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A Look at Pneumonia: Q&A; with Dr. A.K. Misra

Recently, Democratic presidential nominee Hillary Clinton came down with pneumonia while on the campaign trail, resulting in a brief hospitalization. Here we learn more from Dr. A.K. Misra, Board Certified in Internal Medicine (and Sports Medicine) about this condition, which results in about 4 million deaths worldwide each year.

Q: What is pneumonia? What could have caused Mrs. Clinton to get it?

A: Pneumonia is an infection of the lung, usually caused by a virus or bacteria. However, certain regions of our country do see fungal pneumonic infections as well.

A weakened immune system is a significant risk factor in getting pneumonia. Perhaps the stress of the campaign trail led to Clinton’s immune system dipping below a suitable threshold to defend her, resulting in pneumonia.

Many of the organisms thought to cause pneumonia are actually already present in our airways (such as Streptococcus pneumoniae, more commonly known as pneumococcus). This is why patients who are immune-compromised in any way (i.e. HIV/AIDS patients) are more susceptible to contracting pneumonia.

Lung-specific issues such as Chronic Obstructive Pulmonary Disease (COPD) or cystic fibrosis can cause pneumonia, as well as conditions that directly affect lung function (for example, heart failure and stroke can make one more prone to pneumonia). Other things, like being a smoker, also significantly increase the likelihood of coming down with pneumonia.

Q: Is pneumonia contagious? How worried should we be when around someone with pneumonia?

A: Almost any infection can be contagious, however some infections are more so than others. Whether or not Clinton’s pneumonia is, or was, contagious was a focal point of some controversy in the media per the statement of her Internist, Dr. Lisa R. Bardack, about it being bacterial but not contagious.

Although pneumococcus is the most common organism identified, it is only identified about 50% of the time in what is termed “community acquired pneumonia” (meaning pneumonia that is contracted through being out in public as part of daily life). If the infection is a result of one’s own normal respiratory bacteria and they are rapidly treated with the correct antimicrobials, they are less likely to be contagious.

Certain atypical bacterial organisms can be more contagious; however, once redressed with the correct care plan, the level of contagion sharply declines. When pneumonia is actually spread from one person to the next, it occurs via droplets released from the upper respiratory tract when someone coughs or sneezes, usually when they are acutely ill and haven’t received medical care. This tends to happen more frequently during the change of season from summer to autumn.

Q: Can pneumonia be prevented?

A: There is a vaccine for cases of pneumonia caused by bacteria (pneumococcus) called Pneumovax. It is approved for children under the age of 2 and adults over the age of 50 who are at increased risk for pneumonia. The vaccine is recommended for all adults over age 65, as pneumonia is often lethal in that age group due to comorbidities (two diseases or conditions occurring at the same time) seen in the geriatric population.

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