Many people contract pneumonia while staying in a hospital for other conditions. This tends to be more serious because the patient's immune system is often impaired due to the condition that initially required treatment. Every year, more than 60,000 Americans die of pneumonia — an inflammation of the lungs usually caused by infection with bacteria, viruses, fungi or other organisms. Pneumonia is a particular concern for older adults and people with chronic illnesses or impaired immune systems, but it also can strike young, healthy people. Worldwide, it's a leading cause of death in children, many of them younger than a year old.In some people, particularly the elderly and those who are debilitated, bacterial pneumonia may follow influenza or even a common cold .
Pneumonia is commonly caused by viruses, such as the influenza virus (flu) and adenovirus. Other viruses, such as respiratory syncytial virus (RSV), are common causes of pneumonia in young children and infants. Bacteria such as Streptococcus pneumoniae can cause pneumonia, too. People with bacterial pneumonia are usually sicker than those with viral pneumonia, but can be effectively treated with antibiotic medications.
Viral pneumonias are usually not very serious, but they can be life-threatening in very old and very young patients, and in people whose immune systems are weak. Even severe acute respiratory syndrome (SARS), which is believed to have a viral cause, has caused very few deaths (approximately 3-4% of all cases) as of March 19, 2003.
Vaccines are available for influenza virus and respiratory syncytial virus for people at high risk of these forms of viral pneumonia.The routine vaccinations that most people receive as kids help prevent certain types of pneumonia and other infections.People who have diseases that affect their immune system (like diabetes, HIV infection, or cancer), are 65 or older, or are in other high-risk groups should receive a pneumococcal vaccination.Because individuals age 65 and older are at higher risk of serious illness from tetanus, influenza and pneumococcal disease, routine immunization is recommended.
Over the past 50 years, the widespread use of vaccines has been a major contributing factor in improving the health of people worldwide. Diseases like polio have been eliminated and others, such as German measles, diphtheria and whooping cough, have been significantly reduced. Immunization programs for the elderly have not been as successful, however. Despite available vaccines, deaths from preventable diseases including influenza and pneumococcal pneumonia persist in the elderly.
Patients hospitalized for community-acquired pneumonia are about 33 percent less likely to die if they are up to date with their influenza vaccinations, even if the effectiveness of the vaccine is suboptimal, results of a 4-year study suggest.
Despite its known benefits, many people who have the greatest risk are not vaccinated, Dr. David N. Fisman and associates note in the Archives of Internal Medicine. One reason may be the fact that the vaccine does not prevent all cases of influenza, although it is likely to make the illness less severe.
"Information on protection against death, even in the absence of prevention of infection, could form the basis of an extremely effective public health message promoting vaccination," the authors propose.
To prove their point, Fisman, currently at the Research Institute of the Hospital for Sick Children in Toronto, and colleagues collected data for 38,000 consecutive individuals hospitalized with community-acquired pneumonia at 34 institutions during four influenza seasons starting in November 1999.
The hospitals -- located in California, Florida, Louisiana, and Missouri -- were operated by the Tenet Healthcare Corporation in Dallas.
The investigators classified the patient's risk using demographic information, the presence of other illnesses, and various clinical factors, to calculate Pneumonia Outcome Research Team scores. Complete records for 17,393 - about half of the patients -- were available for analysis.
The overall mortality rate was 7 percent.
The 1,590 currently vaccinated patients were less likely to die during hospitalization than the 6,661 who had never received an influenza vaccine, even though the vaccinated patients were older and had higher pneumonia scores.
Vaccinated patients were also more likely to survive than 9142 subjects whose vaccination status was unknown.
"No statistical evidence was found to suggest that influenza vaccination was less effective in preventing death in individuals 65 years or older," the investigators report.
Based on these findings, the team concludes that important additional benefits are gained when people at risk for community-acquired pneumonia are up-to-date on their influenza vaccinations.
Influenza vaccination is also recommended since pneumonia often occurs as a complication of the flu. Because pneumonia is often caused by contagious germs, a good way to prevent pneumonia is to keep your distance from anyone you know who has pneumonia or other respiratory infections. Use separate drinking glasses and eating utensils, wash your hands frequently with warm, soapy water, and avoid touching used tissues and paper towels.
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