MOST PEOPLE WHO smoke know the habit raises their risk of serious health problems, including lung cancer and heart disease. And vaping can lead to nicotine addiction and expose the lungs to potentially harmful chemicals. But doctors say those who smoke, vape, or have certain chronic conditions like COPD, asthma, or diabetes may also be more susceptible to a lesser-known threat: pneumococcal pneumonia.
As with most illnesses, the severity of pneumococcal pneumonia can vary widely from one person to another. “It can range from a mild illness treated at home to a severe, life-threatening infection requiring hospitalization,” says Jonathan Parsons, MD, a pulmonologist at The Ohio State University Wexner Medical Center. Even a mild case can disrupt your day-to-day life, so prevention is critical—and vaccination is one way to lower your risk.
Most people don’t know much about pneumococcal pneumonia—or even how to pronounce it. Below, pulmonologists explain why it matters and what you can do about it.
Pneumococcal Pneumonia, Explained
PNEUMOCOCCAL PNEUMONIA IS a type of lung infection caused by the bacteria Streptococcus pneumoniae, or pneumococcus, according to the Centers for Disease Control and Prevention (CDC). The infection develops when the bacteria reach the lungs, says Bushra Mina, MD, chairman of medicine and chief of Pulmonary Critical Care Medicine at Northwell’s Northern Westchester Hospital. The bacteria then infect the air sacs, leading to inflammation and fluid buildup, he explains.
“The bacteria can also spread beyond the lungs into the bloodstream or the lining around the brain, which is why doctors take it seriously even in otherwise healthy people,” Dr. Parsons says.
Your Lungs, Their Defense System, and Your Risk
TO UNDERSTAND WHY certain behaviors and health conditions can raise the risk of pneumococcal pneumonia, it helps to know about the lungs’ built-in defenses against infection.
“The lungs are exposed to bacteria and viruses all the time, and the lungs are very efficient at protecting themselves,” says Sanjay Sethi, MD, chief of the division of pulmonary, critical care, and sleep medicine at University at Buffalo. That includes macrophages, specialized immune cells that act as the “policemen” of the lungs, he says. “Whenever we have bacteria or viruses come, they’ll grab it and destroy it.”
Smoking and vaping, in particular, can impair the function of cilia, the tiny hair-like structures that line the airways and normally sweep bacteria and mucus out of the lungs. “[Smoking and vaping] also irritate and inflame the airway lining, making it easier for bacteria like pneumococcus to take hold,” Dr. Parsons says. Together, these effects can make it harder for the lungs to clear bacteria before they multiply and lead to pneumonia, Dr. Sethi adds.
Underlying health issues increase susceptibility in different ways. “People with chronic lung conditions like COPD or asthma often already have inflamed, more vulnerable airways, so an infection on top of that can hit harder and take longer to recover from,” Dr. Parsons explains. “Simply, anything that stresses the lung’s defenses gives an infection more room to settle in.”
The increased risk isn’t limited to conditions that affect the lungs. Diabetes and chronic heart disease are also associated with higher rates of pneumococcal disease. Persistent high blood sugar can impair immune function, which may help explain the connection in people with diabetes. In fact, the relative risk of pneumococcal disease may be particularly high among younger adults with the condition.
Symptoms, When to Seek Care, and Treatment
PNEUMOCOCCAL PNEUMONIA SYMPTOMS can appear suddenly. Fever and chills are common, but the infection can also cause a cough that brings up mucus, weakness, and shortness of breath, Dr. Mina says. “Any new or worsening symptoms should be concerning,” he adds.
“People with underlying lung disease should have a lower threshold for getting checked, since their reserve is lower and they can decline more quickly,” Dr. Parsons adds.
In the most severe cases, symptoms can escalate into a medical emergency. Dr. Parsons recommends contacting your doctor if you have a cough that isn’t getting better after a few days, especially if you’re experiencing other symptoms of pneumococcal pneumonia. Difficulty breathing at rest, bluish lips or fingertips, confusion, a high fever that won’t come down, or severe chest pain warrant a trip to urgent care or the ER, he says.
If you’re diagnosed with pneumococcal pneumonia, treatment typically involves antibiotics, according to the CDC. Certain strains of pneumococcal bacteria have become resistant to commonly used antibiotics, so testing may be needed to determine which treatment is likely to work best.
For serious infections, treatment often begins with broad-spectrum antibiotics, which work against a range of bacteria. Once testing is complete, doctors may switch to a more targeted antibiotic.
The Steps You Can Take to Prevent It
THE CDC RECOMMENDS pneumococcal vaccination for all adults 50 and older, as well as adults ages 19 through 49 who smoke cigarettes or have certain risk factors, including COPD, asthma, diabetes, and chronic heart disease. If you vape but don’t smoke, vaccination recommendations are based on your age and any other risk factors you may have, since vaping alone isn’t currently included in the CDC’s risk-based guidance.
Several vaccine options are available. The appropriate pneumococcal pneumonia vaccination schedule depends on which pneumococcal vaccines, if any, you’ve previously received. Some people need only one dose, while others require a follow-up dose, so ask your healthcare provider what is appropriate for you.
Vaccination isn’t the only preventive step. Quitting smoking or vaping can eliminate an ongoing source of airway irritation. The CDC also recommends washing your hands regularly and taking good care of chronic medical conditions.
“Pneumococcal vaccines are highly effective at preventing the most severe forms of this infection,” Dr. Parsons says. “They don’t guarantee someone will never get a mild respiratory illness, but they substantially lower the risk of serious complications like bloodstream infections, meningitis, hospitalization, and death.”
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more. She has a master’s degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.
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