| Clinical Features |
Pneumonia, an inflammation of the lung, is characterized by cough and fast, difficult breathing. Fever and muscle aches may occur. |
| Etiologic Agent |
Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) are the leading bacterial pathogens. Other bacteria (Staphylococcus aureus, and gram-negative pathogens) more often affect newborns and malnourished children. Respiratory viruses (RSV, influenza, parainfluenza, and adenovirus) can be identified in approximately a quarter of children with pneumonia but are much less likely to cause fatal infection than are the bacterial pathogens. |
| Incidence |
Each year, there are more than 150 million episodes of pneumonia in young children in developing countries, and more than 11 million children need hospitalization for pneumonia. |
| Sequelae |
Each year, acute respiratory infections cause approximately 2 million deaths among children <5 years old and are the leading cause of death in this age group. About 1% of pneumonia cases result in sequelae or after-effects of the condition (e.g., damaged airways), which increases the risk of recurrent infections. |
| Transmission |
Person-to-person transmission may occur by direct contact with infectious secretions. Most cases of pneumonia among children occur sporadically, not in outbreaks. |
| Risk Groups |
Infants (especially premature or low birth weight). Nearly 75% of pneumonia deaths occur among infants under 1 year old. Risk also increases with malnutrition, malaria, and suppressed immunity. The burden of pneumonia among children with HIV infection is high. |
| Surveillance |
No standard approach exists for surveillance in developing countries. |
| Trends |
There has likely been some decrease in the number of pneumonia deaths over the last decade due to more widespread use of antibiotics, antiretroviral medications for HIV treatment, and vaccines against Streptococcus pneumoniae and Hib. |
| Challenges |
The impact of the HIV epidemic in sub-Saharan Africa and Asia, spread of antibiotic resistance, use of case-management algorithm, widespread training of health workers, assuring antibiotic supply, and identifying strategies to promote global use of Hib and pneumococcal conjugate vaccines. |
| Opportunities |
Conjugate vaccines for Hib and pneumococcus offer the best opportunity to prevent morbidity and mortality. Increased use of case management and risk reduction also are important. Use of prophylactic antibiotics and antiretroviral medicines may decrease the incidence of HIV-infected children. Improved hygiene, improved nutrition and promotion of breast-feeding, and reduction in exposure to indoor air pollution are also areas to be explored. |
