Pneumonia Vaccine (I)

It isn’t easy having a hard time breathing, coughing and getting a fever most especially if it gets worst, resulting for an individual to be very sick and end up in the hospital. Aside from being costly, it wastes a lot of one’s time, leaving one’s work and important tasks unattended. As the technology advances and man’s urge continuously strikes to its highest curiosity, mankind develops a lot of helpful and sustaining materials for its survival. Man have created a vaccine to cure and escape from the misery of a lung infection that results for a person to be very sick; Pneumonia vaccine.

What Is The Pneumonia vaccine?

A pneumonia vaccine provides protection for one individual against most of the bacteria that leads to pneumococcal pneumonia and pneumococcal diseases. Pneumococcal bacteria attacks the different parts of the body, when it attacks the lungs, it results in pneumonia, bacterium in the blood and meningitis in the brain. One can get pneumonia anywhere, at school or at work likely to have it after a cold or flu.

Thus, it is preferred to take and have the vaccine for protection and lessen the tendency of having pneumonia. The vaccine is safe and it works giving results that could protect an individual against the bacteria for about 10 years. Experts say that for the adults the effects are best felt when taken by age 50 to 65 yrs. Of age but one can have a shot of the vaccine any time.

Bacterial Causes of Pneumonia

Pneumonia can be caused by viruses, bacteria, or fungus. Bacterial causes of pneumonia are most common. The most common typical bacteria that are found in pneumonia are Streptococcus Pneumoniae, Haemophilus Influenzae, Chlamydia Trachomatis, Mycoplasma Pneumoniae, and Legionella Pneumophila.

Streptococcus Pneumoniae: This is a gram-positive bacterium. It is catalase negative and alpha-hemolytic (which means that it somewhat likes to grow on blood agar). They are in the shape of elongated cocci. Usually, they are seen as pairs called diplococci, but may also occur singly or in short chains. S. Pneumonia are normal inhabitants of the human respiratory tract. Disease happens only when the host is immunocompromised. It is also known to cause otitis media and meningitis. It usually causes lobar pneumonia in the elderly and children or the immunologically compromised. They do not form spores and are non-motile. They ferment lactose. Purulent, "rusty-colored" sputum in patients with S. Pneumonia is usually the hallmark of S. Pneumonia in patients suspected of suffering from Lobar Pneumonia.

Haemophilus Influenzae: This is a small, non-motile, Gram-negative bacterium that resides in the Pasteurellaceae family. In 1890, it was mistakenly thought to be the cause of the disease Influenza, and it was named accordingly. It is presently known that the Rhinovirus is the major cause of the flu, and not a bacterium. The name has stuck with the bacterium, though. It is present in the nasopharynx of approximately 75% of people. It is a blood loving and fastidious bacterium, which means it is picky on where it will grow. This bacterium will grow on chocolate agar. Its shapes range from coccobacillus to filamentous rods on the Gram Stain. Pathogenic species of H. Influenza typically have a capsule. It typically causes infections of the respiratory and genital mucous membranes. Infection can happen from inhalation or fomites. (A fomite is an inanimate object carrying infectious organisms such as a table top or a door knob.) H. Influenzae form "satellite colonies." Initially, H. influenza invades the nasopharyngeal mucosa before spreading to the lower respiratory tract where the organism invades and destroys the mucus membranes producing Pneumonia.

Chlamydia Pneumoniae: This is a less common causative agent of Pneumonia. It is a gram-negative, aerobic, obligate intracellular pathogen. It is the only bacteria known that have a life cycle, the elementary body (infectious form, and the reticulate body (replicative form). It comes in the shape of a small bacillus with no peptidoglycan in its cell wall. The Chlamydiae species is known for its lack of peptidoglycan membrane and only has an outer membrane and an inner membrane. It is therefore, harder to kill by most antibiotics which actually target the peptidoglycan membrane. They cause harm by invading macrophages, but show its virulence when the cause the macrophage to not make the bacterium fuse with lysososme. The lysosome is the main killer of bacteria inside of a macrophage. In this way, the Chlamydiae bacteria escape killing by a macrophage, and actually live inside of a macrophage! When they replicate, they lyse the macrophage cell.

Mycoplasma Pneumoniae: This bacterium is a member of the class called Mollicutes, meaning soft skin (hence, can change shape). They completely lack a bacterial cell wall. Wall-less bacteria are more difficult to kill because our antibiotics target the cell wall. M. Pneumoniae, like Chlamydiae, is an obligate intracellular pathogen. It lives inside of macrophages and other cells. It cannot survive on its own as it is too small. Mycoplasma do not have their own machinery to replicate because they are so small. M. Pneumoniae is currently thought to be responsible for both tracheobronchitis and primary, atypical pneumonia. M. Pneumoniae can be caught through close personal contact via respiratory droplets. It's peak prevalence times are usually in autumn and winter.

Legionella Pneumophila: Legionella Pneumophila was first discovered in 1976 when an outbreak of pneumonia at an American Legion convention killed 29 people. It is motile, rod-shaped, gram-negative, aerobic bacterium. It requires complex nutrition, such as high cysteine levels and low sodium levels to grow optimally. It has always have been found in non-marine aquatic environments such as lakes and ponds. L. Pneumophila can survive in tap water at room temp for over a year! Legionella bacteria are transmitted to the lungs of human beings through a process called aerosilisation. (Air conditioning cooling towers). It is the cause of Legionnaire's Disease and Pontiac Fever (a mild infection which causes flu-like symptoms that goes away without treatment). Legionnaire's Disease incidence has increased over the past decade or so because of the wide use of central air conditioning, especially in office buildings, hotels, and hospitals. The major side effect of Legionnaire's Disease is respiratory failure which requires mechanical ventilation.

How to Spot Pneumonia: Common Symptoms

by Brent Boyd

Pneumonia is inflammation and often infection of the lungs. Although some forms of pneumonia are mild and don't require medical treatment, other forms of the disease can be severe and need prompt medical intervention. Statistics indicate that over 3 million people in the United States are diagnosed with pneumonia each year, and many of them require hospitalization. When pneumonia is caused by infectious agents, the disease is very contagious and it can be easily transmitted through sneezing, cough or physical contact. Therefore, many patients are not hospitalized for the seriousness of their disease, but to prevent them from spreading pneumonia to other people.

There are many forms of pneumonia and some are not caused by infection with microorganisms. Aspiration pneumonia is common in very small children and elderly people, but it can also occur in adults. This form of pneumonia is caused by inhalation of foreign matters: fluids, dust, chemicals or other irritants. This condition is mostly common in small children due to inhalation of vomit or food. Aspiration pneumonia symptoms are usually not very intense and they ameliorate within a few days. Aspiration pneumonia symptoms are: dry cough, chest soreness and pain, wheezing, difficult breathing. Although medical treatment is not required for overcoming this form of pneumonia, it is best to see a doctor as soon as you spot its symptoms.

Infectious forms of pneumonia can be either caused by viruses, bacteria and mycoplasmas. Viral and mycoplasma pneumonia are usually milder than bacterial forms of the disease and they rarely require medical treatment.

Viral pneumonia is very common in children, teenagers and elderly people and it can be mistaken for flu or cold. Viral pneumonia symptoms are: throat inflammation, cough, swelling of the lymph nodes, chest discomfort when breathing, headache and a generalized state of fatigue. The cough can sometimes produce small amounts of mucus. Mild fever and chills may accompany viral pneumonia symptoms in the early stages of the disease. Viral pneumonia symptoms usually ameliorate within a few days and the infection completely clears up on itself in a few weeks.

Bacterial pneumonia can be severe and therefore, it can produce more intense symptoms. Bacterial forms of pneumonia are more common in adults and people with weak immune system. Bacterial pneumonia symptoms are: high fever, excessive sweating, mucus-producing cough, shortness of breath, chest pain and soreness when breathing, abdominal pain, nausea, muscle pain, pronounced body weakness. Bacterial pneumonia symptoms can also include cyanosis (due to lack of blood oxygenation) and brown-colored mucus producing cough. If the disease is severe, the cough may contain traces of blood.

Mycoplasma pneumonia can be developed by anyone, regardless of health condition and age. However, this form of pneumonia is usually mild and doesn't require any medical treatment. Mycoplasma pneumonia symptoms are: mucus producing cough, chest pain, difficulty breathing, headache, fatigue. Other mycoplasma pneumonia symptoms are: moderate fever, chills, abdominal pain and discomfort, nausea and vomiting. This form of pneumonia develops slowly and its symptoms may only be perceived after several weeks from catching the disease. Although mycoplasma pneumonia is not considered to be serious, it is advised to see a doctor as soon as you spot its first symptoms.

About the Author
Read about viral throat infection and at the Throat Problemswebsite.

Fluoroquinolones Pneumonia Treatment Overview

In cases shown by people older than 18, the treatment for pneumonia may be done with fluoroquinolones, also known as quinolones, medicines that prevent bacteria from reproducing.

Generally, all types of antibiotics have an increased rate of curing pneumonia. Those rates range from 73 to 96 percents for people treated in hospitals and above 90 percents for people treated outside hospitals.

Fluoroquinolones were proved to be very effective.

* Many types of bacteria may be exterminated with one type of fluoroquinolones.
* Fluoroquinolones have various effects depending on the bacteria type. As an example, while ciprofloxacin may not have the desired effect against some types of Streptococcus pneumoniae, levofloxacin may work better.
* Some bacteria that are resistant to penicillin and erythromycin may be exterminated by fluoroquinolones.

Fluoroquinolones may show side effects like:

* Headache.
* Dizziness.
* Nausea.
* Vomiting.
* Rash.
* Taste of metal in the mouth.
* Phototoxic reaction (increased sensitivity to the sun).

Sunburns are easier to encounter while taking fluoroquinolones so it is recommended to avoid direct sunlight or tan salons when a fluoroquinolones treatment is followed or for five days after it was completed.

* Phototoxic reactions are not fully avoided with sunscreens because most of them don't absorb enough of the ultraviolet rays.
* Covering as much as possible of the body surface is recommended in those cases when exposure to sunlight can't be avoided.

People over the age of 18 got the approval to use fluoroquinolones but there are yet some categories of persons that are recommended not to use them because their effectiveness and safety is not clear:

* Pregnant women.
* Women who are breastfeeding.
* Persons aging less than 18. For children under the age of 8, fluoroquinolones are not recommended unless prescribed by a specialist because they can harm the cartilages.

A lower dose of these medications may be prescribed by the doctor in case the patient suffers from kidney conditions, in order to minimize the side effects.

When a person starts a fluoroquinolones treatment, prior treatments containing the blood thinning medicine warfarin (Coumadin) will be reduced in dosage.

It may be easier to remember taking the prescribed medicines in the case of levofloxacin, moxifloxacin, and gatifloxacin because they are taken only once a day.

The levofloxacin, moxifloxacin, and gatifloxacin treatments are usually not the first choice of doctors even if they are highly efficient. This is due to the concern that overusing of fluoroquinolones may decrease their effectiveness against the bacteria.

Risk for patients contracting pneumonia increases threefold when treated with pantoprazole

According to researchers at Wake Forest University School of Medicine, a popular stomach-acid reducer used to prevent stress ulcers in critically ill patients needing breathing machine support increases the risk of those patients contracting pneumonia threefold.

Hospital-acquired pneumonia is the leading cause of infection-related deaths in critically ill patients. It increases hospital stays by an average of seven to nine days, cost of care, and the risk of other complications.

"As best we can tell, patients who develop hospital-acquired pneumonia or ventilator-acquired pneumonia have about a 20 to 30 percent chance of dying from that pneumonia," said senior study author David L. Bowton, M.D., professor and head of the Section on Critical Care in the Department of Anesthesiology. "It's a significant event."

The study, published in a recent issue of CHEST, compared treatment with two drugs that decrease stomach acid: ranitidine, marketed under the name ZantacTM, and pantoprazole, marketed under the name ProtonixTM or PrilosecTM.

Both drugs decrease stomach acid, but the newer pantoprazole is considered more powerful and has become the drug of choice in many hospitals.

However, in the analysis of 834 patient charts, the researchers found that hospitalized cardiothoracic surgery patients treated with pantoprazole were three times more likely to develop pneumonia.

"We conducted this study, in part, because we thought we were seeing more pneumonias than we were used to having," said study co-author Marc G. Reichert, Pharm.D., pharmacy coordinator for surgery at Wake Forest University Baptist Medical Center.

Both acid-reducing drugs can make the stomach a more hospitable place for bacteria to colonize. Patients on breathing machines sometimes develop pneumonia when stomach secretions reflux into the lungs.

Current treatment guidelines to prevent pneumonia recommend raising the head of the bed for patients on breathing machines, which reduces the risk of stomach secretions getting into the lungs.

But the study's findings suggest some other steps could keep critically ill patients from developing ventilator-associated pneumonia.

Doctors should consider whether an acid reducer is needed at all, Bowton said. The occurrence of stress ulcer bleeding has gone down in recent years, perhaps because patients with breathing tubes are fed earlier, and food in the stomach may neutralize or reduce the effects of stomach acid.

Bowton added that in cases where an acid reducer is needed, ranitidine is recommended, given the apparent decreased risk in developing pneumonia.

Doctors should stop using the drug as soon as the risk of bleeding passes - once the patient is off the breathing machine and eating, either on his/her own or through a feeding tube.

Prevention and treatment of pneumonia are critical to reducing child

New World Health Organization data to be published in this week's edition of the Lancet will shed new light on two leading causes of pneumonia, the world's leading killer of children under age 5, both globally and within specific countries. The results, which are the first ever available at the country level, are expected to serve as a clarion call to developing country governments to invest in pneumonia prevention programs.

According to the studies, Streptococcus pneumoniae and Haemophilus influenzae type b [Hib] infections take the lives of an estimated 1.2 million children under age 5 each year. Safe and effective vaccines exist to provide protection against both diseases. However, use of Hib vaccine has only recently expanded to low-income countries and pneumococcal vaccine is not yet included in national immunization programs in the developing world, where children bear the highest risk for pneumonia and where most pneumonia-related child deaths occur.

Streptococcus pneumoniae (Pneumococcal Disease)

Data from the study show that in 2000, there were an estimated 14.5 million cases of pneumococcal disease worldwide, and 826,000 children under 5 years of age died of the disease. Of the 14.5 million pneumococcal cases, 95% were attributable to pneumonia. While the majority of pneumococcal cases (51%) were found in Asia due to the high population, an estimated 54% of pneumococcal deaths occurred in Africa, where the lack of vaccines, a high prevalence of HIV infection and lack of access to medical care contributed to the death toll.

The ten countries with the greatest number and greatest proportion of global pneumococcal cases were in Asia and Africa, and taken together account for 66% of cases worldwide. These countries include India (27%), China (12%), Nigeria (5%), Pakistan (5%), Bangladesh (4%), Indonesia (3%), Ethiopia (3%), Democratic Republic of the Congo (3%), Kenya (2%) and the Philippines (2%).

"In areas of the world where access to quality care is limited, the use of pneumococcal vaccine is particularly necessary to limit disease and save lives," said Thomas Cherian, Coordinator of the WHO Expanded Programme on Immunization. "Implementing pneumococcal vaccine is critical if developing countries are to achieve United Nations Millennium Development Goal 4 for child mortality reduction."

In 2000, only the USA had initiated routine use of pneumococcal vaccine. By August 2008, this expanded to include 24 high and two upper-middle income countries but did not include any from Africa or Asia, the regions with the highest numbers of pneumococcal deaths and cases. According to the study, these 26 countries accounted for less than 0.2% of global childhood pneumococcal deaths in 2000 and the children in these countries, on average, had a 40-fold lower risk of pneumococcal death than the children in countries not yet using the vaccine.

Through the GAVI Alliance (www.gavialliance.com), low income countries can access existing and future pneumococcal vaccines with only a small self-financed contribution of as little as US $0.15 per dose. By February 2009, 11 countries had received GAVI Alliance approval for support to introduce pneumococcal conjugate vaccine (PCV), including 8 in Africa and Asia. Two of these, Rwanda and the Gambia, have now initiated the use of PCV in their routine infant immunization schedules.

"If fully rolled out in GAVI-eligible countries, the pneumococcal vaccine could save the lives of more than 440,000 children by 2015," said Dr. Julian Lob-Levyt, CEO of the GAVI Alliance. "We encourage all developing countries to apply for this support as an important first step to saving children's lives."

Haemophilus influenzae type b (Hib)

Findings from the Hib study indicate that in 2000, Hib caused approximately 8.1 million serious illnesses worldwide and caused 371,000 child deaths. As with pneumococcal disease, the greatest burden of Hib disease lies in Asia and Africa. The ten countries with the highest estimated number of Hib deaths in 2000 include India (72,000), Nigeria (34,000), Ethiopia (24,000), Democratic Republic of the Congo (22,000), China (19,000), Afghanistan (14,000), Pakistan (13,000), Bangladesh (12,000), Angola (9,000) and Niger (8,000).

Highly effective and safe protein-polysaccharide conjugate Hib vaccines have been available for almost 20 years. These vaccines have virtually eliminated serious Hib disease in the developed and developing countries in which they are in routine use. Widespread use of Hib vaccines was found to have a significant impact on the burden of Hib disease in the United States and Europe. The study indicates that among children born in 2000, approximately 338,000 Hib cases and 12,500 Hib deaths were averted by Hib vaccination.

The World Health Organization and the GAVI Alliance, which is supporting the Hib Initiative, have been working to expand supplies of Hib vaccine, reduce vaccine cost and assist countries with vaccine introduction. There is substantial regional variability in vaccine use, and the study suggests that expanded use of Hib vaccines could have considerable benefit in reducing child mortality worldwide.

"These estimates provide the missing link for country policy makers seeking justification for investments in lifesaving vaccines," said Anne Schuchat, Director of the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention

Pneumonia Types That Require Hospitalization

The infection and inflammation of the lungs caused by bacteria or viruses is a condition called pneumonia and it is a common type of pulmonary disease. This condition triggers an overproduction of mucus in the respiratory tract. The symptoms shown by this condition vary greatly depending on many factors like the age of the infected person, the ability to fight the infection of the immune system, the overall health or the causes of the infection. People that have a strong immune system are less likely to encounter pneumonia but people that have certain predisposition to respiratory infections or have an impaired immune system are at higher risk of developing pneumonia and complications caused by this disease. Because of this, we can say that old people are at higher risk of developing pneumonia and complications than other adults.

Nowadays, most cases of pneumonia are hospitalized because without a proper care and close monitoring, the condition may aggravate. There are however, many mild cases that don't require hospitalization, which are treated at home. The milder forms of pneumonia are also not as contagious as the severe forms, so it is possible for them not to infect other people. Because of this, some persons receive treatments to follow at home. Some of the cases, like walking pneumonia, don't even require bed resting, so people can continue with their daily activities while following a prescription.

In the close past, doctors have begun reconsidering the unnecessary hospitalizations of those patients because of the high costs and overcrowding. It has been considered for elderly people to avoid hospitalization in case of pneumonia. It was shown in recent studies that old people who live in nursing homes can receive medical treatment for pneumonia in the nursing home and hospitalization is not required anymore. They already benefit the medical care and surveillance. For those reasons put together, the nursing homes residents are considered not to be in need of hospitalization in the mild and uncomplicated forms of pneumonia.

This process will be benefic for both the patients and doctors. Also, the costs can be reduced with up to 1500 dollars for every patient.

A group of Canadian researchers started a study involving the collaboration of 20 nursing homes, to establish the necessity of hospitalization in case of pneumonia for the nursing homes residents. Half of the nursing homes were asked to follow their own rules for medical care and surveillance and the other half was asked to apply a new set of procedures and guidelines in case of patients with pneumonia. When the two groups were confronted with pneumonia cases, they followed the directions and the usual care group has sent the patients to the hospital while the exponential group kept them inside the nursing center.

The exponential group of nursing homes was asked to offer treatment inside the facilities for the residents suffering from pneumonia with stable conditions. Those residents that presented complications or aggravations were sent to hospital. In the referential group of nursing homes, there were 327 cases of pneumonia while the usual group encountered 353 cases. During the study, 10, respectively 22 percents of the cases of pneumonia required hospitalization. The researchers concluded that the residents of the nursing home from both groups had similar responses to the treatment regardless of the medical regimen. The mild cases of pneumonia can thus be treated inside the nursing home, avoiding the unnecessary hospitalizations.

The medical costs can be greatly reduced by the generalization of the appliance of the guidelines set by the Canadian researchers in the matter of unnecessary hospitalization of the pneumonia cases encountered among the nursing home residents. Each year, 70 millions dollars could be spared in Canada and 800 millions dollars in America if the unnecessary hospitalizations would be avoided.