Despite being easily preventable and treatable, Pneumonia remains one of the leading causes of deaths in children and adults as well. Pneumonia is a disease which is generally associated with young patients. However, it majorly effects adults as well.
According to the Center for Disease Control, 1 out of 20 adults who get pneumonia die. Preventing pneumonia in the elderly is a serious matter. Although vaccines and other preventative efforts are decreasing the burden of the disease, much more work is still required. Those living in poor communities are at highest risk of pneumonia.
Patient with infectious pneumonia often has a productive cough, fever accompanied by shaking chills, shortness of breath, sharp or stabbing chest pain during deep breaths, and an increased rate of breathing. In the elderly, confusion may be the most prominent sign.
"Pneumonia cases can differ from each other because of many other factors that come into play. They can differ according to the 'Illness-Causing Agent', according to 'Where the Infection Was Acquired' and then there are other types of pneumonia that don't fall under the categories listed above. Regardless, it's still important to be vigilant and consult a physician or health expert when you notice symptoms of these infections since some diseases might lead to further harm," said Dr. Chandrashekhar Tulasigeri, Consultant Intensivist and Critical Care Physician, Fortis Healthcare.
One of the most common infectious diseases which is an important cause of mortality and morbidity worldwide is community-acquired pneumonia (CAP). CAP is acquired in the community, outside of health care facilities or within 48 hrs of admission to a hospital. In 2008, the WHO reported the highest burden of pneumonia to be from Asia. Majority of the cases i.e. 43 million were from the Indian subcontinent. 600,000 patients are being hospitalised with pneumonia every year. Approximately 20 percent of patients are hospitalized due to a severe CAP, with the mortality rate being another 20percent.
"Community-acquired pneumonia (CAP) is defined as pneumonia not acquired in a hospital or a long-term care facility. Despite the availability of potent new antimicrobials and effective vaccines, the annual incidence of CAP varies from 5-11 per 1,000 population with the rates being higher in the elderly," added Dr. Chandrashekhar.
The mortality of CAP in India is comparable to that reported elsewhere in the world. The mortality rates are less than 1?5percent in the outpatient setting but may be as high as 12percent in hospitalised patients.
In a study of 150 patients hospitalised with CAP, 8 percent (12) patients died in the hospital, while 2.7 percent (4) succumbed within 30 days of discharge. In another study consisting of 72 patients with CAP over 18 months, 14 percent of young and 35 percent of elderly patients died due to fulminant sepsis or respiratory failure. Other studies from India reported a variable mortality between 3.3percent and 11percent.
Among hospitalised patients, the incidence of bacteremic pneumonia is 25percent with a mortality rate of 20percent. The incidence of infection peaks in winter and spring.
India accounts for 23percent of the global pneumonia burden and 36percent of the WHO regional burden. National estimates may, however, hide significant sub-national disparities. Indian reports on the etiological agents of CAP are very few.
CAP may be prevented by treating underlying illnesses increasing its risk, by smoking cessation and vaccination of children and adults. Smoking appears to be the single biggest risk factor for pneumococcal pneumonia in otherwise healthy adults. Pneumonia is a serious concern amongst adults and one needs to act fast to fight back this infectious killer.
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