Once grimly nicknamed the 'old man's friend' for its perceived swift and painless course, pneumonia remains a leading killer of the elderly more than a century later. This year, the debilitating respiratory condition was named on the death certificates of Hollywood stars Val Kilmer, who died aged 65 in April, and Diane Keaton, 79, who passed away in October.
Earlier this week, Ibiza personality Wayne Lineker, 63, revealed he almost became another casualty after a virus contracted in Dubai left him hospitalised and fighting for his life. He told fans his recovery could take months.
Now, medical experts are explaining why cases of this serious chest infection appear to be prevalent and what triggers the often-debilitating illness.
The Inextricable Link Between Flu and Pneumonia
Pneumonia is an infection that inflames the air sacs (alveoli) in one or both lungs. The sacs may fill with fluid or pus, causing symptoms that include a cough with phlegm, fever, chills, and difficulty breathing. In severe cases, patients may cough up blood or require life-support on a ventilator.
Official figures for 2024 reveal a stark picture. In England and Wales, there were 23,061 deaths where influenza and pneumonia were listed as the underlying cause. Statisticians have grouped these two conditions together since 2020, and experts say there is a clear medical reason for this pairing.
Professor Paul Hunter from Norwich Medical School explained the connection to the Daily Mail. 'There are multiple types of pneumonia, but pneumococcal pneumonia, which is caused by a bacterial infection, commonly follows influenza,' he said.
'How many people die from influenza? It's not that big a number. What is the big number is the people who die from the pneumonia that they develop while they're recovering from the influenza.'
This happens because the influenza virus attacks the lining of the upper respiratory tract, damaging the microscopic hairs called cilia. These hairs are responsible for wafting bacteria and harmful particles away from the delicate lungs.
'The influenza damages those cells so that they can't actually protect the lungs from bacteria and other things, leaving them more vulnerable,' Professor Hunter stated. When bacteria then invade, the alveoli become infected and fill, preventing vital oxygen from entering the bloodstream.
Why an Ageing Population is at Greater Risk
Despite medical advances, pneumonia still poses a grave threat to society's most vulnerable, particularly those in poor health. With Britain's ageing population and the circulation of new flu strains, the risk remains significant.
Dr Simon Clarke, Associate Professor in Cellular Microbiology at the University of Reading, told the Daily Mail: 'We're living longer in a frail state, and that means we are possibly more likely to contract pneumonia.'
He outlined several key risk factors for older people:
- Weaker immune systems.
- Reduced physical activity, leading to less vigorous breathing which helps clear pathogens.
- Other factors like prolonged ventilation during surgery.
'If you're unable to fight them off... if your body is less effective at essentially blowing these bugs away, then you'll be at a higher risk,' Dr Clarke added.
Pneumonia: More Than Just One Disease
A common misconception is that pneumonia is a single disease caused by one specific 'bug'. In reality, it is a catch-all term for a serious chest infection with multiple potential causes.
Professor Hunter clarified: 'Pneumonia is basically an infection of the lungs. It can be caused by tuberculosis or a near-drowning experience. There's also aspiration pneumonia, where you inhale vomit into your lungs.'
People with severely compromised immune systems, such as those with HIV, are more susceptible to fungal forms like Pneumocystis pneumonia.
Dr Clarke emphasised: 'Pneumonia is a catch-all phrase for a set of symptoms relating to a serious chest infection... It is when you have inflammation of the lower airways, and it causes a compromised ability to breathe.'
This inflammation and lack of oxygen can quickly cause havoc, leading to organ failure. One of the most dangerous complications is sepsis, where the infection enters the bloodstream, poisoning the body from within.
However, experts are keen to dispel the myth that pneumonia is always fatal or always requires hospitalisation. Treatments have advanced considerably.
'It depends on the cause of infection. A healthier person will probably last longer, or even recover from pneumonia,' said Dr Clarke. 'Not everyone needs to be hospitalised... It will depend how severe your symptoms are, whether you just need rest, or whether you need antibiotics.'
Antibiotics can effectively treat bacterial pneumonia, helping a patient recover sufficiently for their own immune system to overcome any accompanying viral infection.
Furthermore, recovering from pneumonia does not make you more likely to contract it again, provided underlying risk factors are managed. While age is an unchangeable factor, lifestyle choices such as smoking, obesity, and inactivity significantly increase risk. Addressing these can offer a stronger defence against this enduring health threat.
