Drowning Alive

As I normally do when I begin a talk about a particular health concern, I like to begin by talking about how relevant this concern is by listing a number of statistics that show the impact of the subject at hand. In this case I’m going to talk about pneumonia.  Many of us have had pneumonia in our lives.  Over 1% of the population every year has pneumonia.  That’s pretty big for a disease that can impact life pretty harshly.  That’s almost as common as getting a cold.  In the general population a little over one out of 100 people every year gets pneumonia.  It’s the fifth leading cause of death; 65,000 people a year die from pneumonia.  It’s the 8^th cause of death if you are in a hospital.  The economic cost is about $40 billion a year.  

It’s interesting to see how the medical community divides up pneumonia.  You would think they would divide it by bacteria, and viruses.  Instead they divided it up into hospital-acquired pneumonia and community-based pneumonia.  You’ve got to know there’s a problem in our hospitals if they are dividing diseases according to whether you got them in the hospital or you got it at home or out in the community.  That’s just a little reality check there.

There are different types of pneumonia according to the normal categories of bacterial, viral, fungal, and inflammatory pneumonias.  We talked a little last week about bronchitis.  That’s where that type of pneumonia would begin.  

In the viral category you have flu which we’re all familiar with.  There are two categories of people that pneumonia is really dangerous for: infants and folks over 65.  If you look at that, probably the danger for those over 65 is influenza.  If you’re talking about an infant it’s a whole different category.  Respiratory seneschal virus and other childhood viruses, even chickenpox, can become pneumonia and childhood diseases like measles.  But RSV  is certainly the biggest one among children.

Almost always, it’s a standard in medicine that we should not put people on antibiotics who get a viral infection.  However, pneumonia is probably the perennial disease that gets treated, day in and day out, with an antibiotic because if you’ve already got pneumonia your lungs are already significantly compromised.  Even if it did start with a virus, there are hundreds of different kinds of bacteria in our lungs already as part of the normal bacteria.  One of those is soon going to take over because your lungs are immuno-compromised from using up your immune system fighting the viral particles there.  Sooner or later if you have a viral pneumonia you’re probably going to come down with a subsequent bacterial pneumonia.  So it’s pretty standard operating procedure in medicine, certainly if you’re admitted or if you are out-patient, if you get the diagnosis of pneumonia to go ahead and start you on a antibiotic.  

Doctor’s are trying to back off of antibiotics because we’re getting all these MRS’s (methicillin resistant bacteria).  These bacteria are smart little rascals.  They can even transfer knowledge of immunity or resistance toward antibiotics between themselves.  You may have gotten an antibiotic and then you sneeze or kiss or share some of your bacteria with somebody else, and the bacteria you gave to someone else can transfer the knowledge of resistance to that bacteria to your bacteria.  So these are not just dumb little bugs multiplying out there that we’re dealing with.  There is certainly some intelligence and knowledge that they swap among themselves.  

Certainly there are atypical pneumonias like Legionnaires' disease.  Back in 1976 a bunch of people came down with an infection, pneumonia, at the head table right under an air-conditioning vent at a American Legion conference in Philadelphia.  That’s how the bacteria got its name.  Six out of 8 of those people at the head table died.  Other people died and a lot got really sick from pneumonia from that bacteria which was in an air-conditioning system.  Other people have died since that happened.

You probably heard on the news in 2003 about SARS, acute respiratory syndrome.  Again, that’s viral.  Then there are other bugs such as TB.  It is still out there and it’s making a comeback.  Certainly fungi can cause pneumonia.  Funguses are much more important if you consider a person who is getting drugs for cancer treatment or an AIDS patient, someone whose immune system is compromised.  Those are the people you really watch out for with fungal infection.

Then there are physical ways you can get pneumonia.  If you were to breathe in some caustic chemicals with a lot of alkali or acid in it that could burn your lungs. You might also aspirate some food and the bacteria that was in the food or the bacteria in your lungs could begin to grow. The immune system doesn’t just fight bacteria and infection.  It also takes care of damaged tissue and cleans up the debris and lays down new tissue and does repairs. While your immune system is mopping up all the damage from the aspirated food it has to be able to take care of any bacterial infection as well.  The immune system is a multi-tasking genius that our Creator designed in our bodies. 

Next time I’ll talk a little about what pneumonia looks like and then we’ll deal with the treatments.