Pneumonia: Child killer

Shocking but true. Pneumonia (pneumococcal disease), according to a recent report by UNICEF and WHO, annually kills over two million children under five years worldwide.

This is more than the combined deaths in this age group from AIDS, malaria and measles. Of an estimated 8,60,000 deaths per year in the Asia-Pacific region, India alone accounts for over one-third of such deaths. Indian doctors, under the aegis of Asian Strategic Alliance for Pneumococcal disease Prevention (ASAP, India) and the Indian Academy of Paediatrics (IAP) point out the dangers from this killer disease and strongly advocate preventive measures. According to the American Academy of Paediatrics (AAP) Redbook, pneumococci, the bacteria causing pneumonia, is among the most common causes of bacterial meningitis among small children. Along with children, pneumonia is also a threat to the elderly and to adults with chronic ailments or impaired immune systems.

Although most common bacterial pneumonias can be successfully treated with antibiotics, "antibiotic-resistant strains are a growing problem. For that reason, and because the disease can be very serious, it's best to try to prevent infection in the first place."

Red flags

Pneumonia often begins innocuously, with cough and fever. Chest pain is a symptom of some types of pneumonia. The symptoms may vary greatly depending upon underlying conditions and the type of bacteria causing the infection. According to ASAP India, symptoms may include high fever and other non-specific signs of illness. Mothers should look out for rapid breathing, cough and loss of appetite.

Red flags are sudden shaking, chills, cough, fever and chest congestion.

Associated meningitis symptoms include fever, severe headache, vomiting, stiff neck and avoidance of light due to pain in older children. In infants, fever and non-specific signs of illness are more frequent symptoms. Meningitis can damage the brain. There may be related ear-ache, fever, and muffled hearing. Acute otitis in small babies may be indicated by frequent tugging at the ear.  Related sinusitis symptoms are signalled by low-grade fever, runny nose and cough.

Strikes anywhere

Pneumococcal disease can strike children anywhere and from all strata of society. Even pampered children from affluent families can get infected in crowded places such as play homes and schools, cinema halls, etc. Carriers of the bacteria are often healthy and unaware that they harbour virulent microbes.

Preventive measures are the greatest cure for this childhood scourge. Strong and healthy children are less likely fall prey to the disease even when exposed to the bacteria. A nutritious diet rich in fruits, vegetables, proteins and complex carbohydrates will go a long way in boosting the child's immune system. Adequate exercise, fresh air and proper rest are essential for maintaining health. Proper hygiene is a must. Regular bathing and a clean environment go a long way. Surprisingly, many of us neglect frequent washing of hands, especially before meals, after coming from outdoors, or after handling dirty objects.

Great risk

A smoky, congested and poorly ventilated home can encourage this killer disease. The poor are at great risk because they live in congested tenements polluted by smoky wood, coal or kerosene burning stoves. The more affluent are not exempted. Many parents do not realize that constant smoking, especially within closed doors or in a poorly ventilated or air-conditioned environment, can encourage the disease to strike their children.

The pneumococcal conjugate vaccine (PVC-7) can help protect young children against pneumonia.  Vaccination is of paramount importance. Dr Nitin Shah, Chairman of ASAP-India and former President of the Indian Academy of Paediatrics, says, "Vaccination protects not just one single child, but indirectly benefits many, since one infected child can infect many others." Universal vaccination of Indian children will prevent such virulent strains of pneumonia from spreading to India.