More than just the flu: Get to know pneumonia, Malaysia's leading cause of death

KUALA LUMPUR: Pneumonia has become the leading cause of death in Malaysia, with 18,181 fatalities recorded in 2023, according to the Department of Statistics Malaysia (DOSM), while seasonal influenza remains a global health concern, affecting approximately one billion people annually, including three to five million severe cases.

Sunway Medical Centre Velocity (SMCV) Consultant Respiratory and Internal Medicine physician Dr Nurul Yaqeen Mohd Esa said the rising prevalence of respiratory viruses such as influenza and COVID-19 has made individuals more vulnerable to pneumonia.

She attributed the surge in pneumonia-related deaths to Malaysia's ageing population, delays in seeking medical care, and low vaccination rates.

"Pneumonia is a severe respiratory infection that causes lung inflammation, leading to breathing difficulties, reduced oxygen levels, and potential complications that may require hospitalisation or result in death.

"While the elderly are at higher risk, younger individuals with weakened immune systems, chronic illnesses, or poor lifestyle habits are also vulnerable," she said in a statement to Bernama today.

Dr Nurul highlighted that the increasing pneumonia cases among younger individuals in recent years were largely due to exposure to respiratory viruses, smoking, and vaping.

She explained that influenza and COVID-19 weaken the body's defence mechanisms, making individuals more susceptible to bacterial infections that can trigger pneumonia.

"The flu virus damages the protective membranes lining the airways and the cilia, tiny hair-like structures that clear mucus, creating a breeding ground for bacteria.

"It spreads through respiratory droplets or contaminated surfaces when an infected person coughs or sneezes," she said, advising those recovering from the flu to watch for prolonged fever, worsening cough, or breathing difficulties as potential signs of pneumonia.

Dr Nurul said infected individuals could be contagious one day before symptoms appear and up to seven days after symptoms surface, emphasising the importance of early detection and preventive measures.

Citing recent cases, she noted that Taiwanese actress Barbie Hsu and Chinese actor Liang Youcheng succumbed to pneumonia complications following influenza infections, demonstrating how rapidly respiratory illnesses can escalate, even in younger adults.

"These cases highlight the importance of regular vaccinations, wearing masks in high-risk settings, and practising good hygiene," she said.

She urged high-risk individuals to prioritise both pneumococcal and influenza vaccinations, which could significantly reduce the severity of pneumonia.

The influenza vaccine lowers hospitalisation rates by 40-60 per cent among healthy adults, while the pneumococcal vaccine reduces severe pneumonia risk by up to 75 per cent in older adults.

"Annual influenza vaccination is recommended for everyone, while adults over 65 should receive the pneumococcal vaccine with booster doses based on individual risk factors," she said.

Dr Nurul cited a 72-year-old diabetic patient who received both vaccines and experienced only mild symptoms without developing pneumonia, compared to a 50-year-old diabetic patient who was hospitalised with severe pneumonia after contracting influenza without vaccination.

Meanwhile, SMCV Consultant Emergency Physician Dr Lim Fang Jen said pneumonia symptoms, including shortness of breath, chest pain, and confusion, are often mistaken for typical respiratory infections, leading to delayed treatment.

"When pneumonia becomes critical, its progression could be swift and devastating, and patients experiencing severe respiratory distress, dangerously low oxygen levels, confusion, or altered mental status may require intensive care or mechanical ventilation.

"If left untreated, pneumonia can cause myocarditis (heart muscle inflammation), encephalitis (brain inflammation), myositis or rhabdomyolysis (muscle inflammation or damage), sepsis (a life-threatening inflammatory response to infection), and multi-organ failure.

"Pneumonia can worsen pre-existing conditions, particularly in individuals with diabetes, heart disease, or chronic lung conditions, and those with compromised immune systems face an increased risk of prolonged hospitalisation, permanent organ damage, or death," he said.

These insights highlight the urgent need for early detection, proactive prevention, and timely intervention to mitigate the potentially fatal consequences of pneumonia.

Although pneumonia is a serious illness, it is largely preventable through early detection and preventive measures. Prevention begins with routine vaccinations, supported by simple yet effective practices such as avoiding smoking, practising good hygiene, and maintaining a healthy lifestyle.

"By adopting these preventive measures, Malaysians can significantly reduce their risk of pneumonia and help protect their communities from this life-threatening disease," SMCV said.

-- BERNAMA