KUALA LUMPUR, Nov 13 — Pneumonia became the nation’s main cause of death in 2023, overtaking ischaemic heart disease (which had been leading for the past two decades, except in 2021, when Covid-19 prevailed), cerebrovascular disease (stroke), and road accidents.
The Department of Statistics Malaysia (DOSM) made the announcement recently, providing a sobering lead-up to World Pneumonia Day 2024 which falls on November 12 with the theme “Championing the Fight to Stop Pneumonia”.
According to Prof Dr Zulkifli Ismail, Technical Committee Chairman of the Immunise4Life programme, the pneumonia mortality incidence is alarming, and all Malaysians should make an effort to protect themselves from the disease.
The message is echoed by the Asian Strategic Alliance for Pneumonia Prevention (ASAP) in which Prof Zulkifli serves as a committee member.
Pneumonia Can Be Deadly To Adults
He explained that pneumonia is typically triggered by a respiratory infection (for example, influenza, pneumococcal disease, and so on). Typically, those infected will feel poorly and experience the usual symptoms.
As the respiratory infection worsens, you will start experiencing shortness of breath, make wheezing noises when you breathe, have chest pain and feel confused (common in older people). These could be signs that pneumonia has set in.
“Pneumonia is a condition where one or both lungs become inflamed and fluid builds up in the alveoli (air sacs). This can be dangerous because it hinders oxygen exchange and can result in severe complications, including respiratory failure, sepsis, lung abscesses, and, possibly, death,” said Prof Zulkifli.
Pneumonia develops gradually but can suddenly escalate into a medical emergency. You may find yourself needing to be rushed to hospital, where a chest X-ray will confirm the diagnosis of pneumonia, leading to a course of medication and possibly more intensive care, depending on the severity of the infection. Recovery from pneumonia can take several weeks.
Prof Zulkifli stressed that pneumonia is a life-threatening disease. However, vaccination can effectively protect high-risk individuals, including:
- Those aged 60 years and above.
- Those with chronic medical conditions.
- Smokers.
- Alcoholics.
- Those who are immunocompromised.
- Those on immunosuppressive medications.
Preventing Bacterial Pneumonia
Prof Zulkifli remarked that pneumococcal pneumonia is the most common form of bacterial pneumonia. It is caused by Streptococcus pneumoniae, a bacterium (also referred to as pneumococcus) that typically spreads through respiratory secretions, such as mucus and saliva.
People can get infected with S. pneumoniae either in the community from friends or crowds, known as community-acquired pneumonia (CAP), or from a hospital setting — known as hospital-acquired pneumonia (HAP), which usually occurs within 48 hours of admission.
Pneumococcal pneumonia can be prevented by getting the pneumococcal vaccination. There are two types of pneumococcal vaccines available in Malaysia:
- Pneumococcal Conjugate Vaccine (PCV13 and PCV15, the numbers referring to the number of serotypes covered).
- Pneumococcal Polysaccharide Vaccine (PPSV23).
Pneumococcal vaccination is recommended for all adults of 60 years and above, individuals aged 18 to 59 years with pre-existing medical conditions, immunocompromised individuals, alcoholics, and smokers.
Preventing Viral Pneumonia
According to Prof Zulkifli, viral pneumonia is more common than bacterial pneumonia, and it can develop as either a primary infection or as a secondary complication following other respiratory illnesses.
Viral pneumonia can be caused by the influenza virus, respiratory syncytial virus (RSV), and the Covid-19 virus. It is essential to protect yourself by getting vaccinated against these deadly viruses.
Annual influenza vaccination is recommended for everyone to ensure protection against the virus and to reduce the risk of severe illness and community spread.
For RSV vaccination, adjuvant RSV vaccine is the only available vaccine in Malaysia and is indicated for adults aged 60 and above.
As for Covid-19, although free vaccines are no longer provided, the elderly and immunocompromised individuals can continue receiving antiviral (Paxlovid) treatment to arrest infection and prevent it progressing into pneumonia.
Pneumonia And Children
Prof Zulkifli said: “In Malaysia, pneumonia is a major health threat for children. In 2021, it was the third leading cause of death among those under five years. According to the latest DOSM 2024 report, it is also the second leading cause of death for children below 14 years old.”
For children, the ‘prevention is better than cure’ approach is key, underscoring the importance of the Ministry of Health’s (MOH) National Immunisation Programme (NIP). Several vaccines are provided for infants (under two years of age) against pneumonia-related infections, namely:
- Pneumococcal vaccination (PCV has been given to children in this country since year 2020).
- Pertussis vaccination (as part of the hexavalent combination vaccine).
- Haemophilus influenzae type B (Hib) vaccination.
To further protect their children, parents may consider additional recommended vaccines, namely:
- Influenza.
- Varicella zoster (chickenpox).
- Meningococcal.
Championing The Fight To Stop Pneumonia
Pneumonia is a truly insidious disease. Many groups of Malaysians — young children, older person, people with non-communicable diseases (NCDs), and other immunocompromised individuals — are at risk of developing and possibly dying from pneumonia.
In conjunction with this year’s World Pneumonia Day, everyone should protect themselves and their loved ones against pneumonia by staying up to date with recommended vaccines.
Speak with your health care provider to learn more about the pneumonia-preventive vaccines that are right for you and your family. Prevention is key — let’s work together to champion the fight to stop pneumonia
