Pneumonia is a disease to be feared especially for the elderly, in which it manifests itself with atypical symptoms.
A recent Censis survey on the knowledge of Italians aged 50 and over on the subject of influenza and vaccine reveals that 78.7% know that pneumonia is among the most frequent complications of an infection too often defined as “trivial”. But, despite the awareness of the seriousness of a disease that in old age is even deadly, only 16% of respondents say they contact the doctor immediately and just under half do so if the symptoms do not improve (mostly treating themselves with the do-it-yourself of over-the-counter drugs).
“Bacterial streptococcal pneumonia is actually one of the possible evolutions of influenza,” confirms Emanuele Montomoli of the University of Siena. “The people most at risk are of course the elderly who already have precarious health for other chronic diseases, respiratory and not. But even those who are well may have to face an important inflammatory reaction caused by the infection.”
The causes
In pneumonia, the pulmonary alveoli become inflamed and filled with fluid, hindering respiratory function. The cause may be a virus or a bacterium: the main responsible is Streptococcus pneumoniae or pneumococcus, followed by Haemophilus influentiae, Mycoplasma pneumoniae and Legionella pneumophila.
Pneumococcus is a bacterium present in the nasopharyngeal cavity: when there is a viral infection (such as influenza, for example) the balance between host and bacterium is altered and the lesion affecting the respiratory tree induces the penetration of bacteria.
Pneumococcal infection mainly affects children up to 2 years, while in adults its incidence rises after the age of 50 and peaks after 65. In this age group, in particular, it is responsible for about 40% of all cases of pneumonia.
If there are additional predisposing factors, such as chronic cardiovascular and respiratory diseases (chronic bronchitis or asthma), deep infections are more likely to occur.
The disease causes about 7,000 deaths per year among the over 65s (for respiratory failure, heart failure, septicemia) and 140,000 hospitalizations (also in this case, 80% are over 65 years old) and is among the major causes of hospitalization in our country.
How do you detect an outbreak of pneumonia?
Germs multiply in the pulmonary alveoli giving way to an inflammatory process that leads to the formation of exudates (inflammatory fluids), the presence of which causes a reduction in blood oxygenation.
Montomoli explains: “In people with chronic lung diseases the consequence is dyspnea, that is, shortness of breath. Other early and typical signs of bacterial pneumonia are cough, fever, chest pain.
In the elderly, the clinical presentation is often atypical, characterized by mental confusion, chest pain and fever less pronounced than in the young adult. Complications such as COPD (chronic obstructive pulmonary disease) exacerbations may also occur, overlapping viral and bacterial pneumonia, cardiac complications and cerebral stroke.
The diagnosis is confirmed by an X-ray. In bacterial forms, there is a typical whitening of the affected area. Some tests are also possible: sputum culture, blood culture, antigen detection in urine and more sensitive tests using molecular biology methods.
Bacteremic pneumonia
A further possible evolution of the disease is bacteremic pneumococcal pneumonia: the infection caused by pneumococcus does not remain in the lungs, but trespasses into the blood through which it can reach other tissues and compromise them. About 80% of serious pathologies caused by pneumococcus in adults and the elderly are represented by bacteremic pneumonia.
Prevent with the vaccine
Treatment depends on the type of pneumonia: if it is bacterial, it is treated with antibiotics.
A valid preventive strategy, for the over 65s and for all people with chronic heart and respiratory problems, diabetes and other diseases that weaken the immune system is influenza vaccination combined with pneumococcal vaccination: the latter must no longer be repeated because it lasts for life.
The pneumococcal vaccine has been included in the 2017-2019 vaccination plan and is offered free of charge, in addition to those over sixty-five, also to all newborns, to whom 3 doses must be administered in the first year of life:
First dose | Second dose | Third dose |
---|---|---|
3rd month | 5rd month | 11rd month |
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.