Is your child safe from pneumonia?

Pneumonia is the leading infectious cause of death in children younger than five years old worldwide. Experts in this report by Sade Oguntola say that children especially need to be protected frompneumonia during this cold, dusty season.

He walked into the room, his face sagging because his three-year-old daughter had just been admitted into the hospital for pneumonia.

“I never knew pneumonia in children is deadly. In the ward my daughter was admitted, there were also many children down with pneumonia,” Mr Segun Adekola, a civil servant and a father of two said.

Little Shade had cough, fever, chills and difficulty in breathing. She was rushed to the hospital by her mother. After several tests, including a chest X-ray, she was diagnosed with pneumonia.

Pneumonia, silent killer of children

Unfortunately, pneumonia, an infection of the lungs, is common in children and it may have become severe by the time it is spotted. “Pneumonia is a silent killer of children; it is one of the diseases that children are highly susceptible to developing,” said Dr Bankole Kuti, a consultant paediatrician at the Wesley Guild Hospital, Ilesa, Osun State.

According to Dr Kuti, “the weather is changing and we are entering into a season that could be hot and with lots of dust and germs hanging in the air.

“Children inhale these germs. Since they do not have enough immunity to fight this infection, they succumb to it. Pneumonia is actually one of the diseases they could succumb to.”

Sadly, he pointed out that globally, pneumonia kill more children than malaria. “Worldwide, 15 per cent of children less than five years that die do so frompneumonia. This is significantly more than malaria,” he added.

According to UNICEF, pneumonia claims the lives of 2,500 children every day, making it the leading cause of death in children aged five and below. In 2015, 922,000 children worldwide died from this illness, with most of the fatalities being infants below two years old.

Why pneumonia?

These unfortunate deaths frompneumonia, he said were due to factors such as lack of exclusive breast feeding and prolonged breastfeeding of babies; poor immunisation coverage for children against pneumonia; indoor air pollution; under-nutrition; use of unclean fuels for cooking and overcrowding that are preventable.

According to him, “Studies have shown that children who are well breastfed do not succumb to pneumonia as much as poorly breastfed babies.

“Even if they have the disease, they would not die or have prolonged hospitalisation because of the infection because breast milk contains plenty of antibodies which the mother has developed over the years. This is transferred to the baby when you breast feed.”

Dr Kuti declared that vaccines – pneumococcal conjugate vaccine and the immuophlux influenza conjugate vaccine- are available in Nigeria to protect children against pneumonia.

“These are the two leading causes of fatal pneumonia in children. So children who are not immunised against them can easily have the disease and succumb to them. So immunisation is very important,” he declared.

He warned against under nutrition in children, a very important risk factor for childhood pneumonia. “If your child is under nourished, all sorts of infection can come including pneumonia,” he added.

Nutrition, key to pneumonia prevention

Dr Kuti said the teaching that children should not be given foods like eggs and meat is wrong, adding that “children need more meat and eggs than adults because they are growing rapidly. They need it to boost their immunity and fight infections. So stopping under nutrition is also key in preventing pneumonia.”

Although in some instances, a recurrent pneumonia may be suggestive of an underlying problem like a heart problem in a child, nevertheless, he said that pneumonia is curable and need not result into death.

According to him, “one of the reasons why children die is because a child with pneumonia present with fever. Most mothers take all fever to be malaria and resort to giving antimalarial drugs only for the fever to subside a little bit and pick up again”.

Heart failure as a complication

He added, “If it is not diagnosed early, complications can set in. Complications ofpneumonia are so many. Heart failure is the commonest complication ofpneumonia in children; it can make the heart to fail.

“It can also make fluid or even pus to accumulate in the lung space.  The congestion makes the lung not to work optimally and so you will see the child struggling to breathe. After some time, the lungs will pack up.

“That is why we always advise our mothers that when any child is ill, such a child should be seen by a qualified medical practitioner to assess the severity and plan management accordingly.”

Aside some children convulsing frompneumonia, he declared that in some instances, even these infection in the lungs can spread to other parts of the body like the brain and the spinal cord, causing what is called meningitis.

Dr Kuti, therefore, warned on early detection and treatment of common cold, flu-like illnesses to prevent management ofpneumonia’s expensive complications and a prolonged hospital stay.

Pneumonia’s red flag

He highlighted signs and symptoms ofpneumonia that mothers should look out for to include fast heart beat, trouble breathing, shaking chills, high fever, coughing, vomiting, chest pain and abdominal pain.

He added: “trouble breathing is a very important sign that mothers should look out for to suspect pneumonia. Grunting and fast breathing is more associated with pneumonia than wheezing.”

The paediatrician emphasised that ensuring children complete their immunisation schedule is also important to prevent measles and tuberculosis, both also a risk factor for pneumonia.

Measles can suppress a child’s immunity, allowing for a superimposition of another bacterial infection like pneumonia. So also, tuberculosis can cause chronic pneumonia.

In addition, he warned against parents enrolling their children in day care centres or preschools that are overcrowded and dirty, saying such an environment was synonymous with children that develop pneumonia.

Cold andpneumonia

Can cold weather cause pneumonia? People generally complain of coughs, sniffles and itchy throats during the colder months, but it has little to do with temperature outdoors and does not necessarily indicate the presence of an infection.

In a report, Director of Infectious Diseases at Stamford Hospital, Dr Michael Parry said the truth is that exposure to cold in most situations, has not been shown to increase the risk of getting infections, but the fact that people tend to stay indoors when it is cold out.

However, he said exposure to the cold makes skin more “fragile,” which could lead to infection. “Because it is so dry, the skin chaps and cracks and those cracks can lead to infection, and we do tend to see those types of problems,” he said.

Other experts say that cold also puts stress on the body, and stress has been shown to lower immunity. Some experts also said that the temperature inside the nose — which is typically lower in the colder months — also has a link to immune response.

In 2015, researchers from Yale University released a study showing that the common cold virus reproduced more quickly in the nasal cavity, which is typically cooler than the rest of the body.