Pneumonia the silent killer: disease with deadly effects on children

8-year-old Luqman Nur Hakim Imran thought he had the common childhood cold, as he showed signs of fever, sniffles and cough. Little did he know, what he had was more ominous.

Luqman was hospitalised twice at the National University Hospital (NUH) last year after being diagnosed with pneumonia, as he suffered from a serious lung infection, which left him with breathing difficulties, chest pains and body aches. He spent a total of about 3 weeks in hospital.

His mother, Mdm Norlizam Subari, 46, said that it was a trying time for the entire family.

“He started complaining of chest and back pains, and also had very bad body aches. I felt sad (to see him suffering). During that period, I didn’t get to see my other kids for a few weeks as I had to take care of Luqman,” said the homemaker.

Pneumonia is an infection of the lungs caused by a virus or bacteria, and is the number 2 killer across all ages in Singapore, after cancer, causing about 19% of deaths here. It is often thought to affect mainly the elderly and chronically ill, but younger children are equally vulnerable.

Also known as the silent killer, pneumonia symptoms are not obviously distinguishable from the common cold or flu, and is the top killer of children under the age of 5 - according to the World Health Organisation (WHO).

The paediatric ward at NUH sees and average of 20 to 30 admissions due to pneumonia each month. A figure that excludes those seen in the outpatient clinics and children’s emergency.

One of the earliest signs of pneumonia is fast breathing. The child may appear to be working hard to breathe by sucking in their tummy or neck muscles, sad Dr Mahesh Babu Ramamurthy from the Division of Paediatric Pulmonary and Sleep at NUH.

At the same time, the child may experience a high fever. In more severe cases, the child may be agitated and cry inconsolably, or become drowsy and not respond to normal cues by caregivers, he added. If a child complains of chest or shoulder pains, parents should seek medical attention quickly.

Pneumonia can kill

When pneumonia goes undetected and isn’t treated immediately, the disease can kill as it causes lung failure or massive total body inflammation that may lead to multiple organ failure, warned Dr Charles Wiener, vice-president of Academic Affairs at John Hopkins Medicine International,  who is currently in town for an educational visit at Johns Hopkins Singapore.

Younger children, especially those who suffer from malnutrition and have other chronic illnesses, are at a higher risk of dying from pneumonia because they have poorer immunity compared to adults, said Dr Mahesh.

Pneumonia can spread via airborne droplets when an infected person coughs or sneezes, or by contact.

A recent study in the United States found that viruses are more likely to cause pneumonia than bacteria. About 66% of pneumonia in over 2,000 children studied were caused by viruses alone. This is unlike previously, where bacterial causes were more common.

Viruses typically cause cold symptoms, but can also lead to more severe infections such as pneumonia.

Dr Mahesh noted a similar trend here in Singapore, where more viral causes being detected. Doctors said it could be due to advance tests used to detect them.

According to Dr Wiener, viruses such as influenza (or the flu) are more likely to be contagious than most bacteria. A person with influenza is at a higher risk of getting bacterial pneumonia, a complication that was associated with severe illness and deaths in young people during the 2009 H1N1 pandemic, he added.

“Most cases of bacterial and viral pneumonia are transmitted person-to-person, therefore it certainly can pass within families. The risk of acquiring the infection increases with the number of people around ... Thus being careful about coughing or sneezing in public and hand-washing are excellent preventive strategies,” said Dr Wiener.

Vaccination is another important step to protect yourself from pneumonia.

“I believe that vaccination is important for improving public health. In the hospital, we not only have the influenza vaccination to protect ourselves but also our patients. Similarly, in a household that has at-risk groups living in close proximity, these individuals and the people living with them should do all they can to not bring influenza home,” added Dr Wiener.

Mdm Norlizam urges parents to take their children’s vaccinations seriously. “I hope other children will never have to experience what my son went through last year,” she said.

(Source: TODAY Online)