The death of actor Sam Neill from pneumonia, a lung infection that kills approximately 25,000 people annually in Britain and 42,000 in the U.S., has brought renewed attention to the disease's potentially subtle nature.
Pneumonia is an infection of the deep parts of the lungs where the exchange of oxygen and carbon dioxide occurs. It can be caused by viruses, such as influenza, RSV, and COVID-19, or bacteria. Bacterial pneumonia is often more severe and can have a high mortality rate if left untreated. In rarer instances, pneumonia can result from aspiration, where food, drink, or vomit enters the lungs instead of air.
While often associated with the elderly, experts emphasize that pneumonia can affect individuals of any age. It is a leading cause of death in children under five globally, particularly in low-income countries. Vulnerable populations, including those with weakened immune systems due to cancer treatment, the very young, and the elderly, are at higher risk of contracting pneumonia and experiencing severe outcomes. However, even healthy individuals can develop life-threatening pneumonia.
One of the most concerning aspects of the illness is "silent pneumonia," also known as "walking pneumonia." This form can present with mild symptoms, allowing individuals to continue their daily activities, including work and exercise, with little more than a persistent cough. Experts advise seeking medical attention if cough or cold symptoms last longer than three weeks. While many healthy individuals may clear this type of pneumonia without treatment, those with pre-existing respiratory conditions like asthma may face prolonged inflammation and an increased risk of long-term lung damage. Furthermore, individuals with silent pneumonia may unknowingly spread the infection to others.
More overt symptoms of pneumonia can include a cough producing mucus, shortness of breath, fever, chest pain, body aches, fatigue, loss of appetite, and wheezing. In infants, grunting noises during breathing can be an indicator, while confusion may occur in older adults. Measuring blood oxygen levels with a pulse oximeter can provide an indication of the illness; readings at or below 92% warrant medical attention.
Treatment for pneumonia typically involves antibiotics for bacterial infections, fluids, and sometimes oxygen if breathing is compromised. Hospitalization carries a mortality rate of roughly 15% within a month of admission, which increases to about 30% for those admitted to intensive care. Actors Val Kilmer and Diane Keaton have also been among the notable figures whose deaths were attributed to pneumonia in recent years.
Preventative measures include staying up-to-date with vaccinations for pneumococcal disease, influenza, RSV, and COVID-19. Smoking cessation can also significantly reduce the risk of developing pneumonia.