Overview Of Pneumonia Health Article

Prevention Of Pneumonia

In light of the significant morbidity and potential mortality of pneumonia, appropriate measures should be instituted to reduce the possibility of lung infection. Important but often neglected interventions include smoking cessation and avoidance of illicit drugs or excess alcohol, which may impair consciousness. Optimizing the patient's nutritional status is also important, in that markedly underweight or obese patients are at increased risk. Finally, the appropriate and consistent use of vaccines can strongly reduce the risk of pneumonia in appropriate patient populations. The current pneumococcal vaccine contains 23 purified capsular polysaccharides from the serotypes of S. pneumoniae that are responsible for more than 85% of invasive pneumococcal infections. Overall, this vaccine is approximately 50 to 80% effective in preventing death from invasive infection. Accordingly, current recommendations are that it should be administered to all patients older than 65 years of age and to patients younger than age 65 who have chronic pulmonary diseases, heart disease, diabetes mellitus, alcoholism, chronic liver disease, cerebrospinal fluid leaks, or asplenia, and to patients who live in certain settings, including Alaskan natives, high-risk native American populations, and patients in long-term care facilities. Current pneumococcal vaccines have little toxicity, limited mainly to local site irritation. Individuals generally receive one dose of vaccine, but a single revaccination should be considered 5 years later in those who received their vaccination before age 65 years or who are at increased risk for severe pneumonia.

Vaccination should also be considered for viral influenza. Although usually manifest as an upper respiratory tract infection, influenza can itself cause pneumonia in both immune competent and immunosuppressed individuals. More commonly, influenza may precipitate a subsequent bacterial infection, often due to S. aureus . Influenza vaccines are developed annually against the current influenza strains, so annual revaccination is necessary. Influenza vaccines are estimated to be roughly 80% effective in preventing mortality related to influenza. The vaccine should be considered in all patients older than age 65 years, residents of nursing homes and chronic care facilities, persons with chronic pulmonary, cardiac, or other chronic diseases requiring ongoing medical care, and pregnant women in the second or third trimester during influenza season. ¹ Contraindications to influenza vaccine include allergy to raw eggs or thimerosal. Side effects are generally self-limited and include injection site soreness, myalgias, mild fever, and malaise. The vaccine does not contain live virus and therefore cannot cause influenza. The vaccine should be administered in the fall of the year, but it can also be administered during local epidemics.