Pneumonia is the number one killer disease for young children in India and decreasing the pneumonia disease burden is the next big task for India after Polio. In a developing country like India, young children below the age of 5 fall prey to pneumonia due to poor nutrition, bad sanitation, unhygienic surroundings, over-crowding, pollution, poverty, delayed diagnosis/ treatment, inappropriate antibiotic treatment and low awareness on prevention measures for such vaccine-preventable diseases. Seasonal changes are one of the triggers for Pneumonia. 

Pneumonia is an acute respiratory disease affecting the lungs. The mucus in the lungs is a breeding ground for the bacteria that causes pneumonia. These microbes spread via air-borne droplets from a cough or sneeze and once they enter the respiratory tract they attack the lung where they multiply quickly leading to pneumonia infection. Bacteria Streptococcus pneumonia (pneumococcus) accounts for highest number of pediatric hospitalizations for pneumonia and is the leading cause of death in children.

During an incidence of pneumonia, the lungs that are normally designed to cough out the pockets of mucus stop functioning properly. The mucus becomes a breeding ground for bacteria, viruses causing cold-cough conditions leading to acute respiratory distress. If high fever (more than 102° F), shivers, nonstop cough, body ache, wheezing and respiratory distress are observed for more than 2 days it is important for parents to take their child to a pediatrician. A child with chest in-drawing and cyanosis indicates severe pneumonia. Self-medication is not advisable and cough medicines are not recommended. Coughing enables you to clear mucus from your lungs, so trying to stop your cough could make the infection last longer. Hospitalization may be required to administer intravenous antibiotics.

Complications due to pneumonia can prove fatal. About half the children who survive pneumonia are left with some type of after-effect. These after-effects may be mild or temporary and may improve with time, but 22% of the survivors end up with a moderate or severe disability, according to the Centers for Disease Control and Prevention.  Complications of untreated or neglected pneumonia can result in disabilities such as deafness, brain damage, seizures and in some cases even death.

Diagnosis of the particular virus strain that caused pneumonia needs advanced medical investigation. It is important to know the serotypes causing the disease for early detection of pneumonia and prevention through vaccination. 25% of pneumococcal infections globally are due to serotype 19A, an emerging serotype associated with antibiotic resistance and responsible for the rise in pneumococcal infections in children under age 5.The latest pneumococcal conjugate vaccine PCV13 available in Asia since 2010 provides protection against serotype 19A and six more serotypes than its predecessor PCV7. The vaccination regime starts with a child less than 6 months old then a total 4 doses are administered. For a child who is 6 months to 1 year old, 3 doses are required. If the child is older than a year, 2 doses of vaccine are required.

According to WHO, only half the children with Pneumonia receive appropriate medical care. At times, antibiotic treatments fail because of delay in treatment, inappropriate antibiotic treatment or antibiotic resistant strains. Hence, it is recommended that parents should get their kids immunized with an upgraded pneumococcal vaccine to effectively prevent pneumonia.

US adopted compulsory pneumococcal vaccination in 2000 with PCV13 which has reduced indoor hospitalization due pneumococcus by 90% and has reduced the disease burden by 36%. India could follow suit to significantly reduce the child mortality rate.

While the Government of India has introduced several national programs to reduce infant mortality, there is still need for attention to this area.

* Data Courtesy:Indian Academy of Pediatrics
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