World Pneumonia Day - November 12

World Pneumonia Day, marked every year on 12 November, was established by the Stop Pneumonia Initiative in 2009 to raise awareness about the toll of pneumonia – a leading killer of children around the world – and to advocate for global action to protect against, help prevent and effectively treat this deadly illness.

The goals of the Stop Pneumonia Initiative were to:

• Raise awareness about pneumonia, the world’s leading infectious killer of children under the age of 5
• Promote interventions to protect against, prevent, and treat pneumonia and highlight proven approaches and solutions in need of additional resources and attention
• Generate action, including continued donor investment, to combat pneumonia and other common, yet sometimes deadly, childhood diseases

The initiative drew upon the contributions of advocates and health workers working to fight preventable child deaths, and highlight the impact of their efforts. The coalition strove to educate other advocates, donors, and policymakers about the essential need for progress on pneumonia in order to achieve Sustainable Development Goal (SDG) 3—reducing child mortality.

Stop Pneumonia was spearheaded by the International Vaccine Access Center (IVAC), at the Johns Hopkins Bloomberg School of Public Health. IVAC helped to coordinate efforts and amplify the voice of advocates around the world during World Pneumonia Day, observed on November 12 since 2009. On this day, the global health community comes together to recognize the importance of fighting pneumonia.

Stop Pneumonia provided news, information, and resources for child health and development organizations, policymakers, and countries working to implement the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). GAPPD goes to the heart of the challenge: recognizing that prevention and control of pneumonia and diarrhea cannot be adequately addressed with separate strategies, but rather with integrated programs.

What is Pneumonia?

Pneumonia is the single biggest infectious killer of adults and children – claiming the lives of 2.5 million, including 672,000 children, in 2019.  Pneumonia manifests as a mild to severe illness, ranging from moderate flu-like symptoms to sepsis, respiratory failure, and even death. The range of illness often depends on age, cause of infection, and one’s general health at the time of infection.

While an assortment of germs causes pneumonia, Streptococcus pneumoniae, a resident bacteria of the respiratory tract, is the most common form. Among adults, the influenza virus (the flu) is the traditional cause of viral pneumonia, while the respiratory syncytial virus (RSV) is the leading cause of viral pneumonia in children. Similarly, certain soil-dwelling fungi also promote pneumonia in individuals. For the immunocompromised or those with chronic health conditions, fungal pneumonia is most common.

Lastly, with the onslaught of the recent pandemic, SARS-COV-2 (the virus that causes COVID-19) is also contributing to increasing cases of pneumonia worldwide.Deaths from COVID-19 were projected to add two million more in 2020, bringing the total to more than 4 million. 

No other infection causes anywhere near this burden of death.

This year, World Pneumonia Day, on 12 November 2021, will be held during COP 26 – the UN Climate Change Conference. This is a critical moment to bring together the health, air quality, and climate community to tackle the biggest infectious killer on the planet.

Facts About Pneumonia

1. Pneumococcal disease is a leading cause of serious illness throughout the world. In the US, nearly 1 million adults get pneumococcal pneumonia each year, up to 400,000 hospitalizations occur from pneumococcal pneumonia, and more than 20,000 of those hospitalized will die. The death rate is even higher for adults age 65 years and older.
2. Pneumococcal disease is caused by a common type of bacteria, Streptococcus pneumoniae (S. pneumoniae) or pneumococcus, which can attack different parts of the body. The bacteria can spread through droplets in the air when a person with the infection coughs or sneezes.
3. Pneumococcal disease can cause pneumonia, meningitis, and sepsis (bloodstream infection), which can lead to severe complications.
4. Pneumococcal disease can strike quickly and without warning. Depending on whether the infection causes pneumonia, sepsis, or meningitis, individuals may experience some combination of the following: very sudden onset of high fever, chills, cough, shortness of breath, chest pain, stiff neck, and disorientation. Symptoms may be less specific in older adults, who may experience confusion or lack of alertness.
5. There are two types of pneumococcal vaccines currently recommended in the US: pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23).
6. Vaccination helps protect against pneumococcal disease and related complications. Vaccination reduces the chances of becoming infected with pneumococcal bacteria and is associated with improved survival, reduced chance of respiratory failure or other complications, and shorter in-patient stays for adults hospitalized with community-acquired pneumonia caused by pneumococcal disease.
7. Pneumococcal vaccines are recommended for routine use in children and for many adults including adults age 65 years and older, and those aged 19 to 64 years with certain chronic health conditions like asthma or diabetes.

Pneumonia by the Numbers

Pneumococcal disease can cause pneumonia, meningitis, or sepsis, which can lead to severe complications hospitalization, or death.

• Nearly 1 million US adults get pneumococcal pneumonia each year
• Up to 400,000 hospitalizations occur each year from pneumococcal pneumonia in the US
• More than 20,000 of those hospitalized will die and the death rate is even higher in those aged 65+

Getting vaccinated against pneumococcal disease is safe and effective. Vaccines are recommended for adults age 65 years and older, as well as those aged 19 to 64 years with certain risk conditions like asthma or diabetes

Transmission

Pneumonia transmission manifests through multiple means. According to the Centers for Disease Control and Prevention, the spread of pneumonia can occur in a community-acquired or healthcare-associated fashion, meaning transmission can take place outside the hospital (in the community setting) or after time spent in a healthcare facility, respectively.

Patients who undergo ventilation receive oxygen externally through a tube placed either down their nose or mouth or directly into the trachea (windpipe). In the hospital setting, ventilator-associated pneumonia (VAP) can develop when a patient requires mechanical assistance. While this procedure is effective and life-saving, the presence of a foreign device can introduce germs and cause infection. VAP occurs when these germs enter a patient’s lungs through the ventilation equipment, promoting pneumatic infection.

Hospitals combat VAP through enhanced hygiene protocols and reducing the amount of time spent on the ventilator, for example: frequent cleaning of the patient’s mouth, hand washing before and after touching the patient or ventilator tubes, and daily checks on the patient’s ability to breathe independently.

Smoking greatly increases a person’s risk of contracting VAP. Good oral and personal hygiene reduces the risk.

Diagnosis and Treatment

The symptoms of pneumonia can vary from mild to severe, therefore initial diagnosis can be difficult. Often, physicians will perform a physical exam, followed by diagnostics such as blood tests or mucus samples to confirm infection and determine the source pathogen.

Another diagnostic tool that physicians use is the chest X-ray; the X-ray provides a picture of your lungs, showing sites of inflammation or fluid buildup. In the hospital setting, patients may also undergo a CT scan, which can give a clearer, in-depth view of the lungs and any potential complications.

Once you are diagnosed with pneumonia, your physician will determine a treatment plan; often, this depends on the infectious agent (bacteria, virus or fungi). In the case of bacterial pneumonia, antibiotics are often prescribed. It is important to note that completing the course of antibiotic medication is vital to recovery; stopping medication early can lead to reinfection or the onset of antibiotic resistance. Viral pneumonia often requires an alternate course of treatment, usually in the form of antiviral medications. Similarly, fungal pneumonia infections are treated with antifungal drugs, of which often require administration over several weeks.

Pneumonia Prevention

Pneumonia can affect people of all ages, but there are simple measures you can take to prevent pneumatic infection, such as keeping your vaccinations up to date. According to the CDC, routine vaccinations can lower your risk for pneumonia by reducing the risk of infection by other pneumonia-causing pathogens.

Currently, two pneumonia-specific vaccines are available in the United States and are recommended for different age groups; these include the pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23).

While vaccines cannot prevent all cases of pneumonia, research demonstrates the pneumococcal vaccines exhibit considerable protection in infants, adults and the elderly against invasive and pneumococcal pneumonia.

Aside from vaccinations, adopting and maintaining a healthy lifestyle can also reduce your risk of contracting pneumonia. Maintaining a healthy diet, exercising and getting an adequate amount of sleep all help to reduce the risk of respiratory illness.

For those living with lung disease, the American Lung Association encourages regular exercise, defined as 30 minutes per day, five days a week, to increase lung strength. Physical activity of this kind also reduces the risk of serious illness, such as lung cancer.

While aerobic exercise is beneficial for muscle and lung strength, relaxing breathing exercises enhance lung capacity and function. For individuals suffering with breathing conditions such as asthma or chronic obstructive pulmonary disease, five to 10 minutes a day of exercises, such as diaphragmatic or pursed-lip breathing, have shown to increase lung capacity and efficiency.

Air pollution is the leading risk factor for death from pneumonia across all age groups. Almost a third of all pneumonia deaths were attributable to polluted air, killing around 749,200 in 2019. Household air pollution contributed to 423,000 of these deaths while outdoor air pollution contributed to 326,000.

It is the very young and the very old who are at the greatest risk. Children are more susceptible to household air pollution in homes that regularly use polluting fuels and technologies for cooking, heating, and lighting. While outdoor air pollution, especially from pollutants emitted by industries and car exhaust smoke, disproportionately affects respiratory health among older adults.

Ninety percent of air pollution-related deaths are concentrated in 40 low- and middle-income countries. In many African countries, air pollution contributes to more than 50 percent of all pneumonia deaths. And while pneumonia deaths from household air pollution are declining in Africa, they are tragically increasing as a result of outdoor air pollution. This is also true for Asia.

The need for clean air action is clear. Reducing air pollution will deliver significant benefits to health, the environment, and the global economy.

This World Pneumonia Day, Every Breath Counts is calling on high-burden country governments to take integrated, multisectoral action to reduce air pollution-related pneumonia deaths.

Sources:

https://stoppneumonia.org/latest/world-pneumonia-day/

https://www.nfid.org/2019/11/12/7-things-you-need-to-know-on-world-pneumonia-day/

https://www.asbmb.org/asbmb-today/science/111220/world-pneumonia-day-2020