When an infant or young child experiences heavy coughing, rapid breathing and a fever over 38.5 degrees Celsius spread over several days parents should immediately take their child to see a paediatrician.
“Those symptoms are possible indicators for pneumonia,” says Professor Gesine Hansen from the German Society of Paediatric Pneumology.
The symptoms of pneumonia in children vary widely. Many children go off their food and reduce intake of fluids, have high fever and show disinterest in their surroundings. Other children, however, will continue to play and be active as if they were not sick at all.
“Sometimes it is not easy to diagnose pneumonia because there are no typical symptoms,” explains Hansen.
Hansen says pneumonia in babies and small children is mainly caused by viruses or bacteria. What are known as respiratory syncytial viruses are dangerous for infants because they cause great difficulties breathing. Lung infections that appear during flu are a cause of big concern to doctors. At the moment there are only vaccinations against pneumoccus and Haemophilus Influenzae which are given to children in their first few months.
Doctors have a number of ways to determine if a young patient has an infected lung including physical examination, blood tests, swabs of the nasal and throat areas and if necessary they can use X-rays.
“In clear-cut cases you can hear a bubbly-sounding wheeze in the lung,” says paediatrician Hans-Eberhard Heuer.
However, in many instances it is not so clear what the patient is suffering from. “Sometimes the infection is located so deep in the lung that you can’t hear it.” Hans-Eberhard Heuer said. Young infants also don’t react to requests to inhale deeply or to cough on command, making the diagnosis process even more difficult. “In cases like that an X-ray is recommended.” Heuer added. Physicians also look towards the levels of C-reactive proteins and white cells in the blood to determine whether bacteria or a virus is behind the illness.
“In most cases the infection begins with a virus. Bacteria then take a hold and make the infection worse,” says Christine Firnhaber from the Children’s Hospital in Hamburg. There is a fast test to check for the presence of the respiratory syncytial virus which produces a result within minutes of taking a swab from the nose or throat.
If bacteria are thought to be the source of the infection a doctor can prescribe antibiotics. Heuer says many doctors administer antibiotics early to prevent the child from falling seriously ill.
“Pneumonia is especially dangerous for a child that suffers from asthma or who has a previous history of lung problems,” says Heuer.
Children who have fallen ill with breathing problems are often more likely to contract pneumonia.
New-born infants and children with metabolic diseases, heart problems and cystic fibrosis are also at higher risk of contracting the illness. “Pneumonia is a very heavy burden for a young body to carry and at-risk children are often admitted to a hospital.” The smaller a child is the more likely it is they will be sent to hospital. “A lung infection in a child under the age of three months is unpredictable and doctors must be very cautious,” says Hansen. An important indicator that physicians watch out for is the oxygen level in the blood. That shows how well the lungs are absorbing oxygen from the air. To determine oxygen levels a small clip is attached to one of the child’s fingers. Normal levels are 98 per cent or more. Under 93 per cent a child should be admitted to hospital and given oxygen.
“If a child turns off their food and drink, doesn’t play and has a light-blue face colour we will definitely keep them in hospital,” says Firnhaber. But after just a few days of proper treatment the child will probably be fit enough to go home again. “The important thing is that the child takes their medicine.” he added. Hansen points to data gathered by the World Health Organisation that shows pneumonia is a very serious illness. “Twenty per cent of deaths in children under the age of five are caused by infections of the respiratory system and pneumonia,” he says. That figure is most pronounced in developing countries. Western countries have comparatively few lung infection-related fatalities due to the seriousness the disease is regarded with.