Gasping for air: More awareness on pneumonia needed
PNEUMONIA kills, and the morbidity stats are getting worse.
Despite medical breakthroughs and accessible information, pneumonia remains one of the leading causes of death in the Philippines. Almost 75 percent of pneumonia incidents worldwide occur in just 15 countries, the Philippines among them.
It is the second cause of illness in the country and the fourth leading cause of death. Even more alarming is that pneumonia incidents have been steadily rising, from 41 per 100,000 people affected between 2004-2008, to 46.2 for every 100,000 people today.
Dr. Rontgene Solante, chair of the Adult Infectious Diseases and Tropical Medicine Section at San Lazaro Hospital, blames it on lack of awareness and low vaccination rate. It is unfortunate too, he said, that some doctors are not even aware there’s a vaccine for pneumonia.
“Rarely would doctors discuss this with their patients, because they’re not aware of its existence, they do not have time to explain, or there is simply low priority given to the disease. In my experience, 80-90 percent of my patients do not know there’s a vaccine,” Solante said during the recent Pfizer Philippines symposium for World Pneumonia Day.
Pneumonia is an inflammation of the lung’s air sacs due to infection from viruses, bacteria, or fungi. The air sacs expand during inhalation. During an inflammation, however, the air sacs will have difficulty expanding. When this happens, a problem with the lung’s capacity for gas exchange happens so that breathing becomes labored.
In some cases, the lungs get filled up with fluid and pus.
Pneumococcal pneumonia (lung infection), the most common serious form of a pneumococcal disease, is an infection caused by the streptococcus pneumoniae bacteria. It is spread through coughing, sneezing and close contact with an infected person. In severe cases, the bacteria invade other parts of the body, such as the blood (bacteremia), ears (otitis media) and brain (meningitis) that may eventually lead to death.
“There are two things that can happen when droplets are inhaled,” said Dr. Katrina Florcruz, a pediatrician at the Medical City. “The bacteria can spread to the nose and stay there, making you a carrier, or it can go to the lungs and cause pneumonia.”
Pneumonia, she noted, continues to be the leading cause of death among Filipino children aged 1-4 years old. A recent study by the UP College of Medicine and the Philippine General Hospital showed that pediatric pneumonia kills more children each year than AIDS, malaria and measles combined.
Solante said another reason pneumonia is difficult to control is due to its high concentration of serotypes. Serotypes are groups within a single species of microorganisms, such as bacteria or viruses, which share distinctive surface structures. Most serotypes are capable of causing serious disease in humans.
HIV has two serotypes, and so does flu. Dengue has four. Pneumonia, Solante said, has 90 serotypes, and a third of those can cause severe infection.
Those at risk for pneumonia include people with compromised immune systems, such as HIV/AIDS patients, cancer patients, those undergoing chemotherapy, people with lung infections, smokers, diabetics, alcoholics, those with cardiovascular disease and liver disease.
Solante said local data shows that one out of 16 Filipinos is diabetic, one out of eight has chronic obstructive pulmonary disease, one out of four has hypertension. The most common cause of death among diabetics is pneumonia.
He said it means the general population, regardless of age, is at risk of developing a pneumococcal infection.
“Recent studies in Europe also confirm that if you have a cardiac condition—whether hypertension or coronary heart disease—when you’re admitted due to pneumonia, it can trigger the heart attack.”
Vaccination is imperative, he said, as well as keeping one’s immune system strong by eating right and exercising.
“Vaccinate children so they won’t transfer the bacteria to lola or auntie. Vaccinate lola or auntie to protect them from acquiring pneumonia,” Solante said.
A sequential vaccination schedule must be adopted, he said, as there are different mechanisms of producing antibodies. Consult with doctors to know which vaccine (there are two) comes first. Infants as early as six weeks and adults as young as 18 years old can be vaccinated.
For more information, visit worldpneumoniaday.org.
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