Pneumonia Q&A with Dr Russo

We asked Dr Umberto Russo, MBBS, FRACGP, GAICD, Chief Medical Officer at 13SICK, National Home Doctor Service, some questions about pneumonia, a common and potentially life-threatening illness.

Dr Russo, what causes pneumonia?

Pneumonia is commonly caused by either bacteria or viruses.

These bacteria or viruses are spread from person to person, usually because the sick person is coughing and sneezing, and thereby spreading the germs into the air, or on to their hands and then on to surfaces. The germs are then breathed in or picked up by touching contaminated surfaces, and then touching the nose or mouth.

It is often possible to get a pneumonia after you have been sick with a cold or flu, because the lungs are already irritated and it’s easier for an infection to take hold.

Who has a higher risk of getting a pneumonia?

Babies, young children and the elderly have a higher risk of getting a pneumonia, because their immune systems are not as robust. For this reason too, Aboriginal people living in remote communities, patients with lung conditions (such as asthma or emphysema), those with chronic illnesses and people who smoke are all at higher risk of infection.

However, pneumonia can strike healthy adults too, and so it’s important to be on the look out for the symptoms. It is estimated that each year in Australia more than 77,000 people are hospitalised with pneumonia. In 2015 in Australia, more than 3,000 patients died from influenza and pneumonia. 

What are the symptoms of pneumonia?

Pneumonia can be a life-threatening condition. It’s important to know the symptoms and be sure to see a doctor if you are concerned. This is particularly important if you or someone in your care has an existing medical condition.
The symptoms of pneumonia can vary, depending on age and how severe the infection is.
Common pneumonia symptoms include:

  • difficulty breathing
  • fatigue
  • general malaise
  • loss of appetite
  • cough
  • abdomonal pain
  • blue colouration around the mouth (cyanosis) - due to lack of oxygen
  • headaches and muscular pain
  • feeling very unwell

Small children with signs of pneumonia will look pale and lethargic, have a temperature, be coughing, have difficulty breathing, and will not want to eat.

Is pneumonia contagious?

If the pneumonia is caused by a bug such as a virus or bacteria then it is contagious. Pneumonia can spread from an infected person in a number of ways, including: 

  • coughing or sneezing without coering your mouth or nose
  • sharing food, eating utensils or drinking cups
  • picking up dirty tissues or touching items used by the patient
  • not washing your hands regularly, especially after blowing your nose, coughing, or sneezing

By practising good hand hygiene, washing down commonly touched areas, and maintaining good hygiene at the bedside, you can help contain the spread of infection. 

Are vaccines available for pneumonia?

For some types of pneumonia there are vaccines available, such as the vaccine Pneumovax, which can help prevent pneumonia caused by the pneumococcus bacterium (pneumococcal pneumonia). It is usually recommended for those most at risk from pneumonia infection.

For children, another type of pneumococcal vaccine is recommended which helps to prevent pneumonia and other pneumococcal infections in infancy and childhood.

Also, it is important to remember that other preventable illnesses can lead to pneumonia, and vaccination against these illnesses is strongly recommended:

Flu vaccine
Pneumonia can often be a complication of influenza, (flu) especially in people who are immunocompromised (e.g. whose immune systems are suppressed by medicines) or who are not in optimal health. Having a flu vaccination before winter is a sensible precaution for everyone, but particularly for older people, pregnant women and young children - who all have a higher risk of severe illness with influenza infection.

Other vaccines
Pneumonia can also develop from other vaccine-preventable infections, such as:
• Haemophilus influenzae type b (Hib);
• pertussis (whooping cough);
• varicella (chickenpox); and
• measles
Most children in Australia are protected from these illnesses by the routine childhood vaccinations under the National Immunisation Program Schedule.

What happens if you get pneumonia?

After the pneumonia bug enters your system, it can take hold within 1 to 3 days or alternatively, it can take 7 to 10 days before you to start feeling unwell. How severe the illness becomes can depend on:

  • Your age and health. Older, sicker people usually have more severe cases. There are more likely complications, such as bacteria in the bloodstream (bacteremia) or throughout the body (septicemia)
  • What bacteria or a virus caused the pneumonia. Viral pneumonia usually is less severe than bacterial pneumonia 
  • How quickly you treat it. The sooner you treat pneumonia, the sooner symptoms go away
  • Your immune system. People with weakened immune systems are more likely to have more sever pneumonia than people who have healthy immune systems

In healthy people, pneumonia can be a mild illness that is hardly noticed and, with prompt treatment, will clear up in 2 to 3 weeks. In older adults and in people with other health problems, recovery may take 6 to 8 weeks or longer.

If you think that you, or someone in your care is suffering symptoms of pneumonia, consult your Doctor immediately. If it’s late at night, or on the weekend, and your GP is closed, call 13SICK or use the 13SICK App to arrange a bulk billed*, after hours doctor home visit. Or, if it is an emergency, call 000 or go straight to hospital. 
* if eligible for Medicare rebates

Dr Umberto Russo MBBS (Adelaide) FRACGP is Chief Medical Officer at 13SICK, National Home Doctor Service. He has more than 25 years' experience both as a General Practitioner and a visiting home doctor, with a special interest in urgent medical care.

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