Pneumonia: 150,000 hospitalisations and 9,000 deaths every year, here are the alarm bells to recognise it

With the arrival of the first cold weather, the respiratory tract is put to the test. Low temperatures can in fact compromise the body's immune response and defence mechanisms. One of the main enemies to fear is pneumonia, which causes 150 thousand hospitalisations and 9 thousand deaths in Italy every year. It is the disease of infectious origin that causes the most deaths, as emerges from data published on World Pneumonia Day, which is celebrated on 12 November and promoted by the World Health Organisation (WHO) and UNICEF with the aim of raising public and institutional awareness of the serious impact it has on health, its correct and early diagnostic diagnosis, treatment and prevention, particularly through vaccines.

Pneumonia, particularly interstitial pneumonia, i.e. pneumonia causing inflammation of lung tissue, made headlines during the Covid-19 pandemic and, more recently, because it caused the death of the late Beppe Vessicchio and the hospitalisation of the Bologna coach Vincenzo Italiano. It is a disease that can also manifest itself in serious forms and lead to serious complications and consequences. As experts recommend, if you suspect the disease, you should immediately contact your doctor and avoid DIY, perhaps taking antibiotics without a specific prescription.

Pneumonia is an inflammation of the lung tissue that can be caused mainly by certain bacteria and viruses and, more rarely, by certain fungi and affects in most cases the elderly, children under five and immunocompromised persons. A diagnosis of pneumonia is a cause for concern at any age. "It has always been a cause of hospitalisation and, unfortunately, also a cause of death. Currently, we do not see much change in the numbers, the epidemiology is stable. And as always, every year, there are serious complications that mainly affect people at risk: the elderly, children, chronic patients,' emphasises Claudio Micheletto, president of the National Association of Hospital Pulmonologists (Aipo). Mortality in Italy is one of the lowest in Europe, but we must not lower our guard. 'The most important message,' Micheletto continues, 'is to be very careful in the use of antibiotics. We have no new drugs of this type, so the advice is always to use them with caution to reduce the risks of antibiotic resistance, which is one of the great challenges for the coming years'.

Pneumonia is generally caused by a bacterium, Streptococcus pneumoniae, also known as pneumococcus. Other bacteria can also cause pneumonia, such as Haemophilus influenzae, Staphylococcus aureus and Legionella pneumophila. Another form of pneumonia is viral pneumonia, most commonly caused by the respiratory syncytial virus (RSV), especially in children under one year of age, and known as 'bronchiolitis'. Other causes of viral pneumonia are influenza type A or B viruses and coronaviruses, such as Covid. There is also fungal pneumonia, which is rare and usually affects people with a weakened immune system. Unfortunately, reminds the expert, 'only some causes of pneumonia are preventable, not all'. For example, 'there is the anti-pneumococcal vaccine available, which has been included in the Lea for some time and all people over the age of 65 are invited to get it,' Micheletto specifies. Pneumonia can be localised in a particular place in the lung. 'The most frequent pathogen,' the expert continues, 'in this case is the pneumococcus, against which there is a vaccination. Then there are interstitial pneumonias, which affect the connective tissue of the lung, the area where oxygen and carbon dioxide pass in the opposite direction, between the alveoli and the capillaries, so the infection can be widespread and even bilateral. The interstitium is the supporting tissue of the lung. When it is affected, the exchange is greatly reduced. If the patient has chronic bronchitis or is a smoker, these spaces are already compromised. And so it can give severe cases'. And, again, if the picture wasn't already complicated enough, there are the pneumonias resulting from viral infections such as influenza, which can in turn promote the onset of bacterial pneumonia.

The most common symptoms caused by pneumonia are fever, a dry or oily cough, and dyspnoea, i.e. difficulty breathing, which can give the sensation of being 'short of breath' as during physical exertion. To these may be added exhaustion and pain in the chest or back. "Pneumonia mainly presents with cough and fever, but the severity that causes hospitalisation relates to breathing difficulty, which can be highly risky," the pulmonologist specifies. First of all, it is necessary to understand whether it is a bacterial or viral form. It is possible to distinguish between the two types by performing a swab to establish antibiotic or antiviral therapy or whether it should be treated with cortisone and anti-inflammatories. The clinical picture can also be completed by the result of a chest X-ray or CT scan.