Imagine a homeless family in the heart of India living on the street. That family has a father, a mother, two sons and a daughter. One of the sons is about 4 years old, and he sits in his mother’s lap seven hours a day as she begs for money, until he goes to sleep on his cardboard bed with his siblings. Overnight, he develops a little cough, and feels more tired than normal. A couple of days go by, and his cough turns into a heavy one; he starts feeling very fatigued, and exhibits a shortness of breath. That’s right: pneumonia can just sneak up on you without you realizing its severity until it’s too late. Families or people that aren’t economically stable as well as those in underdeveloped countries have a much higher chance of contracting and dying from pneumonia than people who live in more modern societies with an adequate living environment and the necessary funds to fight illness.

      Description & Background

According to the National Institute of Health (NIH), pneumonia is a disease caused by the inflammation of the lungs by bacterial or viral infections. According to Susan Chow Ph.D. it was discovered in the 18th century by Louis Pasteur, a French microbiologist known for discovering vaccination and pasteurization, and George Sternberg an American microbiologist. They both separately encountered the bacterial disease in saliva.  She also says that it was first seen in old Greek civilizations. The severity of this disease can vary quite a lot, whether it’s because of age, health conditions, living conditions etc. All of these factors dictate how long recovery takes, but there are some general time frames for a symptom to go away. For people over the age of 65, or with Covid-19 and/or other heart or lung conditions, the severity is higher than for teenagers that have no concerning health conditions. According to John P. Cunha, a medical editor for eMedicineHealth, as a generalization, a complete recovery of pneumonia can take up to six months. The first week, the patient has the highest possible fever he/she can possibly have during their course of the disease. After approximately four weeks, the synthesis of mucus should significantly decrease as will chest complications. Two weeks later, shortness of breath and coughs, heavy or light, should have decreased drastically. After three months, all symptoms except fatigue should have gone away, and most people will have fully recovered after six months (Cunha[GU1] ).

    Symptoms & Different Types

There are different symptoms of pneumonia, according to the NIH, but they do not vary with specific cases; they’re always the same ones. First, whether it’s a heavy or light one, there will almost certainly be a cough. The cough is a way to get the phlegm or pus out of the airways when it clogs them up. Fatigue becomes more recurrent and frequent with a patient, as well as trouble breathing where the airways are clogged up with bacteria or viruses, that can also cause chest pains, whether intense or not. The last main symptoms are heavy chills, which, is the act of shivering or shaking mostly caused by the cold or in this case, a fever. The body does this during a state of fever to raise or lower the temperature to its optimum level, 37 degrees or so. Sweating enables the body temperature to lower when it’s too high, and shivering makes it higher when needed.

As for the types of pneumonia, there’s two main ones according to Kelly Burch, a writer for VeryWellHealth; bacterial and viral. For the latter, 27% of pneumonia patients have an identifiable virus clogging their airways, and as for the former, 14% of patients have identifiable bacteria in their airways. Then, there are the least common ones, like walking pneumonia, which is a type of bacterial infection. It is a mild infection which usually means the patient can keep doing daily activities at a slower rate, hence its name walking pneumonia. Another one is fungal pneumonia, when there are fungi in the area/environment the victim lives or works in, and they enter the lungs to then grow. This type usually happens to people with weaker immune systems than others as their system can’t fight off the fungi itself. Finally, there’s what they call aspiration and chemical which is when someone inhales a foreign substance and/ or chemical and it then leads to bacterial pneumonia (Burch). To sum up, all these symptoms and types of pneumonia are all worth knowing just in case there is a case in your family or close friend. It would be beneficial to know them more to be able to do your own “diagnosis” than anything else.

Cause & Effect

The National Heart, Lung, and Blood Institute states that the causes of pneumonia differ depending on what type it is. In general, when a bacteria, fungus or virus gets into your lungs, your immune system tries to fight it because that’s the system used to fight against germs and infections. The problem is that the immune system doesn’t always succeed in destroying the bacteria or virus that causes this disease. To be specific, in viral pneumonia, the common cold, as well as the flu or influenza, are the two most common causes of this type of pneumonia in adults. For children, Respiratory Syncytial Virus, or RSV, is a common and contagious virus that causes infections or inflammation in the respiratory tract that lead to pneumonia. In bacterial pneumonia, there are different bacteria as the main causes, such as Pneumococcus bacteria which is the most common in America. Mycoplasma pneumoniae is the cause of a mild type of pneumonia or walking pneumonia. Instead, Legionella Pneumophila causes one of the most severe types of pneumonia called Legionnaire’s Disease, and unfortunately this disease is considered to be life-threatening. This disease targets mostly older people, smokers and people who inhale bacteria and viruses from water, air, or soil. It cause muscles aches and fevers that go up to 40 C or higher. The legionella bacteria mostly multiply in systems such as A.C. Lastly, fungal pneumonia mostly targets people with weak immune systems and can be due to fungi like pneumocystis jirovecii.

 If these are all the causes, what are some effects? Effects on the body can include mental confusion due to a high fever or low amount of oxygen in the bloodstream. In rare cases, organ failure is a possibility as there is not enough room in the lungs for oxygen because they are so impacted. Again, in rare cases, the bacteria can travel into the blood and very rarely cause septic shock, which is when your body has a very negative reaction to an infection and can result in injury or failure of tissues and organs. Again, this life-threatening effect of pneumonia is only in extremely rare and severe cases.

Problem & Solution

            Many people ask whether there is some type of precautionary step they can take. Others ask whether there is a way to prevent pneumonia. Unfortunately, there is no direct prevention as there is no vaccine. However, there is a pneumococcal vaccine, which is a vaccine against a specific type of bacteria that causes pneumonia, but other than that, there isn’t any other direct prevention. The ones who ask the former, the answer is yes. There are precautions you can take such as vaccines against certain bacteria and viruses are always a good idea so that those can’t turn into bacterial or viral pneumonia. For example, if you have the influenza shot, then you reduce your chances of getting viral pneumonia as that is a big cause of pneumonia. Having said this, can it be cured? That does seem to be a frequent question, and yes it can be cured. The treatment for milder cases like walking pneumonia for example, would be a simple intake of antibiotics for 48 to 72 hours and the bacteria should be gone. For viral pneumonia, antivirals are required to treat it and should be taken for the same amount of time. Some say to take cough suppressant, but many find that it’s better to get rid of the mucus by coughing it out. After you’ve taken the antibiotics, doctors recommend taking probiotics for a month or so. According to Dr. Ruairi Robertson, a contributor to the Healthline magazine, probiotics help stabilize your gut microbiota and ease it back into a healthy state. Since our bodies aren’t used to antibiotics, probiotics also normalize that intake by creating so called “good bacteria”.

Do’s & Don’ts

            There are many things one should and shouldn’t do during or after having/having had pneumonia. For example, you shouldn’t walk too much just because you have walking pneumonia, that’s not what it means. One thing that should be clear and common sense is that you cannot smoke or consume alcohol as those will both interrupt your healing cycle, in different but major ways. Doctors also recommend four to six glasses of fluids per day: tea, water, juice etc. They also recommend eating smaller meals, four or five a day instead of the conventional three, to maintain a stable diet, to recover muscle mass and not lose too much weight (Torres Martí). Doctors do not think it’s a good idea to isolate yourself in your bed all day while having the disease. It’s better to stick to your normal daily routine, they say, so your body doesn’t work so hard to get back to its normal state once healed. Obviously, tiring yourself out wouldn’t be the best idea, but going for a stroll once in a while can only do you good. As far as travelling is concerned, that should only be in case of an emergency.

Places & People’s Vulnerability

            The difference in ages and places is a huge factor when it comes to contracting pneumonia. Countries in Africa and South-East Asia are much more vulnerable than countries in Europe. A study done in 2019 showing that European countries are significantly less vulnerable backs this up. In European countries, the rate of deaths caused by pneumonia is 10 per 100,000, while in less economically stable countries, in Africa and South-East Asia, said rate rises to 100 per 100,000 (Dadonaite & Roser). Clearly there is a unbalance in the mortality rates from pneumonia when it comes to more or less economically stable countries. Why is this? Some countries don’t have the funds to clean up their streets, where the bacteria and viruses live, they also can’t fix up their hospitals and afford to pay for the best possible care for this disease and for others. In this study, it was found that in the Philippines, the mortality rates from pneumonia are especially high and the second cause of death in children under 5and adults over 70. Another discovery from this study is that half the deaths from five countries in Sub-Saharan Africa and South Asia -- India, Nigeria, the Democratic of Congo, Ethiopia, and Pakistan -- are due to pneumonia. This again backs up the claim that non-economically stable countries are victims to this treacherous disease. Since this study, people have referred to the disease as “the ultimate disease of poverty” (Dadonaite & Roser).

             Ultimately, there are many reasons why the citizens of some countries and certain other groups of people are more vulnerable than others when it comes to pneumonia. The lack of funds seems to be the leading cause of this problem, and unless something is done about that, then the “ultimate disease of poverty” will surely continue to do its unfortunate job, and nothing good will come of that.  Certainly, age is the primary reason of contracting and being vulnerable to pneumonia, then come the confounding variables such as health problems/complications, whether victims have the funds to treat it, the state of the environment they live in, and so forth.

Remember that 4-year-old who contracted pneumonia in India? He could be fine, but others might not be unless we have the courage to confront the symptoms head on.