Lung protection: Preventing pneumonia in the young and elderly

Pneumonia is a serious lung infection characterized by symptoms such as coughing, rapid or difficult breathing, fever, and loss of appetite. Without timely and effective treatment, it can be fatal.

Every year, November 12 is observed as World Pneumonia Day, aiming to raise awareness and strengthen efforts for its prevention and treatment.

Pneumonia is one of the most common causes of death worldwide. The disease claimed about 2.18 million lives in 2021, according to data from the Institute for Health Metrics and Evaluation. In China, it poses a significant health burden. According to the Chinese Center for Disease Control and Prevention, the pneumonia mortality rate is 12.7 per 100,000 people.

It claims more lives of children under five than any other infectious disease, and also poses a serious threat to older people and those with chronic health conditions, particularly in low- and middle-income countries, according to the World Health Organization.

Immunity declines with age. Older adults often experience a general weakening of organ function, including a reduced immune and defensive capacity of the respiratory system. Issues like dental problems or poor appetite can lead to malnutrition, further compromising their immune system.

Children's immune systems are still developing, making them more vulnerable to various pathogens. Their immune function typically approaches adult levels only after age six. Anatomically, children have narrower airways in the trachea and bronchi, rich blood supply, delicate mucosa, and a poorer ability to clear microbes. Combined with increased exposure to infectious agents in crowded settings like schools, this makes them prone to lung infections. Children with risk factors like malnutrition or anemia are more likely to develop severe pneumonia.

Common causes of pneumonia

Pneumonia can be bacterial, viral, or fungal. Pneumococcal pneumonia, caused by Streptococcus pneumoniae, is the most common type. It can cause infection when immunity is lowered, such as during a cold, fatigue, chronic bronchitis, heart disease, or due to long-term smoking.

"The most typical symptom of pneumococcal pneumonia is coughing up rust-colored sputum, meaning there are blood streaks in the phlegm," said Qin Qiang, director of the Respiratory Center at Beijing Children's Hospital.

Viral pneumonias are also increasingly significant. A 2019 study across 33 medical centers in China found that viruses accounted for 39.2 percent of adult pneumonia cases. Common respiratory viruses include influenza, respiratory syncytial virus (RSV), and adenovirus.

RSV is a highly contagious virus and a leading cause of hospitalization for lower respiratory tract infections like bronchiolitis and pneumonia in infants and young children. It spreads through coughs, sneezes, and close contact, and initially presents with upper respiratory symptoms such as sneezing, nasal congestion, and fever.

As medical experts point out, treatment depends on the pathogen.

"For viral pneumonia, there are often no specific antiviral drugs; care focuses on monitoring for complications and organ function damage," said Zhang Chengye, deputy chief physician of the Emergency Department at Beijing Children's Hospital.

"For Mycoplasma pneumonia, targeted antibiotics like macrolides are used under a doctor's guidance. Pneumococcal pneumonia is typically treated with antibiotics such as amoxicillin or cephalosporins," Zhang added.

Prevention is key

The focus for these vulnerable groups should be on prevention. They are advised to open windows for ventilation at least twice daily, in the morning and afternoon, for 20-30 minutes each time. They should also wash their hands frequently with soap and running water and avoid touching their eyes, nose, and mouth with unwashed hands.

Adequate fluid intake helps keep respiratory mucous membranes moist, aiding in the prevention of lung infections. Seniors can opt for walking or Tai Chi, while children can engage in activities like jumping rope or running to boost immunity.

Older adults should ensure sufficient intake of protein, vitamins, and minerals, especially foods rich in protein and antioxidants like Vitamin C. Children's diets should be balanced, emphasizing foods rich in Vitamins A, D, C, and zinc.

Regular vaccination against pneumococcal disease and influenza is recommended for children aged 6 months and older and adults aged 65 and older. They are also advised to limit visits to crowded and poorly ventilated public places. 

Meanwhile, both the elderly and children should maintain a routine with a balance of work, rest, and leisure as stress also weakens immunity.