Pneumonia is a serious life threatening illness in children. It is a form of acute respiratory infection (ARI) that affects the alveoli in the lungs, which are the small sacs that fill with air when a healthy person breathes.
When there is an infection in the lungs, these alveoli fill with pus and fluid, which is the body's natural response to fighting infection. This infection in the lungs makes breathing difficult and limits oxygen intake.
There are two kinds of bacteria that are responsible for most pneumonia related deaths: Haemophilus influenzae type b (Hib) and Streptococcus pneumonia (Spn). Hib and Spn bacteria can also cause acute meningitis (infection of the membranes covering the brain) in young children, which can lead to life-long disabilities.
Symptoms of pneumonia
Cough is a common symptom of respiratory infections including pneumonia. Many children with cough, cold and fever have upper respiratory tract infections caused by viral infections.
Children with pneumonia experience fast breathing along with a severe cough. In severe cases the child may have in-drawing of the lower chest wall when he breathes in, which might lead to grunting and difficulty in breathing. If your child exhibits such a cough with fast breathing, an immediate check-up is recommended even if these other symptoms do not occur, as it could be a case of pneumonia.
Disease burden of pneumonia
Very few people are aware that pneumonia is the single largest cause of death in children worldwide. Every year, it kills an estimated 1.2 million children under the age of five, accounting for 18% of all deaths of children under five years old worldwide. In India, it kills nearly 397,000 children every year and is the leading cause of infant mortality. However, pneumonia can be easily prevented. Death is not the only consequence of pneumonia -severe illness which affects a child's development is caused by pneumonia. Pneumonia can cause serious sickness, leading to several visits to the doctor and often times hospitalizations, placing significant burden on families, the healthcare system and society at large.
Prevention
Pneumonia can be easily averted with existing child survival interventions. These interventions include a variety of comprehensive prevention strategies such as frequent washing of hands and general cleanliness, reducing the spread of disease, access to healthcare, and, vaccination. Exclusive breastfeeding for the first six months is vital to ensure the child gets adequate nutrition and build natural immunity against infections. Addressing environmental factors such as indoor air pollution (by providing affordable clean indoor stoves, for example) and encouraging good hygiene in crowded homes also reduces the number of children who fall ill with pneumonia.
Immunisation of pneumonia
Vaccines are the most cost effective way to safeguard your child against pneumonia. A comprehensive approach to prevention of pneumonia, including access to new and available vaccines, is needed to combat this deadly disease.
In India vaccines for both Hib and Streptococcus pneumoniae are available. The Government of India has recently introduced the pentavalent vaccine in Tamil Nadu, Kerala, Jammu & Kashmir, Haryana, Karnataka, Gujarat, Delhi, Goa and Puducherry. Pentavalent protects children against 5 diseases including Hib pneumonia/meningitis/blood infection, diphtheria, whooping cough (pertussis), tetanus and hepatitis B. This vaccine is available free of cost in Government hospitals and health centres in the above mentioned states.
Infants are given three doses of the pentavalent vaccine at the 6, 10 and 14 weeks of age. After that, they need a booster dose of DPT and Hib at 15 to 18 months of age. The vaccine follows the normal immunization schedule and can be integrated into the immunization program of the country. Hib vaccine has been demonstrated to be effective in numerous studies and is widely supported by global and Indian health communities. Hib vaccine has been introduced in more than 180 countries worldwide including the neighbouring countries of India including Bangladesh, Bhutan, Pakistan, Sri Lanka, Vietnam, etc. All these countries are currently administering the pentavalent vaccines.
Treatment of pneumonia
Pneumonia is not only preventable but is also treatable, particularly with early diagnosis. While children with viral respiratory tract infections do not require medicine, children with bacterial pneumonia should be treated with appropriate antibiotics. Treatment in hospitals or health centres often includes supportive care such as the administering of oxygen.
(Data Courtesy: Prof. Dr. P. Sudershan Reddy, M.D., D.C.H., Consultant Chief Pediatrician, Krishna Childrens Hospital, Lakdi-ka-pool, Hyderabad, AP)
