We are living in an era of extreme weather, promoting more frequent outbreaks of influenza. Although the flu is a mild disease, that we can resolve ourselves, it can pose a great risk in elders or people with low immunity or underlying diseases, causing pneumonia and even death. Dr. Sirichai Saengngammongkhol, a specialist in pulmonary medicine and pulmonary critical care medicine at Bangkok Hospital Hua Hin, shares that the severity of influenza depends on an individual’s immunity. People who have low immune system such as children, older adults, pregnant women as well as people with chronic diseases such as kidney diseases, diabetes and cancer, when having influenza, they are at higher risk of complications such as pneumonia and infection of the middle ear. Lung inflammation or “Pneumonia” is a consequent condition caused by the influenza virus entering the body through the respiratory system.
The severity of the disease varies from person to person. Elders with low immune systems are at more risk of complications from pneumonia, conditions such as infection in the bloodstream or respiratory failure carry a 50% fatality rate. As a result pneumonia in older people is far more dangerous than in younger people. “Pneumonia is developed in a period of 3 – 4 days after the illness has begun. The main symptoms are coughing, changes of sputum color, shortness of breath, pain in the chest, exhaustion and a highgrade fever. These symptoms indicate complications other than an ordinary flu.
The common symptoms of pneumonia in elders is alteration of consciousness or confusion which may or may not follow fever episodes or coughing.” Dr. Sirichai also shares that if a patient is suspected of having lung infections, the doctor will investigate via a chest x-ray and blood tests. The sputum is also collected for a culture and sensitivity test to find out what type of bacteria may cause the pneumonia.
The results will lead to the appropriate treatment. Influenza can be resolved by itself with proper rest, however, the presence of a high fever, difficult and painful breathing or loss of appetite, you should see a doctor as soon as possible. Some people can self-treat by using antipyretic drugs from a pharmacy, but for elders or people with underlying diseases, it may take longer time to recover and at the same time run the risk of further complications. Some types of pneumonia are caused by bacterial infection and require oral or injection antibiotics.
The treatments also depend of the severity of the infection. Normally, patients will improve within 2-3 days after receiving the antibiotics. For viral pneumonias, the treatment is supported by lots of rest and good hydration. However, elderly patients or ones with underlying diseases may be hospitalized for closer observation to prevent or detect complications early. “We can reduce the risks of influenza by once-a-year vaccination and the reason for this, rather frequent vaccinations, is mainly because the strains of the influenza virus change all the time.”
Dr. Sirichai emphasizes that all people should receive the influenza vaccination once a year and for people over 50, IPD vaccination to prevent pneumococcus pneumonia is also recommended. This IPD vaccine requires 2 injections with oneyear intervals in order to have long term protection. In addition, the prevention of influenza and pneumonia is still the priority. Enough rest and avoiding close contact with people with influenza are key. Moreover, frequent hand washing also helps to prevent contracting the illness along with regular exercises and a proper diet.
Pulmonary Medicine Clinic, Bangkok Hospital Hua Hin