On account of World Pneumonia Day (November 12), Indian Academy of Pediatrics (IAP) – Mumbai chapter highlighted how Pneumonia continues to be the leading cause of morbidity and mortality among children below 5 years. Dr. Uday Pai, Past –President – IAP Mumbai 2014-15 said, “There has been a 2-5% increase in respiratory diseases including Pneumonia among children below 5 years in Mumbai in the past year. The top risk factors for pneumococcal disease in children are Malnutrition, Immuno-deficiency and Anemia. Hospitalization and Intensive care due to Invasive Pneumonia can be an economic burden for families and therefore immunization with Pneumococcal Conjugate Vaccine (PCV) is a safe and cost-effective preventive measure.”
WHO Guidelines to decrease Pneumonia Burden5
- Proper complimentary feeding with Zinc, vitamin A
- Prevent with vaccines such as PCV, Hib, Pertussis, measles
- Prevent indoor and outdoor pollution
- Avoid overcrowding
- Hand hygiene
- Treatment with antibiotics, oxygen, oral zinc
Pneumonia is a lung inflammation caused by bacteria, viruses, fungi or parasites. Bacterial Pneumonia called as Pneumococcal disease is more severe compared to other Pneumonia as it leads to medical complications such as Meningitis (brain infection), acute otitis media (ear infection), empyma and even death. Symptoms of Pneumonia include dry cough, chest pain, fever, chills, difficulty in breathing, nausea, fatigue and quick heart rate. In case any of these symptoms are observed, it is advisable to visit a Doctor and undergo a Chest X-ray for diagnosis.
India is one of the five countries contributing to 44% of the world’s pneumonia cases2. The government and medical community are taking strong steps towards reducing the Pneumonia burden in India3. However, pneumonia continues to be a common cause of morbidity and mortality among children below 5 years in India4.
The WHO recommends inclusion of Pneumococcal Conjugate Vaccine (PCV) in the national immunization programs as a priority in countries such as India5. Inclusion of PCV in National Immunization Programme has the potential to save 7–8 million cases and 0.3–0.5 million deaths due to Pneumonia world over6. Though both PCV10 and PCV13 are recommended Need for Pediatric Pneumococcal Disease Surveillance1:
- Monitor national and local disease trends and seasonality
- Monitor impact of vaccines
- Track emerging strains and serotypes
- Track antibiotic drug resistance
- Reduce unnecessary use of antimicrobials
- Development of future vaccines
- Research and policy development
- Awareness among clinicians and general public
by the IAP, a recent study from CMC Vellore in children below 5 years concluded that PCV13 shows 74.6% serotype coverage versus 64% for PCV10 in Indian context7.
Stating Precautionary measures for Pneumonia, Dr. Uday Pai, Past – President – IAP Mumbai 2014-15 said, “Exclusive breastfeeding in the first 6 months with balanced complimentary feeding is important to prevent deficiency. Vaccination is important for prevention against Pneumococcal Disease by serotypes in children below 5 years old. Vaccination is also recommended for premature children as well as infants of mothers who were suffering from pre-eclampsia, hypertension, gestational diabetes, malnutrition and tuberculosis during pregnancy. There is also a need for national pneumococcal disease surveillance for R&D and development of policies that will help alleviate burden of pediatric pneumonia in the country.”