Underestimated danger of pneumonia

35,000 deaths annually from pneumonia

02/19/2014

In Germany, around 680,000 people suffer from pneumonia every year. Approximately 35,000 patients die every year, according to estimates. Often, the infectious disease is not properly diagnosed or mistreated.

Pneumonia is an underrated disease
As a rule, the consternation of fellow human beings is usually great when someone suffers a heart attack. In contrast, hardly anyone reacts to pneumonia, as Tobias Welte of the Hannover Medical School (MHH) according to a report of „world“ said. „Pneumonia is an underrated condition“, so the doctor. According to his estimates, around 35,000 people in Germany die each year from pneumonia contracted outside a hospital. There is no exact statistics about pneumonia as a cause of death. However, the pulmonologist described the Federal Statistical Office's data on the total of just under 19,500 deaths from pneumonia and influenza for the last year, 2011, as far too low.

Contagion pathways at home and in hospitals differ
The Deputy Director of the Department of Pulmonology at the University Hospital Schleswig-Holstein, Klaus Dalhoff, agrees. He goes even further and says that the numbers of the world are too conservative. In his opinion, these could be even higher, especially if one includes the pneumonia patients have contracted in a hospital. The two routes of infection, at home or in a hospital, differ fundamentally in the nature of their pathogens. Pneumococcal bacteria are responsible for outpatient pneumonia. With such an infection, treatment with antibiotics is usually unproblematic. However, this is different in hospital pneumonia, which is often caused by bacteria such as enterococci or staphylococci. Since these bacteria are resistant to numerous antibiotics, such an infection is particularly dangerous.

Frequent infections in intensive care units
Since patients in intensive care units are weakened by their illness and their organism can only defend itself badly against pathogens, it often comes to infections with multidrug-resistant pathogens. In addition, the risk of infection increases drastically through some treatment measures such as mechanical ventilation via a tube in the trachea, because it can pathogens from revenge and nose migrate to the lungs. This is because the cough reflex in anesthetized patients does not work properly and the tube does not completely seal the trachea.

Situation in Greece especially bad
According to press reports, around 680,000 people a year contract pneumonia in Germany. The mortality rate of the 230,000 patients who need hospitalization is around ten percent. „Resistance and antibiotic consumption are related“, so worlds. The more antibiotics are used, the more bacteria develop immunity to the different types of the drug. In the development of such resistant types Germany keeps in the European midfield. On the other hand, the situation is in Eastern Europe and the southern European countries „dramatically bad.“ The situation in Greece since the economic crisis classifies the physician as particularly bad. He complains that there antibiotics are not used properly. For example, multi-day therapies are often started but not completed. In addition, antibiotics are all too often unfounded. Both can make bacteria resistant to these agents.

One of the deadliest diseases worldwide
According to the World Health Organization (WHO), the poor treatment of pneumonia is a problem especially in African and Asian countries. Every year, around 1.1 million children worldwide die of pneumonia before the age of five. Thus, pneumonia is one of the deadliest diseases worldwide. The multiply resistant pathogens that arise in other parts of the world are also a problem for Germany because the dangerous bacteria are also brought here by travelers. However, Dalhoff believes that even simple pneumonia by general practitioners is not always recognized correctly. He is responsible for the often impractical training of medical students. Although they would learn the theoretical basics in their education, the students would have to have seen a pneumonia a few times for a correct diagnosis. This is not always the case.

Diagnosis more complicated in older patients
Dalhoff points out that it is also quite difficult to distinguish pneumonia from the many simple viral infections. In pneumonia, the lung tissue is acute or chronically inflamed, which is caused in most cases by an infection with bacteria, more rarely by viruses, fungi, pollutants, allergic diseases or radiation exposure. The question: How do I recognize pneumonia? is especially difficult in older patients. While in younger people affected symptoms with fever, chills and respiratory problems usually clear, are missing in seniors often single symptoms. Due to the generally higher frailty of the elderly, signs are sometimes not interpreted correctly. Nevertheless, according to Dalhoff, it is important not to use antibiotics on mere suspicion. Otherwise, the development of resistance can not be contained.

The policy is required
In order to deal with the resistant bacteria types in the future, it is necessary to develop new effective antibiotics. But this is not really lucrative for the pharmaceutical industry, as it can earn much more money with antibiotics than with antibiotics. „Here is the policy required“, Dalhoff For example, a co-financing of the development of such drugs by the state would be conceivable. Also the pulmonologist Welte sees new antibiotics as central to „not to lose the fight against fast-moving pathogens.“ (Sb)