Every year a day is set aside to raise awareness of pneumonia, promote prevention, treatment and provide an annual forum for the world in the fight against pneumonia. The theme for World Pneumonia Day in 2024* is, ‘Championing the fight to prevent pneumonia’. 

According to the World Health Organization (WHO), pneumonia is one of the most common causes of morbidity in SA children, despite improvements in immunisation and HIV management programmes. WHO also states that globally a child dies from pneumonia every 30 seconds. This is higher than malaria, HIV/AIDS and tuberculosis combined.

In South Africa, flu and pneumonia ranked second (after intestinal infectious disease) as the leading cause of death in children under 5 years. This just doesn’t make sense when vaccines are available in both the private and public healthcare sector for children and adults. As part of the Expanded Programme on Immunisation, babies have a series of 4 vaccinations: At 2 months of age, 4 months, 6 months and 12–15 months.

What is Pneumonia?

Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund says, ‘pneumonia is a respiratory infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing symptoms such as cough with phlegm or pus, fever, chills and difficulty breathing’. 

Types of Pneumonia

• Bacterial pneumonia
• Viral pneumonia
• Fungal pneumonia
• Aspiration pneumonia: This type is more common among certain people, including older people and those with nerve disorders or swallowing issues

The flu shot as the first line of protection 

Dr Hadebe recommends having a flu vaccine and says it is the first line of defence when it comes to protecting yourself. Studies show it reduces the risk of contracting flu by about 50 to 60% and also helps prevent the development of Pneumonia.  

According to the New England Journal of Medicine (NEJM – 2015), ‘In addition to reducing the risk of hospitalisation for an influenza (flu) infection itself, flu vaccination appears to reduce the likelihood of hospitalisation for influenza-associated complications such as pneumonia.’ Perhaps the more telling piece of data shows that only 29% of the overall population have been vaccinated against flu, emphasising the need for more effective delivery of preventative services to prevent Pneumonia deaths.

Pneumococcal vaccine 

There is also a vaccine that protects you against Streptococcus pneumoniae bacteria which causes 80% of Community Acquired Pneumonias (CAPs). These streptococcal bacteria can spread from the nose, throat and ears to cause pneumonia – a severe infection of the lungs. It also protects you against other pneumococcal diseases including those of the bloodstream (Bacteraemia) and the lining of the brain and spinal cord (Meningitis).

Who should have the Pneumococcal vaccine?

• People over 65, particularly in a retirement village 
• Anyone with heart and lung problems, including asthma or with chronic illnesses like anaemia, diabetes or kidney failure.
• Immune-suppressed people, including those who are HIV-positive
• Caregivers and close contacts of any of the above
• Smokers, as they are more prone to respiratory illnesses
• Cancer sufferers
• The WHO reports that some preliminary studies suggest that obesity and especially extreme obesity, may also be a risk for more severe disease.

Signs and symptoms of Pneumonia may include:

• Chest pain when you breathe or cough
• Confusion or changes in mental awareness (in adults aged 65 and older)
• A cough, which may produce phlegm
• Fatigue
• Fever, sweating and shaking chills
• Lower than normal body temperature (in adults older than age 65 and people with weak immune systems)
• Nausea, vomiting or diarrhoea
• Shortness of breath

When to see a doctor?

With virtual consultations readily available, it’s recommended you first consult your doctor via a telephone or video call to discuss your symptoms, especially if you are having difficulty breathing, chest pain, persistent fever of (39°C) or higher or a persistent cough, especially if you’re coughing up phlegm. Your physician will then decide whether you need a face-to-face consult and examination.

Dr Hadebe says that, despite the evidence of the efficacy of these vaccinations, there is not enough uptake. ‘It is up to each one of us to take charge of our health, this includes having regular wellness checks and ensuring that you have a flu vaccine and, if you are vulnerable to develop pneumonia, have the pneumonia vaccine at the same time.’

Remember that your GP is your first port of call for all your healthcare needs.