Growing older makes us more susceptible to respiratory infections. What used to be easily cleared by our bodies can now pose a serious danger, even for someone as prominent as the Pope. At 88, Pope Francis is currently hospitalized with pneumonia affecting both lungs, a condition more common among the elderly. The pneumonia developed after he contracted bronchitis and a polymicrobial infection.
Dr. David Strain, an expert in viral infections from the University of Exeter Medical School, explains that bronchitis was likely triggered by a common virus, causing inflammation in the blood vessel linings. A polymicrobial infection occurs when the usual bugs in the respiratory tract start to replicate excessively, leading to one dominant bug triggering an inflammatory response that results in pneumonia.
Understanding the differences and recognizing the symptoms of flu, bronchitis, and pneumonia is crucial:
– Flu typically starts with a sudden fever, body aches, and fatigue.
– Bronchitis manifests as a hacking cough with mucus production.
– Pneumonia causes breathing difficulties, chest pain, and high temperature.
In older individuals, the progression of symptoms from flu to bronchitis and then pneumonia can vary based on their overall health and biological age. Dr. Strain notes that seniors who are aware of their illness are in a better state than those who are extremely unwell but unaware due to their body focusing solely on fighting the infection.
Flu is highly contagious and spreads through the air or by touching contaminated surfaces and then the face. While a healthy individual can typically recover within days, the same viruses can cause severe illness in older adults by damaging the protective lining of their airways.
It is essential for seniors to be vigilant, seek medical attention when necessary, and take preventive measures to safeguard their respiratory health.
“It’s not necessarily the same virus, but rather the amount of protective layer and reserve available,” he explains. “A young, healthy individual may only need to use 10% of their reserve to combat the flu virus, while an older adult might require 100%. The body expends all its resources fighting the virus, leaving nothing for the next threat.”
What is bronchitis?
“Bronchitis refers to inflammation and irritation of the airway linings,” Dr. Strain explains. “Bronchus denotes the airways – the tube that carries air from the windpipe to the lungs – and ‘itis’ signifies inflammation.” It is the body’s response to the flu but can also be triggered by other respiratory viruses.
“If a young, healthy person develops bronchitis, the protective lining in their respiratory tract will heal quickly,” Dr. Strain notes. “However, for older adults, the healing process is much slower, rendering them susceptible to bacterial infections that can lead to pneumonia.”
What is pneumonia?
Pneumonia is the inflammation of the lungs, typically caused by an infection. When the body detects inflammation, such as in bronchitis, and the presence of bacteria, the immune system releases white blood cells (leukocytes) to combat infection and inflammation. “However, these cells can accumulate in the alveoli, tiny air sacs in the lungs responsible for gas exchange, hindering proper breathing,” he adds.
In England, emergency admissions for pneumonia vary from 130,000 to 270,000 annually, with a fatality rate of 5-14% among hospitalized cases. “Most individuals succumbing to pneumonia are in the final two years of life,” Dr. Strain points out. For those with multiple health issues, pneumonia is often the tipping point, he emphasizes. In 2023, flu and pneumonia accounted for over 24,000 deaths, constituting 4.2% of all deaths in England and Wales.
Home treatment:
Influenza infections manifest as flu-like symptoms such as high fever, body aches, and fatigue. At this stage, Dr. Strain recommends using paracetamol and staying hydrated to alleviate symptoms. Antibiotics are ineffective against the flu. “Lowering a fever with paracetamol helps the body recover faster as fevers consume additional energy,” he explains.
Bronchitis typically resolves within weeks through rest, fluids, and paracetamol. Hospitalization is unnecessary if the individual can stay hydrated and alert. Pneumonia patients are usually prescribed antibiotics and recover at home within two to four weeks, but older or high-risk individuals may require hospitalization.
When to seek medical attention:
“If a person’s behavior changes – exhibiting erratic, hyper-emotional, or withdrawn tendencies – it’s crucial to seek medical attention,” Dr. Strain advises. “Even during the viral stage of the flu, assessing for bacterial
The occurrence of infections is typically determined through a rapid blood test. Should the infection be viral in nature, the patient will receive fluids and paracetamol, in a manner similar to home care. Conversely, if there are indicators of a bacterial infection, the treatment involves administering potent antibiotics for a period of 24 to 48 hours, as advised by Dr. Strain. “Taking swift action in addressing the infection is highly advantageous for the well-being of the patients,” he emphasizes.
To prevent the onset of influenza, bronchitis, and pneumonia, the crucial initial step is to avoid contracting any respiratory infections. While it may not always be possible to evade infections, practical measures such as staying away from individuals with viral illnesses – including advising family members to postpone visits if they exhibit symptoms like a cough and cold – can be highly effective, according to Dr. Strain. Additionally, receiving the flu vaccine increases the likelihood of experiencing a milder form of the infection.
Dr. Strain also highlights the significance of maintaining physical activity to prevent frailty. “Frailty, which can impede the body’s ability to combat infections effectively, is a factor that often leads to hospitalization,” he points out. Engaging in simple activities like a brief daily walk to collect the newspaper, or even going outdoors a few times each week, has been shown to significantly enhance the immune system, notes Dr. Strain. Individuals who stay physically active may still experience discomfort when affected by a respiratory infection, but they tend to recover swiftly.
In contrast, individuals who are frail may face a prolonged recovery period following pneumonia. “Rebuilding strength to pre-illness levels can take several months, and it’s crucial for caregivers to understand that their loved ones may not regain their previous level of physical vigor immediately upon discharge from the hospital,” Dr. Strain cautions. Ultimately, the aim is not to prolong life indefinitely, but rather to support individuals in maintaining optimal health until the end. Notably, pneumonia often emerges as a significant health challenge for those with underlying health issues.
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