India lacks a robust surveillance system in lower respiratory tract infections (LRTI). Pneumococcal disease is not notifiable in India and the problem is compounded by the poor observation system, according to Dr Anoop Amarnath, director - Geriatrics, Apollo Hospitals, Bengaluru.

Both India and global countries are reporting a high incidence of streptococcus pneumonia, one of the leading causative organisms for lower respiratory tract infections.

The condition is the commonest cause of community acquired pneumonia which accounts for significant morbidity and mortality across the world.

“The ageing population is at a heightened risk of contracting lung infections given their declining immune system combined with the co-morbid ailments such as heart disease and diabetes. The other major issue with lung infections, as with other diseases in the elderly, is the varied nature of their manifestation. Although classically they present as cough, fever and breathlessness, in the elderly they may manifest as confusion, giddiness, drowsiness and some even present to the hospital with sudden loss of consciousness. It is very important to have a high index of suspicion, carry out appropriate investigations and treat aggressively,” he added.

According to World Health Organisation (WHO) data (refer image), LRTI such as pneumonia are among the top 10 leading causes of death worldwide. Pneumonia, a serious inflammation and infection of the lungs, is responsible for over 220,000 deaths annually in older adults  which covers 225 per 100,000 adults above 60 years of age, making it one of the leading causes of mortality amongst older adults. Apart from mortality, pneumonia can result in poor outcomes and have a long-term negative impact on the quality of life. Further, LRTI is  amongst the leading causes of impairment in the quality of life.

An infectious disease crisis of global proportions is threatening hard-won gains in health and life expectancy. Over the next hour alone, 1500 people will succumb  from an infectious disease, of which most are working-age adults. Most deaths from infectious diseases occur in developing countries with the least money to spend on health care. In India cases of infectious diseases such as pneumonia are increasing rapidly. “Therefore it is vital for patients and their families to take preventive steps. Apart from the emotional trauma, the financial aspects of hospitalization during the disease-episodes are considerable and can take a toll on patients and their families,” said Dr Amarnath at the second International Conference on Geriology, Geriatrics Medicine and Rehabilitation.

Global Burden of Disease Study, supported by WHO reports that India accounts for over one fifth of the total LRTI episodes observed globally, and nearly one fourth of the global LRTI-related mortality. Indians have a tendency to self-medicate and delay seeking medical intervention which can result in additional complications such as antibiotics resistance. This is why health experts believe preventive strategies including vaccination may benefit the elderly, he said.