World Pneumonia Day marks today, November 12
by Vasco Barreto, Internist and SPMI Member
When winter and low temperatures approach, there is an increase in the number of cases of influenza and other respiratory infections. In some patients, such as the elderly or those who have chronic diseases, it can develop into more severe situations, including pneumonia.
Pneumonia is an infection of the lung tissue, more precisely the pulmonary parenchyma, which interferes with gas exchange at the level of the alveoli and respiratory bronchioles, causing respiratory problems.
This disease is developed, in many cases, through inhalation of bacteria and other microorganisms in the pharynx and oral cavity. More rarely, it can also develop through contact with other patients, through the transmission of infected particles or droplets, and hospital settings where there are many microorganisms, parts that are resistant to antibiotics.
More common in older people and children, pneumonia affects other risk groups, such as chronic patients (with chronic obstructive pulmonary disease, diabetes, HIV infection, kidney failure, immunosuppression, etc.), smokers, alcoholics and drug addicts.
The most common symptoms are difficulty breathing or shortness of breath, pain in the chest area, fever (in many cases increasing), chills, coughing with possible spread and headaches and in the muscles. Usually, these complications appear quickly, with the possibility of manifesting at the same time.
This is where it is important to make a diagnosis on time, because all the symptoms mentioned are common for other diseases of the respiratory system. Except in very serious cases, patients must begin by handling primary health care, where the doctor is in a position to decide whether treatment can be started only on the basis of symptoms and physical examination or whether chest radiographs, which usually force patients to go to the hospital.
With regard to treatment of pneumonia, it focuses on administering antibiotics and on controlling symptoms, as well as general steps such as rest, proper eating and correct fluid intake. Depending on the severity of the patient's condition, it is decided whether he will be treated on an outpatient basis or whether he will be treated.
Even with a list of the majority of cases handled on an outpatient basis, pneumonia continues to be a major cause of hospitalization in our country. This is due to the seriousness of the clinical picture or fragility of patients, who often see their chronic disease decompensating.
Pneumonia can and should be prevented by adopting a healthy lifestyle (including healthy eating, exercise, quitting smoking, and reducing alcohol consumption), and is very important through vaccination, which includes pneumococcal vaccines and influenza vaccines. In the hospital environment, respect for infection control rules is very important (hand hygiene, use of protective equipment, respect for signs on the ward).
There is still a lot of resistance on the part of the Portuguese population against seasonal vaccinations against the flu. It is therefore important to work to increase awareness, especially in risk groups, of this potentially deadly disease and the importance of vaccination. Only this year, the National Health Service has 1.4 million doses of vaccine to give, in addition to vaccines that can be purchased at drug stores prescribed.
Adopting such preventive behavior is already a big step in reducing the number of cases of pneumonia, something that continues to be at stake by the Portuguese Internal Medicine Society, or to promote initiatives directed at the population, or on continuous training from internists and other health professionals.