KUALA LUMPUR, Nov 4 — Once considered uncommon in Malaysia, pneumonia is now the biggest killer in the country.

Chief Statistician Datuk Seri Mohd Uzir Mahidin recently reported that pneumonia accounted for 18,181 cases or 15.2 per cent of the 119,952 medically certified deaths reported in the "Statistics on Causes of Death, Malaysia 2024”. In 2000, it was responsible for less than 5 per cent of recorded deaths.

This is the first time pneumonia has overtaken ischaemic heart disease in over two decades, excluding 2021 when Covid-19 was the primary cause.

The report said the post-pandemic landscape has seen increased vulnerabilities in populations with respiratory infections potentially leading to pneumonia, especially among those with weakened immune systems or pre-existing medical conditions.

What is pneumonia?

Pneumonia is an acute respiratory infection that affects the lungs’ alveoli, the tiny air sacs responsible for breathing.

When these air sacs become inflamed or filled with fluid, oxygen intake becomes difficult, leading to breathing difficulties.

Although pneumonia can affect anyone, it poses a significant threat to infants, older adults, and individuals with chronic illnesses, such as diabetes, heart disease, or conditions that weaken the immune system.

What are the leading causes of pneumonia?

Pneumonia can be caused by various pathogens, including bacteria, viruses, and fungi.

The most common type in adults is bacterial pneumonia.

Viral pneumonia, often from influenza or respiratory viruses, primarily affects children and immunocompromised individuals.

Fungal pneumonia is less prevalent and typically occurs in those with severely weakened immune systems, such as individuals undergoing chemotherapy for cancer or those with HIV/AIDS.

Contributory risk factors include smoking, prior respiratory infections, pollution, and chronic conditions like chronic obstructive pulmonary disease or asthma.

Why is pneumonia potentially deadly?

The severity of pneumonia arises from its capacity to cause widespread inflammation and fluid accumulation in the lungs, leading to severe complications like sepsis — a life-threatening body response to infection — or acute respiratory distress syndrome.

These complications are hazardous for vulnerable groups, including the elderly and those with chronic health issues, as they can precipitate rapid health deterioration without timely medical intervention.

Rising antibiotic resistance also poses a challenge, complicating treatment efforts and increasing mortality risks.

This resistance stems from the over-prescription of antibiotics, and is now a significant public health concern as bacteria evolve to become resistant to the antibiotics that were once effective in treating infections caused by these bacteria.

This resistance makes infections harder to treat, leading to prolonged illnesses, increased healthcare costs, and a higher risk of mortality.

What are the symptoms of pneumonia?

Pneumonia presents with a range of symptoms that can vary in intensity.

Common indicators include a persistent, productive cough often with green or yellow mucus, high fever accompanied by chills, shortness of breath during routine activities, and sharp chest pain that worsens with deep breaths or coughing.

Other symptoms might include excessive fatigue, nausea, vomiting, diarrhoea, confusion particularly in older adults, and reduced levels of oxygen in the blood detectable by cyanosis — bluish colouration of lips or nail beds.

Chronic coughs — over two weeks for the elderly, and four weeks for children — also merit a doctor’s visit to rule out pneumonia.

How is pneumonia treated?

Treatment of pneumonia hinges on its severity.

Bacterial pneumonia is typically treated with antibiotics, the choice of which depends on the strain involved.

Viral pneumonia may resolve on its own with supportive care, but antiviral medications can be employed if the doctor prescribes them.

For those with fungal pneumonia, antifungal medications are prescribed. In all cases, adequate rest, hydration, and observing symptomatic relief measures are crucial.

Oxygen therapy and hospitalisation might be required for severe pneumonia or when complications arise.

It is vital to seek medical attention early if symptoms escalate or fail to improve with initial outpatient care, particularly if there is persistent difficulty breathing, high fever that doesn’t subside with medication or severe cough producing significant amounts of mucus.

Early intervention can significantly reduce complications and improve recovery outcomes, highlighting the importance of timely and appropriate medical care.