Influenza : Pneumonia

Influenza:

Considered deadly in high risk groups, influenza is a viral infection that attacks the respiratory system (nose, throat, and lungs). Influenza, commonly called the flu, is not the same as stomach "flu" viruses that cause diarrhea and vomiting. For most people, influenza resolves on its own, however there are conditions that bring upon the symptoms that can be deadly for the body. With over 3 million cases in the US alone per year, it is clear to see that it is easily contracted. The good news is that the flu can be partly preventable by vaccine, can be self-treatable, and can be diagnosed by the self. Usually the flu only lasts for a short period of time between days to weeks.

Children under the age of 5, adults older than 65 years, pregnant women, and people with weak immune systems or have chronic diseases or illnesses (i.e. asthma, heart disease, kidney disease, and diabetes) are the high risk groups. Those who have a body mass index of 40 or higher are at higher risk including residents of nursing homes and other long-term care facilities.

Causes:

People with the virus are likely contagious from the day or so before symptoms first appear until about five days after symptoms begin. It is possible for people to be contagious for as long as 10 days after symptoms appear. Children and adults with weakened immune systems may be contagious for a slightly longer time. The flu spreads through airborne respiratory droplets (when another individual nearby coughs or sneezes), skin-to-skin contact (whenever people physically interact through handshakes or hugs), saliva (kissing or shared drinks), and lastly by touching a contaminated surface (blanket or doorknob) -are then transferred to your eyes, nose, or mouth.

Influenza viruses are constantly changing, with new strains appearing regularly. Many people have had influenza in which the body has made antibodies to fight that specific type of virus. However, because this virus is ever changing these antibodies that your body has created cannot fight against a new influenza sub-types because they vary in their immunology.  But if a future flu virus is similar to the past viruses a person has experienced then only by having the disease or by vaccination can those antibodies prevent infection or simply lessen the severity.(B)

 

Symptoms:

Influenza is a contagious respiratory illness caused by influenza viruses. Although at first the flu may seem like the common cold with similar symptoms such as runny nose, sneezing, and sore throat, it may be difficult to know which one you have. The difference is, is that colds tend to develop slowly whereas influenza or the flu tends to affect the body suddenly. In addition, even though the common cold and the flu seem very similar, the symptoms of the flu include more severe symptoms such as fever, chills, muscle aches, cough, congestion, runny nose, headaches, and fatigue.

Serious flu infections can lead to hospitalization or death. Older people, young children, and people with certain health conditions are at higher risk for these serious flu complications. As of today the best way to prevent the flu, is by making sure to get vaccinated each year before the flu season begins.

Research:

Research has indicated the most common viruses such as influenza A (H1N1) virus, an influenza A (H3N2) virus, and one or two influenza B viruses will modify the new and upcoming flu vaccine to protect the body against these very same viruses as well as the general influenza virus. (B)

There are some signs to look out for that are related with the flu such as a fever of over 100F (38C),aching muscles, especially in your back, arms and legs, chills and sweats, headache, dry, persistent cough, fatigue and weakness, nasal congestion, and sore throat. As soon as symptoms are noticed it is strongly advised to take antiviral drugs within the first 48 hours to reduce length of illness and aid in the prevention of more serious problems to come. (B)

Treatment: 

The flu is treated primarily with rest and fluid to let the body fight the infection on its own. Over-the-counter anti-inflammatory pain relievers may help with symptoms. An annual vaccine can help prevent the flu and limit its complications.From the most recent 'FluView Report', a decrease in flu activity can be observed within the US, however still maintaining it's slightly elevated levels. The flu viruses usually circulate at very low levels during the summer. (A)

CDC recommends a yearly flu vaccine for people 6 months and older. Vaccination can reduce flu illnesses, doctors' visits, and missed work and school due to flu illness, as well as prevent flu-related hospitalizations. CDC also recommends that patients suspected of having influenza who are at high risk of flu complications or who are very sick with flu-like illness should receive prompt treatment with influenza antiviral drugs without waiting for confirmatory testing.(A)

Pneumonia:

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. While pneumonia always refers to an infection of the lungs, there are many different types. Some are caused by viruses, fungi, or parasites, but many cases of pneumonia are caused by bacteria. The most common bacterial pneumonia is called pneumococcal pneumonia.

Pneumococcal pneumonia is a serious disease that can strike anywhere, anytime, and to anyone. It is one kind of community-acquired pneumonia. It is caused by common bacteria called Streptococcus pneumoniae. Even if the individual leads a healthy lifestyle pneumonia is still just as possible for him or her because pneumonia is not a cold or the flu. The risks of being infected with Pneumococcal pneumonia increases as a person ages.

Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems. Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

People older than age 65 and people in poor health or with a weakened immune system may have a lower than normal body temperature. Older people who have pneumonia sometimes have sudden changes in mental awareness.

While some health and lifestyle factors may increase the risks of getting pneumococcal pneumonia, one of the primary risk factors in adults is age. This is due to the fact that natural, age related decline of the immune system. Pneumonia can begin quickly withing the body with little warning. Symptoms of cough and fatigue that last for weeks or longer can be confused with a common cold or flu. If these symptoms persist beyond weeks, it may result in hospitalization of the individual. In severe cases, it can lead to death.

Causes:

There is a common misconception that hospitals are where the majority of people get pneumonia. However, it is more commonly acquired through communities as well as throughout their daily lives, outside of hospitals or health care settings. Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. The human body is able to prevent these germs from infecting your lungs, however there are times in which these germs can overpower your immune system (even if the individual is healthy). Pneumonia is classified according to the types of germs that cause it and where you got the infection.

Some people catch pneumonia during a hospital stay for another illness. This type of pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia. Health care-acquired pneumonia is a bacterial infection that occurs in people who are living in long-term care facilities or have been treated in outpatient clinics, including kidney dialysis centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics.

The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae, a bacteria.  This form of pneumoniae can develop on its own or after a cold or flu. Bacteria like organisms such as Mycoplasma Pneumoniae also can cause pneumonia.Walking pneumonia, a term used to describe pneumonia that isn't severe enough to require bed rest, may be caused by M. pneumoniae. Viruses can also cause not only pneumonia but colds and the flu as well.Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years.

Viral pneumonia is usually mild. But in some cases it can become very serious. Lastly, fungi, the lesser cause, can also cause people to get pneumonia. This type of pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings. Aspiration pneumonia occurs when inhaling food, drinking, vomit, or saliva into the lungs.Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

 Symptoms:

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer. These symptoms include; fever, sweating and shaking chills, cough, which may produce phlegm, chest pain when you breathe or cough, shortness of breath, fatigue, nausea, vomiting or diarrhea.

Individuals who suffer from chronic disease such as chronic obstructive pulmonary disease, heart disease, or asthma. Those who have suppressed immune system (i.e. those who have HIV/AIDS, have had an organ transplant, or receive chemotherapy or long-term steroids are at risk). Smoking damages the body's natural defenses against the bacteria as well as the viruses that cause pneumonia. Patients who are being hospitalized, especially those in a hospital intensive care unit, or on a ventilator are at greater risk of pneumonia.

Treatment:

People who catch pneumococcal pneumonia are typically treated with antibiotics, since the illness is caused by bacteria. Many times, more than one antibiotic is prescribed and the treatment can be either oral or IV antibiotics depending on the severity of the pneumonia. Those who are considered 'high-risk' groups may experience complications. These complications include the following.  

Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure.

Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is usually treated with antibiotics. Sometimes, surgery or drainage with a long needle or tube placed into the abscess is needed to remove the pus.

Fluid accumulation around your lungs (pleural effusion). Pneumonia may cause fluid to build up in the thin space between layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may need to have it drained through a chest tube or removed with surgery.

Difficulty breathing. If your pneumonia is severe or you have chronic underlying lung diseases, you may have trouble breathing in enough oxygen. You may need to be hospitalized and use a breathing machine (ventilator) while your lung heals.

Research:

From recent clinical studies of oral anti-bacterial drugs for treatment of community acquired pneumonia results showed that in these 7 studies, majority of patients had Pneumonia Patient Outcomes Research Team scores of I or II. Similar results were observed from several recently submitted clinical studies of intravenously administered antibacterial drugs for treatment of community-acquired pneumonia. The goal of these studies were to find a clinical cure for patients after the 7-21 day completion of therapy. Over 80% clinical cure rates were in the intent-to-treat populations whereas over 90% were in the pre-protocol populations. (D)

The percentage of randomized subjects with pathogens identified at baseline ranged from 47% to 76%, and the percentage of subjects with Streptoccocus pneumoniae isolated at baseline ranged from ∼6% to 20%. All studies recently submitted to the US Food and Drug Administration (FDA) for review of drugs for the indication of community-acquired pneumonia (CAP) have been designed as noninferiority studies. The noninferiority study was created for the aim of demonstrating that the test drug is similar enough to the control drug. In order for the test drug to be of noninferiority to the control drug to be informative, one would need to know if the control drug would have been better than the placebo and by how much if a placebo was indeed included in the trial. (D)

The fundamental limitation and concern regarding noninferiority studies is whether the finding of similarity of a test drug and a control drug are informative. The study should therefore assess the ability of the study to have a variation between treatments. Similarity of test drug and active control can mean either that both drugs were effective or that neither was effective. Subsequently, through analysis of the study, the researchers should be able to conclude whether the drugs were effective and why. If this cannot be done, one cannot conclude efficacy from an active-controlled study that claims to show noninferiority. (D)

All the studies that were conducted and submitted to the FDA were active-controlled trials that showed non-inferiority. Within these studies the patients that took part had signs and symptoms similar to those of CAP. Results from the trails showed that the oral antibacterial drugs were generally less that those in the trails who took intravenous drugs. Although each of these studies showed that the test drug is “similar” to the control drug, uncertainty remains regarding what conclusions can be drawn from a non-inferiority study when evidence to support a non-inferiority margin has not been provided.(for more info on these trials go to this link: http://cid.oxfordjournals.org/content/47/Supplement_3/S150.full)

Links:
(A)http://www.cdc.gov/flu/
(B)mayoclinic.com/flu
(C)http://www.knowpneumonia.com/pneumococcal-pneumonia-treatment
(D) http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/definition/con-20020032
(E)http://cid.oxfordjournals.org/content/47/Supplement_3/S150.full

*Please note! These are not my images! If any are yours please let me know so that I can give you credit for them~ Also these images have no relation whatsoever between the people in these images and the Diseases I am discussing about. Thanks so much~ Enjoy!