Hillary Clinton’s wobbly early departure from a Sept. 11 memorial ceremony on Sunday came as she was suffering from pneumonia, according to her physician, Dr. Lisa R. Bardack.
Here’s what you need to know about pneumonia:
What is it?
Pneumonia is an infection of the lungs. That infection can be relatively mild, but it can also be severe.
In some cases it can be fatal. Just last week, obituaries for transgender performer The Lady Chablis — made famous in the book “Midnight in the Garden of Good and Evil” — noted that she died from pneumonia.
But pneumonia is most dangerous in young children and the frail elderly; fatalities are rare in healthy adults. It does take time to recover from, however. “It’s going to be very hard for [Clinton] for the next month, probably, to maintain the kind of schedule that she was planning to maintain,” said Dr. Allison McGeer, an infectious diseases expert at Mount Sinai Hospital in Toronto.
What causes it?
A variety of pathogens can cause pneumonia: bacteria, viruses, even fungi.
Pneumonia that is caused by a bacteria — something like Streptococcus pneumoniae, for instance — is treatable with antibiotics.
Bardack said Clinton was started on antibiotics on Friday, which might suggest the cause of her infection was bacterial. But physicians will often start a patient on antibiotics as a precaution, rather than waiting for test results that might take some time to come back.
We don’t know what testing was done — a chest X-ray? rapid diagnostics? — to determine that Clinton actually has pneumonia or its likely cause.
Viral infections like influenza and respiratory syncytial virus can also lead to pneumonia. But it is off-season for both of these now, according to Dr. Trish Perl, chief of infectious diseases at University of Texas Southwestern Medical Center in Dallas.
Viruses aren’t quelled by antibiotics. Rest and hydration — and medical monitoring — would be the prescription here. “Viral infections get better by themselves in healthy people. It just takes time,” McGeer said.
How do you catch it?
Pneumonia is spread just like colds and the flu. Infected people cough around other people. Or they cough on their hands, and those hands touch things. Uninfected hands may touch the same things — picking up the bugs in the process.
The Centers for Disease Control and Prevention suggests washing your hands a lot to avoid pneumonia.
But candidates for president shake a lot of hands. And there are likely long stretches between the rows of outstretched hands and the next available sink.
Why might pneumonia have made Clinton so weak?
Pneumonia impedes the ability of the lungs to take in oxygen; with low oxygen levels, a person’s energy levels can plummet. But McGeer said if Clinton had low oxygen levels, she probably would have been hospitalized.
Even without low oxygen levels, however, pneumonia can just sap your strength. Bardack noted in her statement that she had advised Clinton to “rest and modify her schedule” after diagnosing the pneumonia on Friday.
“It is surprising how much energy fever and infection take out of you,” McGeer said, noting that she is speaking from firsthand experience, having had pneumonia.
Perl said a few things probably contributed to Clinton’s incident.
“She probably wasn’t drinking. She was outside and it was hot. She had a little bit of a fever. Everything all combined and it was a perfect storm, as they say,” she said.
If Clinton has pneumonia, how has she been campaigning? Wouldn’t she be home in bed?
There is something euphemistically called “walking pneumonia.”
STAT is not suggesting that’s what Clinton has; we don’t know. But both McGeer and Perl raised that possibility. “It’s totally plausible,” Perl said.
It’s often caused by a bacterium called Mycoplasma pneumoniae. The CDC says somewhere between 2 and 20 percent of US pneumonia cases that aren’t caught in the hospital are caused by this bacterium.
It’s more common in kids and school-aged children, but can infect people at any stage in life.
McGeer said this form of pneumonia has a gradual onset that could easily be confused with seasonal allergies — which is what both Clinton and her doctor said she’s had by way of explaining recent coughing fits.