Myths and Facts: Pneumonia

Pneumonia is the single deadliest infection in the world.¹ In the United States, pneumonia is the No. 1 cause of death from infection. Half of all pneumonia cases are adults over the age of 65, and often they are hospitalized.² And, children and those immunocompromised are just as susceptible to contracting pneumonia.

Yet, pneumonia also is one of the oldest diagnoses available to physicians. Hippocrates described the symptoms more than 2,300 years ago, and even then he said it was the disease “named by the ancients.”³ In 1875, Edwin Klebs first identified bacteria in the airways of patients who had died of pneumonia. By 1884, researchers following up on Klebs’ work had shown that pneumonia could be caused by more than one type of bacteria.⁴

But while we’ve known since the earliest days of civilization (and perhaps before) that the lungs are prone to infection — and that those infections can quickly become life-threatening — it wasn’t until relatively recently that we understood what can cause this disease.And it’s even more recent that we’ve had the capability to prevent many potential cases of pneumonia through vaccination.

Despite these advances, many myths persist about pneumonia, and patients often don’t know when to contact a doctor because symptoms of pneumonia often mimic those of a chest cold or the flu. And, those most at risk — the elderly, infants and people with compromised immune systems or other underlying health issues — are not always educated about the seriousness of pneumonia, or the ways in which they can help to prevent it. To help bridge this gap, getting out the truth about pneumonia is the best way to counter the many myths that stand in the way of effective treatment.

Separating Myth from Fact

Myth: Pneumonia is rare; only people who are HIV positive or have lung cancer get pneumonia.

Fact: Pneumonia kills more than four million people a year. Even in the United States, 1.2 million people were hospitalized in 2006, and more than 55,000 died from it.¹ While many of these patients did have underlying health issues, others were perfectly healthy before contracting pneumonia.

Myth: Pneumonia is caused by the pneumococcus bacteria.

Fact: While pneumococcus-caused pneumonia is the most common cause of pneumonia in the United States, pneumonia also can be caused by viruses, fungi, parasites and chemical agents, as well as non-pneumococcus bacteria.⁵ However, the bacterial pneumonia — including pneumococcus-caused cases — generally are more severe than viral cases, particularly among children and the elderly.⁶

Myth: It is easy to diagnose pneumonia.

Fact: Symptoms of pneumonia often are similar to those of a chest cold or bronchitis. According to the National Institutes of Health, symptoms of pneumonia include high fever, chills, cough with phlegm, shortness of breath, chest pain when coughing or breathing, nausea, vomiting or diarrhea and feeling worse after having the flu or a cold.⁷

Infants and newborns may not exhibit any symptoms, or they may show lethargy, restlessness or fatigue. The elderly may display milder symptoms, even a lower temperature, and also may exhibit sudden changes in mental alertness.⁷

By listening to a patient’s breathing through a stethoscope, looking at X-rays of the lungs or having a culture taken from the patient’s sputum, a case of pneumonia can generally be differentiated from a common cold or the flu.

Myth: Pneumonia will go away on its own.

Fact: Most cases of pneumonia caused by bacterial infections will clear up with bed rest at home within a few weeks. And, cases caused by viral infections perhaps may last a little longer. However, the elderly, infants and those with compromised immune systems or other underlying health challenges need to seek immediate medical care to prevent the infection from worsening.

Myth: Only the elderly and those patients with compromised immune systems are at risk of serious complications from pneumonia.

Fact: Pneumonia is the leading cause of death in children,⁸ and even otherwise healthy people can and do contract pneumonia.

Myth: Viral pneumonia is more dangerous because it can’t be treated with antibiotics.

Fact: Most cases of viral pneumonia (generally caused by an influenza virus) are mild. However, while viral pneumonia will generally abate on its own within a month or so, patients are at increased risk of also contracting a bacterial infection in their lungs while sick with viral pneumonia.⁵

Some cases of viral pneumonia can be treated with antiviral medications if caught within the first 48 hours of infection. Drugs such as rimantadine or amantadine may be used to treat pneumonia caused by influenza A, while oseltamivir and zanamivir are used to treat both influenza A and B.⁹

Myth: Hospitalized patients don’t have to worry about catching pneumonia.

Fact: The medical profession actually classifies pneumonia by where it is contracted (as well as the underlying pathogen causing the infection or inflammation), and hospital-acquired pneumonia is one of those classes. The risks associated with hospital-acquired pneumonia are exacerbated since those contracting it are usually already ill. Patients on a ventilator may be especially prone to pneumonia. There also is the risk of being exposed to resistant bacteria in a hospital, which makes treatment more difficult.¹⁰

Myth: There is no way to prevent pneumonia.

Fact: While the pneumococcus vaccine isn’t widely known among the public, it has been available since 2000 and is highly effective at preventing pneumonia from the pneumococcus bacteria (Streptococcus pneumoniae). Even those patients who have received the pneumococcus vaccine and later contract pneumonia have, on the whole, milder cases of pneumonia and fewer serious complications.¹¹

Because the seasonal flu virus also can cause pneumonia, an annual flu vaccine is a good preventive measure. In addition, since the Haemophilus influenzae type b (Hib) bacterium is responsible for pneumonia (as well as meningitis), the Hib vaccine, usually part of the course of infant vaccines in the United States, also is part of a good defense.¹²

The Centers for Disease Control and Prevention (CDC) points out that general rules of good hygiene always apply. Frequently washing hands with hot water and soap, keeping hard surfaces like door knobs and countertops sanitized, and coughing and sneezing into a tissue or even a sleeve all can help to slow the spread of bacteria and viruses that cause pneumonia.

Myth: A pneumonia vaccine is good for only one year.

Fact: Only one dose of pneumococcal polysaccaride vaccine is needed. However, it is recommended that individuals age 65 and older who received their first dose when they were younger than 65, and it has been more than five years since then, get a second dose.¹³

Myth: Only the elderly need to get the pneumococcus vaccine.

Fact: While the CDC recommends that all adults 65 and older receive the pneumococcal polysaccaride vaccine, it also calls for all children under 5 years of age to receive the pneumococcal conjugate vaccine.¹⁴ The pneumococcal polysaccaride vaccine also is recommended for children 24 months and older if they have high risk factors (HIV, sickle cell or other immunological disease) for pneumococcal disease. In addition, many states require the pneumococcal conjugate vaccine for any child in a daycare environment.¹⁵

Dispelling the Myths Now

Pneumonia is one of the oldest known diseases, so it seems only logical that individuals would be knowledgeable about its causes and how to prevent it. On the contrary, pneumonia is still a leading killer, giving evidence to the fact that this knowledge isn’t readily available. Countering the growing number of myths surrounding the disease with the real facts can help to change that. And, with flu season not far off, now is never a better time.