase the chances of acquiring pneumonia. It is diagnosed based on the symptoms along with signs of chest retractions, tachypnea, etc. , Chest Xray can show consolidation/ground glass appearance/military mottling/effusion, direct detection of organisms on smear, culture or PCR from bodily fluids.

What is the treatment for pneumonia?

It depends on the type of pneumonia- starting with oral/injectable antibiotics/anti-viral/anti-fungal depending upon the clinical condition of the patient, initially empirical therapy and then shifting to culture-proven antibiotics as per sensitivity. Supportive therapy with humidified oxygen or assisted ventilation, iv fluids and electrolyte correction, symptomatic management of fever and cough, nebulization, monitoring of vital parameters, treatment of complications and zinc supplementation along with a good nutritious diet.

Measures to prevent pneumonia:

1.Adequate and proper nutrition, good eating/feeding habits, breastfeeding in first 6 months.

2.Use good hygiene practices. It has been observed that handwashing with soap reduces the risk of pneumonia by up to 50 per cent by lowering exposure to bacteria.

3.Reducing risk factors like air pollution (which makes the lungs more vulnerable to infection)

4.Seek timely medical assistance for symptoms

5.Proper and timely vaccination of newborn and children with recommended vaccinations should be done in order to prevent pneumonia for e.g. Most pneumonias caused by bacteria is easily preventable with vaccines like PCV (pneumococcal conjugate vaccine) when taken in 3 doses 4 weeks apart and a booster dose later. Other vaccination like BCG, Diphtheria, pertussis, Measles, H influenza B, influenza vaccines must be taken.

Child deaths due to pneumonia are concentrated in the world’s poorest countries. Within these countries, it is the most underprivileged and marginalized children who suffer the most. Both prevention and treatment require strong primary health care as well as engaged and empowered communities. Globally, only 68 per cent of children with pneumonia symptoms are taken to a health care provider.

Urgent action is needed now to end these preventable deaths. Health workers who are trained and equipped to support both prevention and treatment of pneumonia can change the course of the disease and help keep every child alive.