SINGAPORE: The past few months have been a sobering reminder of how deadly respiratory illnesses can be. Taiwanese actress Barbie Hsu and American actor Val Kilmer succumbed to pneumonia, at the ages of 48 and 65 respectively.

The 88-year-old Pope Francis battled a complex respiratory tract infection, requiring a five-week hospital stay and prolonged care. Though he recovered enough to make public appearances in April, he died on Monday (Apr 21) after suffering a stroke and heart failure.

Respiratory infections are a persistent and evolving health threat. Continued vigilance and protective measures are needed – especially for those at high risk.

WHY PNEUMONIA REMAINS A MAJOR HEALTH THREAT

Pneumonia is a lung infection that can be caused by bacteria, viruses or fungi. Among the pathogens most closely monitored for their public health impact are respiratory syncytial virus (RSV), influenza viruses, pneumococcal bacteria and SARS-CoV-2.

Pneumonia does not discriminate. Infants and young children are at heightened risk because their immune systems are still developing. Older adults are also highly susceptible to severe complications, given the natural decline in immune function with age.

Those with chronic conditions such as diabetes, asthma or heart disease face additional risks, as do immunocompromised individuals, including those undergoing chemotherapy or living with HIV or AIDS.

A recent study published in The Lancet found that compared to influenza, RSV infections in adults resulted in higher odds of mortality, more intensive care unit admissions and greater healthcare utilisation.

It also found RSV patients had higher ICU admission rates than COVID-19 patients with updated vaccines.

RSV, often assumed to be a childhood illness, is a significant threat to seniors and those with underlying health conditions. The study showed that older adults and patients with diabetes had higher odds of mortality when hospitalised for RSV.

While influenza and COVID-19 have been at the forefront of public health efforts, RSV has been quietly exacting a toll on healthcare systems, making it crucial for both healthcare providers and the public to acknowledge its risks.

PREVENTION IS OUR STRONGEST DEFENCE

The key to tackling pneumonia is minimising exposure to respiratory infections. For instance, reduce close contact with unwell individuals, particularly in crowded or enclosed spaces.

Good hygiene practices play a vital role, such as regular handwashing, covering coughs and sneezes, and refraining from touching the face to limit disease spread. Wearing masks during flu season has proven to be a simple yet effective way to reduce exposure.

Maintaining a strong immune system is equally important. This involves a balanced diet, regular exercise, adequate sleep, and avoiding smoking and excessive drinking.

Above all, seek medical attention at the earliest signs of illness, such as persistent cough, fever, or difficulty breathing, can make a critical difference. Timely intervention with appropriate treatments can help prevent complications and improve recovery outcomes.

Vaccination remains one of the most effective strategies to prevent pneumonia caused by key respiratory infections. Immunisation efforts have advanced significantly in recent years, offering protection against multiple pathogens.

In 2024, the RSV vaccine was approved in Singapore for adults over the age of 60, and for infants through maternal vaccination.

The influenza vaccine, recommended yearly, helps guard against the most prevalent flu strains and minimises the risk of complications.

Pneumococcal vaccines, including PCV13, PCV15, PCV20 and PPSV23, are recommended for young children, older adults, and those with high-risk conditions, offering essential protection against bacterial pneumonia.

Similarly, the COVID-19 vaccine continues to play a crucial role in reducing severe disease and hospitalization rates. Together, these vaccination strategies form a critical line of defense against respiratory infections that can lead to pneumonia.

CHANGING ATTITUDES TOWARDS PNEUMONIA PREVENTION

Despite clear evidence supporting pneumonia prevention, many people remain hesitant about taking proactive health measures. Some assume pneumonia is an inevitable consequence of ageing, while others may not realise they are at risk. There is also a tendency to underestimate how rapidly respiratory infections can escalate.

We need ongoing efforts to encourage health-conscious behaviors, particularly among high-risk populations. No one should have to suffer – or lose a loved one – because of a preventable disease.

By staying vigilant, prioritising preventive health measures and seeking medical guidance when necessary, we can protect ourselves and our communities from this silent but serious threat.

Dr Leong Hoe Nam is an infectious disease specialist at Mount Elizabeth Novena Hospital.