Who do you immediately imagine when the illness pneumonia is mentioned? A frail, elderly woman at the end of her life? A man with decades of smoking and years of wearing oxygen, laid up in the hospital? People succumbing to pneumonia and getting the most advanced medical technique of the 16th century, bloodletting?
Yes, those scenarios exist, minus the bloodletting; but truth be told, pneumonia does not always pick on the stereotypes.
Who can get pneumonia? Well, you, or me, or anyone.
What predisposes one to get pneumonia? Breathe in and out a couple of times. That's it. If you have lungs, you can get pneumonia. If you don't have lungs, you won't get pneumonia, but you have a much bigger problem on your hands. Or you're a fish.
Pneumonia, simply put, is infection of the spongy part of the lungs, in which bacteria create inflammation and thickening of lung tissue, preventing blood cells from absorbing oxygen. Without oxygen, the body begins to die, and an infected person may require IV antibiotics in the hospital, and sometimes a ventilator to survive.
A number of bacterial types cause pneumonia, but the most common bacterial species to do this is streptococcus pneumoniae, or simply pneumococcus. It is also a common cause of ear infections and sinus infections, so if you can get one of these infections, you can get pneumonia, although most people have a good immune system to fight it off. Pneumococcal bacteria can also cause blood (sepsis) and spinal fluid (meningitis) infections.
Unfortunately, the immune system of some people has difficulty fighting pneumococcus.
According to the Centers for Disease Control and Prevention, persons most susceptible to pneumococcal pneumonia are children under the age of 2 years, adults over the age of 65 years (that's age discrimination!) and anyone with a condition that can decrease the immune response against bacteria that fight pneumonia. These conditions especially include chronic illnesses (lung, heart, liver, or kidney disease; asthma; diabetes; or alcoholism), conditions that weaken the immune system (HIV/AIDS, cancer, or damaged/absent spleen), and people with cochlear implants or cerebrospinal fluid leaks (escape of the fluid that surrounds the brain and spinal cord). And of course, people who smoke.
Fortunately for those groups, two types of pneumococcal vaccines are available and highly recommended by the CDC and the Food and Drug Administration. The one recommended for you depends on where you fall in the age group or disease state above, and most adults in the above categories will need both. These vaccines are well-tested, well-vetted, and are very safe.
Why are there not more people getting immunized? Inconvenience, time management, fear of needles, fear of the vaccine itself.
Do you know what is inconvenient? Hospitalization. Do you know what I am afraid of? Dying of pneumonia. I am a primary-care physician, and I believe that another reason people do not get immunized is that I/we in the medical community need to work harder at discussing with the public the need for these immunizations. Ergo, this letter.
According to the CDC, on average, 18,000 people die each year in the U.S. from pneumonia and pneumococcal-related illnesses. I'm not a math guru, but I think 18,000 is a large number and one that can be more easily prevented.
So I recommend that as soon as you read this letter, put it down and pick up the phone to call your physician's clinic to inquire if you or your family members should get one or both of these vaccines and how to get them. There is no reason to be one of the 18,000.
It's not like our only option is leeches. You have read this, and now you have no excuse.
For more information, go to the CDC website (cdc.gov), and type in "pneumococcal vaccine," or consult the state's Health Department website. For Arkansas, that is healthy.arkansas.gov, then click on "P" at the top alphabetical menu.
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M. Carey Roach, M.D., is a physician of adult internal medicine and pediatrics in Little Rock.
Editorial on 05/22/2017