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Pneumonia Fact Sheet

April 2006

Pneumonia is an inflammation of the lung caused by infection with bacteria, viruses, and other organisms. Pneumonia is often a complication of a pre-existing condition/infection and triggered when a patient's defense system is weakened, most often by a simple viral upper respiratory tract infection or a case of influenza, especially in the elderly. Pneumonia affects the lungs in different ways. Lobar pneumonia affects a lobe of the lungs, and bronchial pneumonia can affect patches throughout both lungs. Together, pneumonia and influenza represented a cost to the U.S. economy in 2004 of $37.5 billion, $5.6 billion due to indirect mortality^I costs and $31.9 billion in direct^II costs.¹

• Pneumonia and influenza together are ranked as the seventh leading cause of death in the United States.² Pneumonia consistently accounts for the overwhelming majority of deaths between the two. In 2003, 63,241 people died of pneumonia.³
• There were an estimated 678,000 hospital discharges in males (47.7 per 10,000) and 715,000 discharges in females (48.5 per 10,000) all attributable to pneumonia in 2003. The highest pneumonia rate that year was seen in those 65 and over at 224.4 per 10,000.⁴
• Pneumonia is mainly caused by viruses, bacteria and other organisms. Pneumonia can also be caused by the inhalation of food, liquid, gases or dust. One type of pneumonia caused by fungi is pneumocystis carinii pneumonia (PCP) which primarily affects AIDS patients. Certain diseases, such as tuberculosis, can also predispose someone to pneumonia.
• Approximately 50 percent of pneumonia cases are believed to be caused by viruses and tend to result in less severe illness than bacteria-caused pneumonia. Most pneumonia in the very young is caused by viral infection, including respiratory syncytial virus (RSV). The symptoms of viral pneumonia are similar to influenza symptoms and include fever, dry cough, headache, muscle pain, weakness, fever and increasing breathlessness.
• Streptococcus pneumoniae or pneumococcal pneumonia is the most common cause of bacterial pneumonia acquired outside of hospitals. The bacteria can multiply and cause serious damage to healthy individual lungs, bloodstream (bacteremia), brain (meningitis) and other parts of the body, especially when the body's defenses are weakened. Pneumococcal pneumonia accounts for 25 to 35 percent of all community-acquired pneumonia, and an estimated 40,000 deaths yearly.⁵
• The onset of bacterial pneumonia can vary from gradual to sudden. In most severe cases, the patient may experience shaking/chills, chattering teeth, severe chest pains, sweats, cough that produces rust colored or greenish mucus, increased breathing and pulse rate, and bluish colored lips or nails due to lack of oxygen.
• Mycoplasmas are the smallest free-living agents of disease in man, with characteristics of both bacteria and viruses. The agents generally cause a mild and widespread pneumonia. The most prominent symptom of mycoplasma pneumonia is a cough that tends to come in violent attacks, but produces only sparse whitish mucus. Mycoplasmas are responsible for approximately 20 percent of all cases of pneumonia.
• People considered at high risk for pneumonia include the elderly, the very young, and those with underlying health problems, such as chronic obstructive pulmonary disease (COPD), diabetes mellitus, congestive heart failure and sickle cell anemia. Patients with diseases that impair the immune system, such as AIDS, or those undergoing cancer therapy or organ transplantation, or patients with other chronic illnesses are particularly vulnerable.
• There are no generally effective treatments for most types of viral pneumonia, which usually heal on their own. Early treatment with antibiotics can cure bacterial pneumonia and speed recovery from mycoplasma pneumonia. However, the disease has become more resistant to these drugs, making treatment of pneumococcal infections more difficult.
• A vaccine is also available for bacterial pneumonia. The pneumococcal vaccine protects against 23 types of pneumococcal bacteria populations and is effective in approximately 80 percent of healthy adults. Unfortunately, the vaccine may be less effective in people in high risk groups.⁶ People over age 65, and those over 2 years in high-risk groups are still advised to receive the pneumonia vaccine.⁷
• The pneumonia vaccine is generally given once, although revaccination after 3-5 years should be considered for children with nephritic syndrome, asplenia, or sickle cell anemia who would be less than 11 years old at revaccination. Revaccination should also be considered for high risk adults who received their first shot six years ago or more, and for those who are shown to have rapid decline in pneumococcal antibody levels.⁸
• Influenza vaccination is also recommended since pneumonia often occurs as a complication of the flu. Pneumonia and influenza vaccines are covered by Medicare, as well as some state and private health insurance.

For more information call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872), or visit our web site.

Footnotes:
I. Indirect mortality costs represent lost future earning by those who died from the given disease.
II. Personal health care expenditures allocated to diagnosis are primarily hospital care, physician and professional health services, drugs and nursing home care.

Sources:
1. Division of Epidemiology. National Heart Lung and Blood Institute. Morbidity and Mortality: 2004 Chartbook on Cardiovascular, Lung and Blood Diseases, May 2004.
2. National Center for Health Statistics. National Vital Statistics Report. Deaths: Leading Causes for Mortality 2002. Vol. 53(17), 2005.
3. National Center for Health Statistics. National Vital Statistics Report. Deaths: Leading Causes for Mortality 2003. Preliminary Data for 2003.
4. National Center for Health Statistics. National Hospital Discharge Survey. 1998-2003
5. Centers for Disease Control and Prevention. Pneumococcal Polysaccharide Vaccine. What You Need To Know. July 1997.
6. Ibid.
7. National Immunization Program. CDC. January 2006. Epidemiology and Prevention of Vaccine Preventable Diseases.
8. Centers for Disease Control and Prevention. Pneumococcal Polysaccharide Vaccine. What You Need To Know. July 1997.

*Racial and ethnic minority terminology reflects those terms used by the Centers For Disease Control.

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