Pneumonia & women: pneumonia specialist Orin Levine, PhD, is the first to admit that the disease to which he's devoted his life gets no respect.

"The reality is that many people don't appreciate the frequency and severity of pneumonia as a global health problem," says Dr. Levine, an associate professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Yet the disease is the leading cause of death in the world and the leading cause of death from infectious disease in the United States. It is responsible for the deaths of 36,000 women a year, most 65 or older, and more than one million hospitalizations. (22) But when Dr. Levine runs a Google news search on the word "pneumonia," he gets far fewer hits than you'd expect from such a rampant disease. (23)

So why is pneumonia considered the "Rodney Dangerfield" of infectious diseases?

For one, it's not a new disease, says Dr. Levine, "and our friends in the media and politics like new stuff, emerging diseases, those kinds of things." The disease also suffers from what he calls "lingo" problems. Translation: The words associated with it are hard to spell and pronounce. Just consider the lexicon of pneumonia: pneumococcal pneumonia, streptococcus pneumnoniae, Mycoplasma pneumnoniae. These aren't words that roll off the tongue like AIDS or cancer.

Then there's the fact that pneumonia is considered a disease of the elderly. It's even been called "the old person's friend," because it is often the cause of death in the frail and infirm. Yet in parts of the world where pneumonia vaccines aren't readily available, says Dr. Levine, pneumonia is the leading cause of death in children.

So Dr. Levine, who spends much of his time trying to develop new and better pneumonia vaccines, has also made it his mission to get the disease the respect and attention it deserves. Why? Three reasons, he says: An aging population, which will lead to more infections; the growing incidence of antibiotic-resistant strains of pneumonia, which makes it harder to treat the disease; and the likelihood of a flu pandemic. During a pandemic like the one that hit in 1918, the leading cause of death isn't flu, but pneumonia, which invades the lungs once flu breaches the body's defenses. (24)

Today, however, we have a vaccine that can protect people against 23 types of pneumonia-causing bacteria. Unlike the flu vaccine, the pneumonia vaccine only has to be given once, although some children and high-risk adults require a booster a few years later. The vaccine is particularly important for children, says Dr. Levine, since studies find that vaccinating children helps reduce the spread of the disease in adults.

That's why Dr. Levine and others have been urging Congress and "anyone who will listen" to expand the use of the pneumococcal vaccine so if a pandemic does hit, more people will be protected against pneumonia. Currently, the vaccine is recommended for those over 65 and those over two years old who are in high-risk groups, such as those with suppressed immune symptoms.

Dr. Levine is also working on next-generation vaccines that can protect against additional pneumonia-causing bacteria and those that use additional ingredients to "turbocharge" the vaccine's effect on the immune system.

"I don't want women in America to live in fear," he says, "but I also don't want them thinking, 'Oh, pneumonia is only a problem in old people,' or that it can always be treated."

References

22 National Center for Health Statistics. National Hospital Discharge Survey: 2004 Annual Summary.

23 McNeil DG. A Campaign to Get a Disease Some Respect. The New York Times. Dec 5, 2006.

24 Taubenberger JK, Morens DM. 1918 influenza: the mother of all pandemics. Emerg Infect Dis [serial on the Internet]. 2006 Jan, Available from www.cdc.gov. Accessed Feb 22, 2007.

25 Pneumonia fact sheet. American Lung Association. Apr 2006. Available at: www.lungusa.org. Accessed Feb 22, 2007.

RELATED ARTICLE: Pneumonia Symptoms

The American Lung Association describes pneumonia as an "inflammation of the lung caused by infection with bacteria, viruses and other organisms." It can also develop if you inhale bits of food, liquid, water or dust. Symptoms vary depending on the type of infection, with viral pneumonia often imitating flu symptoms, while bacterial pneumonia tends to come on suddenly and involve severe chest pain, fever, mucus-producing cough and increased breathing rate. (25) While bacterial and Mycoplasma pneumonia can be treated with antibiotics, there is no treatment for viral pneumonia.