Get vaccinated against pneumonia
The very young and elderly should take greater precaution against it, say doctors
She had a tummy ache and a persistent fever.
The usually active housewife just did not feel good.
She told The New Paper on Sunday: "I just couldn't get well."
Family members took Madam Teo Guat Kim, 54, to the accident and emergency department of Mount Alvernia Hospital in April.
At the hospital, doctors diagnosed that Madam Teo suffered from "an unusual abdominal infection and underwent emergency surgery".
She later learnt that she had a pelvic infection caused by a germ called Group A Streptococcus.
"Dr Leong Hoe Nam told me it was a life-threatening infection," she said.
It turned out the former tailor developed pneumonia as a result of the infection.
She spent two weeks in hospital, and it took another two months for her to fully recover.
According to the Ministry of Health (MOH), pneumonia is one of the top killers, second only to cancer, in Singapore.
Last year, it remained the number one killer for those aged 70 and older.
According to MOH, pneumonia caused nearly one in five deaths in Singapore in 2014.
Hospitalisation records indicate that pneumonia remains the fifth most common cause, with more than 13,000 admitted for that in 2013.
The lung infection is caused by either a virus or bacteria.
Those most susceptible to the infection include adults above 65 years, children under two, and those with medical conditions such as diabetes and chronic heart or lung disease.
GLOBAL STUDY
A global study, published in The Lancet medical journal this year, found that between 1990 and 2014, pneumonia deaths in Singapore increased by more than half.
In the first 32 weeks of this year, there were already 87 cases of invasive pneumococcal disease recorded. This is a 17.6 per cent increase from the 74 cases in the same period last year.
Some doctors have urged that the elderly, young children and those who have compromised immune systems get vaccinated against pneumococcal disease, one of the major cause of pneumonia in Singapore.
Dr Wong Hang Siang, a respiratory and critical care medicine physician from Changi General Hospital, said: "Every infection is a cause of concern as this disease causes high mortality even with antibiotics treatment.
"Vaccination is therefore important as a preventive measure."
There are currently two types of pneumococcal vaccines in the market.
Infectious disease physician Leong Hoe Nam said a new one, called the pneumococcal conjugate vaccine, has recently been proven to be effective in preventing pneumonia in the elderly.
"It targets the most common 13 strains of the germ Streptococcus pneumoniae. With this vaccine, we can reduce pneumonia incidence in the elderly by about half," he said.
Respiratory medicine physician Dipika Agrawal of Ng Teng Fong General Hospital said the overall mortality of pneumococcal pneumonia today is between 11 and 20 per cent.
"It can cause respiratory and cardiac complications in some patients and they may require (intensive care) support and artificial ventilation to support the breathing," she said.
"Mortality is also higher in persons over 65 years of age and with existing diseases."
One reason is that their body's protective mechanisms have weakened and they face trouble expelling germs or clearing phlegm from their throats, causing fluids or secretions to enter their lungs.
Pneumococcal pneumonia: Causes and treatments
WHAT IS PNEUMONIA?
Pneumonia is an infection of the lungs. It can be caused by viruses or bacteria, and is rarely fungal. The common viruses like influenza, adenovirus and respiratory syncytial viruses are responsible for the usual upper respiratory tract infections. Occasionally, they extend downwards to the lungs, and this in turn causes pneumonia (infection in the lungs).
The group of people most susceptible includes adults above 65 years old, children under two years of age, and those with medical conditions such as diabetes and chronic heart or lung disease.
WHAT ARE THE SIGNS OR SYMPTOMS?
The symptoms vary, depending on the cause, age of the patient, and the severity of the condition.
Common pneumonia symptoms in adults include cough with phlegm, breathing difficulty, chest pain, body and muscle pain, fever, chills and headache.
In children, the symptoms include a sudden onset of fever, cough, laboured and rapid breathing, wheezing and fatigue.
WHAT ARE THE CONVENTIONAL TREATMENTS?
The most important treatment for pneumonia is antibiotics if the cause is a bacteria. But if it is a virus, then the treatment will be an antiviral drug like Tamiflu. For germs that have no specific treatment, the treatment is supportive like paracetamol for fever and cough suppressants for cough. If the patient has respiratory failure, then mechanical ventilation or intensive care is needed.
CAN IT BE PREVENTED?
Yes, through vaccination. Doctors especially recommend this for small children, adults over the age of 65, and patients with chronic diseases and those recovering from severe illness. Unfortunately, vaccination does not reduce the severity of pneumococcal disease once a patient has contracted it.
Source: Dr Leong Hoe Nam, Infectious Disease Physician, Rophi Clinic; Dr Sewa Duu Wen, Department of Respiratory and Critical Care Medicine, Singapore General Hospital; Associate Professor Philip Eng, Senior Consultant Respiratory & ICU Physician with Mount Elizabeth Hospital.
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