Pneumonia in children

Pneumonia is a respiratory infection that involves the lungs. Normally, in a healthy person tiny air sacs in the lungs known as alveoli get filled with fresh air during breathing.

However, an infection causes the alveoli to be filled with fluid and pus causing difficulty in breathing and reduced oxygen supply to the body tissues.

Pneumonia begins after inhaling germs such as viruses and bacteria into the lungs.

A child can develop pneumonia from an episode of the flu or common cold. According to Dr Anne Irungu, a Paediatric Chest Specialist, a child may experience around three to six episodes of colds and flu’s that usually clear with minimal or no treatment at all.

However, 20 per cent of these cases may become more serious and develop into pneumonia.

Children whose immunity has been suppressed due to infections like HIV/AIDS are likely to develop more severe disease and are at higher risk of dying from pneumonia.

Dear doc,

How can I tell that my child is having pneumonia and not just a common cold? Thanks,

Linda.

Dear Linda,

Usually, a child with pneumonia may initially show symptoms similar to those of common cold. Generally, a child with pneumonia may present with symptoms such as fever, a cough which may be accompanied by production of mucous (phlegm) from the lungs, rapid breathing or difficulty in breathing. In older children, chest pain may be present.

Chest pain may be worsened by breathing in or coughing. Infants and younger children will have these symptoms and in addition, they may appear dull, lethargic — they may appear to have little or no energy at all— fussy, and are unable to feed properly.

If your child has these symptoms, it is good to consult a doctor immediately so that accurate diagnosis can be made. While some cases are usually mild, others may be severe.

Dear doc,

My niece was recently diagnosed with pneumonia. We stay in a climate that is warm. What could have caused the illness?

Concerned Aunt.

Dear Concerned Aunt,

Pneumonia is a lung infection caused by viruses such as influenza and bacteria like pneumococcus.

There also exist other types of bacteria that can cause pneumonia. These infections are airborne and can occur at any season of the year. Contrary to popular belief, cold air is not a cause of pneumonia, but during the cold season certain viral infections like influenza peak and can cause pneumonia. 

Spending more time together in an enclosed place, such as crowded matatus can encourage the bacteria that cause pneumonia to spread more easily from one person to another.

Dear doc,

How is pneumonia spread in children and how can it be prevented?

Ska.

Dear Ska,

The bacteria and viruses responsible for causing pneumonia are present in the nose and throat of a person who is infected. The disease can be easily spread when a person who is infected sneezes or coughs on a healthy child, shares utensils like cups and plates, or when a healthy child comes into contact with things like handkerchiefs or wash towels used by a sick person.

The most important form of prevention is ensuring your child receives their primary vaccinations.

This confers immunity against pertussis and pneumococcus that are among the known causes of pneumonia.

Keep the child away from persons with flu and colds and encourage the child and anyone in contact with the infection to wash hands frequently with soap and water to avoid spread of germs.

If you have an adult who smokes cigarettes in the family, encourage them to quit the habit.

This is because smokers e carry more pathogens in their pharynx and are therefore more infectious to young children.

In addition, ensure that the child is getting a well-balanced diet for good nutrition, essential for boosting the child’s natural immune system and also helps shorten the duration of the illness if the child falls sick.

Dear doc,

What is the importance of pneumonia vaccine and how does it work?

Maundu.

Dear Maundu,

The pneumonia vaccine is against bacteria known as Streptococcus pneumoniae (pneumococcus).

Pneumococcus is known to cause severe infections affecting the brain, the lung, the ear and throat. These infections can cause long-term complications or death. Groups that are more vulnerable to these infections are children below two years, older people (65 years and above), and people who have underlying medical problems that affect their immunity such as diabetes and cancer.

The pneumococcal vaccine is given in order to boost your natural immunity against pneumococcus. The pneumococcal conjugate vaccine (PCV) is given to children less than 2 years of age as part of Kenya extended program on childhood immunisation (KEPI). It is given at six, 10, and 14 weeks.

A booster vaccine is then given at 18 months. The vaccine is normally injected into the thigh. Side effects are usually mild and may include fever, pain or tenderness at the injection site. But, serious side effects of the vaccine are uncommon.

KNOW YOUR BODY

Understanding the human respiratory system 

Each time you breathe in, different parts of the body such as the respiratory system work in unison to ensure that the oxygen you inhale is taken to where it is needed.

The respiratory system plays a key role of supplying body cells with oxygen needed for body’s metabolic functions. This process is achieved through the act of respiration or breathing, which is the exchange of gases, inhaling oxygen and exhaling carbon dioxide, a waste gas.

To achieve respiration, several organs are involved. These include the nose, mouth, windpipe, diaphragm and the lungs. The act of breathing usually begins at the mouth and nose. Though most breathing occurs via the nasal cavity, the oral cavity can at times substitute or supplement the functions of the nasal cavity whenever there is a need.

Air enters into the mouth or nose, and then moves down the rear of the throat and into the trachea (windpipe), a long tube that goes into the chest cavity.

The trachea gives a clear air passage whereby the air enters and leaves the lungs. In addition, trachea also helps filter inhaled air. The trachea then splits into airways known as bronchial tubes, which lead straight to the lungs.

In order for the lungs to work properly, the bronchial tubes need to remain open during the process of breathing in and out. In addition, there should be no inflammation or any unusual or excessive secretion of mucus in the bronchial tubes.

RESPIRATORY PROBLEMS

As the bronchial tubes goes through the lungs, they further split into tiny airways referred to as bronchioles. These bronchioles end in small air sacs known as alveoli. The body normally has millions of alveoli. Enclosing the alveoli is a group of small blood vessels known as capillaries. At this point, the air that has been inhaled travels via the walls of the alveoli and then right into the blood via the capillaries.

Once the blood has absorbed oxygen, it leaves the lungs and carries the oxygen to the heart where it is pumped throughout the body to supply oxygen to the cells of the body organs and tissues. As the body cells utilise oxygen, carbon dioxide is also being produced and taken in into the blood.

This carbon dioxide is then transported by the blood back to the lungs and gotten rid off from the blood when a person exhales.

The process of breathing is facilitated by a muscle called the diaphragm.

The diaphragm is a muscle located beneath the lungs. Breathing occurs when the diaphragm contracts and relaxes. When one inhales the air, this muscle usually contracts downward and forms a space which allows the lung to expand and let in oxygen rich air.

When breathing out, the diaphragm relaxes up and pushes the lung letting the air out.

Usually, the respiratory system has mechanisms in place to keep harmful substances from getting into the lungs. Lining the nose are tiny hairs known as cilia which work by filtering large particles.

These hairs are also present along the airway and move about to ensure that the airway remains clean. However, when harmful substances are inhaled, for example smoke from a cigarette, the cilia fail to work correctly hence causing respiratory problems such as bronchitis.

The bronchial tubes and the windpipe are lined with cells that secrete mucous which keeps the airways moist and helps stop viruses, bacteria, allergens, dust, as well as other harmful substances from getting into the lungs.

Any impurities that manage to get into the deepest part of the lungs can be pushed up by mucous and are either swallowed or coughed out.