What you don't know about pneumonia: It is the 'big killer' for people of any age

For six hours in a Saint Luke's Hospital emergency room recently, Dakota Allen worried that he might become a fatal pneumonia statistic. He'd been coughing for weeks.

"I overlooked it," said the 20-year-old who works two jobs, one of them at Operation Breakthrough in Kansas City. "I thought it could be early flu.

"Then it just got to the point where I was coughing pretty regularly and I went to the CVS MinuteClinic. That's when I was first diagnosed with pneumonia."

But antibiotics didn't really stop the coughing, "and that's when it got pretty dangerous." Pneumonia had him firmly in its clutches.

"I think that, especially in young adults and people my age, I just really think the flu is what we talk about a lot more, and there's kind of this invincibility complex, that even if they did get pneumonia they wouldn't take it seriously," said Allen, who is at risk for pneumonia because he has asthma.

"You don't have to be asthmatic or elderly or a child for it to get as serious as it can get."

About 1 million adults in the United States are hospitalized with pneumonia every year, and 50,000 die from this infection of the lungs, according to the American Thoracic Society.

Influenza and pneumonia often hit together during the flu season, though there is no "pneumonia season."

This flu season, the Kansas Department of Health and Environment has reported 15 deaths from the flu and 529 from pneumonia.

The Missouri Department of Health and Senior Services has reported 16 flu deaths and 511 deaths related to pneumonia.

"If you look at pneumonia by itself, yes, it is a more serious diagnosis than, say for example, run-of-the-mill flu or cold or anything like that, because lots more ... people get hospitalized with it, and a lot more people die from it," said Raghavendra Adiga, an infectious disease specialist and chief medical officer at Liberty Hospital.

"Pneumonia is a big killer among infections that are out there ... and it's the second most common reason to be in the hospital."

'Do I Have Pneumonia?'

The death last month of ESPN college football reporter Edward Aschoff set off new anxiety about pneumonia. His social media followers were shocked when, at first, it seemed that pneumonia had killed him. He died on his 34th birthday.

Aschoff didn't know other health conditions were conspiring against him when he wondered aloud on social media how he got pneumonia.

"Anyone ever had multifocal (bilateral) pneumonia in their early 30s as someone who never gets sick and has a very good immune system?" Aschoff tweeted on Dec. 5. "Asking for two friends ... my lungs."

His tweets about pneumonia inspired his followers to share their own battle stories, one man tweeting that "pneumonia ain't no joke. I had it for over a month in 2017. Got to a point where I was sure it was gonna kill me and I had to come to terms with my own mortality."

But after Aschoff died on Christmas Eve, his fiancee, Katy Berteau, tweeted that a rare immune system condition, called HLH, caused his death.

She revealed that doctors found Stage 4 non-Hodgkin's lymphoma in his lungs after he died.

They were planning to get married in April.

"Both pneumonia and non-Hodgkin's lymphoma can trigger HLH in the body and that is seemingly what happened with Edward," she wrote on social media. "All of this combined is what led to his very rapid decline those last few days, and ultimately his passing. ...

"I also wanted to provide this update because he would have wanted everyone to know that something way bigger than pneumonia took him down."

Anyone can get pneumonia. Half of all adults with a healthy immune system who are hospitalized for severe pneumonia in the United States are between the ages of 18 and 57, the Thoracic Society says.

"While young healthy adults have less risk of pneumonia than the age extremes, it is always a threat," the society says.

But, "it is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems," says the Mayo Cilnic.

People who have asthma like Allen are at risk, along with patients with chronic obstructive pulmonary disease (COPD), diabetes, heart failure and other health issues that compromise their immune system. Other at-risk groups include transplant patients and cancer patients who have had chemotherapy, Adiga said.

And if you smoke, pneumonia's got your number, too. "People who smoke are at much higher risk for having pneumonia than non-smokers," said Adiga.

Don't Ignore The Chest Pains

People might not know they have pneumonia because the symptoms, according to the Mayo Clinic, mimic symptoms of the flu or a cold, "but they last longer." Even health professionals themselves have been known to miss the signs in their own bodies.

Symptoms include chest pain when you breathe, a cough that hacks up phlegm, a fever and shortness of breath.

"You can have fever with a lot of different things. You can have a cough with a lot of different things," Adiga said. "But can you differentiate? Many times patients can't make the differentiation between 'do I have pneumonia, do I have just a cold, the flu?

"But the thing you want to watch out for is being short of breath. 'Am I getting short of breath not doing anything?' Then they need to have it checked out."

Chest pains are another telltale sign.

Unlike body aches associated with the flu, pneumonia can reveal itself in pain when you take a deep breath, Adiga said.

If you feel that pain "in one area of your chest ... that is not a guarantee that you have pneumonia but it needs to be checked out."

'People Should Be Aware'

Even though he was taking a Zithromax Z-Pak antibiotic, Allen had been coughing up rust-colored phlegm and feeling tightness in his chest.

But then, at his Kansas City, Kansas, home one night after work he had an asthma attack in the bathtub "that was so bad I almost couldn't get out. ... I was so nervous especially with how fast and bad it got."

He managed to stumble into his roommate's room and tell him something was wrong. He went to his bedroom and used his nebulizer breathing treatment. He's had asthma since fourth grade.

When he still couldn't catch his breath, they headed for Saint Luke's where, Allen said, he was treated with steroids and placed on another machine to help him breathe. A chest X-ray found two spots on his right lung.

"Even if you're not at risk (for pneumonia) it's something I think people should be aware of," he said.

There'S A Vaccine For That

Just because you have a cough doesn't mean you have pneumonia. The only way to diagnose it "is with a good exam ... and of course getting a chest X-ray. That's pretty much the gold standard," said Adiga. "You need an X-ray to be able to tell whether you have pneumonia or not."

It's rare that pneumonia gets better without treatment, he said. "Typically (people) will get sicker and sicker and seek help. A lot of those can be treated outpatient. Doctors do send people home from their offices with antibiotics for pneumonia if they are otherwise not too ill and they are reliable in taking medications."

Preventing pneumonia involves common-sense hygiene habits, and vaccines.

The Centers for Disease Control and Prevention recommends two kinds of vaccines for at-risk people to help prevent pneumococcal disease, the type of pneumonia caused by Streptococcus pneumoniae, or pneumococcus, bacteria.

The CDC recommends the PCV13 vaccine for all children younger than 2 and anyone older than 2 with certain medical conditions.

It suggests anyone 65 or older talk to their doctor about that vaccine. "It's for high-risk adults, people who have asthma, COPD, immune system suppression," said Adiga. "Those people are candidates for that."

The CDC also recommends the PPSV23 vaccine for all adults older than 65, anyone between 2 and 64 with certain medical conditions, and adults 19 to 64 who smoke cigarettes.

The vaccine for children has worked so well—reducing pneumonia among pediatric patients by nearly half since it came on the market—that "it's kind of bled over into adults too," Adiga said. "Because we're vaccinating kids, it's not spreading as much to adults, so that has helped."

Wash Your Hands

Other ways to avoid pneumonia? "Stay away from sick people," Adiga said.

Practice good respiratory etiquette, which is a fancy way of saying cover your mouth and nose when you cough or sneeze. Which is another way of saying don't bless the world with your germs.

The CDC wants you to use tissues and throw them away, and to wash your hands or use a hand sanitizer every time you touch your mouth or nose.

Washing your hands "is the most important thing people don't pay attention to," said Adiga. "You need to be washing your hands as frequently as possible, especially before you eat or drink."

And, take care of yourself.

"If you have a medical condition, you need to make sure that is taken care of better," he said. "If you have asthma, diabetes, see your doctor and make sure you are in the best shape that you can be. Because it's the immune system that goes down ... and then you catch something else."

And, the doctor advised, "quit smoking."