“Pneumonia is caused by bacteria, viruses or fungus. There are literally dozens of different causes of pneumonia, grouped by the most common types.

Walking pneumonia, also known as atypical pneumonia, is caused by mycoplasma pneumoniae bacteria. It usually causes cold-like symptoms, in addition to a fever (often low grade) and a hacking cough. It is most common in school-aged children and young adults. , says Annette Cameron, MD, a Yale Medicine pediatrician.

Because this type of pneumonia typically causes milder symptoms, it may go undiagnosed for a while, especially if the child is able to participate in normal activities and isn’t as visibly sick as he or she would be with other forms of pneumonia. “And that’s why it’s called walking pneumonia,”.

Yale Medicine (https://www.yalemedicine.org/conditions/pneumonia)

Important facts to know about pneumonia via The American Thoracic Society (https://www.thoracic.org):

1. Pneumonia is an infection of the lung.The lungs fill with fluid and make breathing difficult. Pneumonia disproportionately affects the young, the elderly, and the immunocompromised. It preys on weakness and vulnerability.
2. Pneumonia is the world’s leading cause of death among children under 5 years of age, accounting for 15% of all deaths of children under 5 years old.There are 120 million episodes of pneumonia per year in children under 5, over 10% of which (14 million) progress to severe episodes. There was an estimated 935,000 deaths from pneumonia in children under the age of five in 2013.
3. In the US, pneumonia is less often fatal for children, but it is still a big problem.  Pneumonia is the #1 most common reason for US children to be hospitalized.
4. For US adults, pneumonia is the most common cause of hospital admissions other than women giving birth. About 1 million adults in the US are hospitalized with pneumonia every year, and about 50,000 die from this disease.
5. While young healthy adults have less risk of pneumonia than the age extremes, it is always a threat.  Half of all non-immunocompromised adults hospitalized for severe pneumonia in the US are younger adults (18-57 years of age). Half the deaths from bacteremic pneumococcal pneumonia occur in people ages 18-64.
6. Older people have higher risk of getting pneumonia, and are more likely to die from it. For most geriatrics it harder for their body to fight infection overall and pneumonia terribly weakens the person’s overall system with many geriatrics already immune compromised in someway.

For US seniors, hospitalization for pneumonia has a greater risk of death compared to any of the other top reasons for hospitalization.

7. Pneumonia is the most common cause of sepsis and septic shock, causing 50% of all episodes. Sepsis is so common today in acute hospitals that is has gone national to have what we call s “septic code” like how a cardiac arrest in hospitals is either “blue code” or still in some a “red code” (since most hospitals have a “red code” for fires in the hospital. This is how much sepsis is common.  Sepsis is hard to fight which can lead to SARS which in short is all systems in the body failing.  To give you some tangibility in how high let us go to a great resource, The World Health Organization (WHO).  They estimated that today the overall fatality rate for SARS (severe acute respiratory syndrome) patients at 14% to 15%, significantly higher than previous estimates. The agency estimated the rate for people older than 64 years to be more than 50%.  That is how serious the diagnosis sepsis/SARS can be, especially for geriatrics!
   
8. Pneumonia can develop in patients already in the hospital for other reasons. Hospital-acquired pneumonia has a higher mortality rate than any other hospital-acquired infection.
9. Pneumonia can be caused by lots of different types of microbes, and no single one is responsible for as many as 10% of pneumonia cases. For most pneumonia patients, the microbe causing the infection is never identified.
10. Vaccines are available for some but not many causes of pneumonia. The influenza vaccine is effective for those strains circulating that year, so it should be taken again every year. The pneumococcal pneumonia vaccines are recommended for those in higher risk groups (children, immunocompromised individuals, and seniors).                                                             
    
11. In the US and the rest of the world, viral pneumonias arethe leading cause of hospitalization of infants.  The World Health Organization has set a high priority on developing new vaccines and new therapeutic drugs to tackle these viral pneumonias that largely have no currently available vaccines or treatments. A.)Antibiotics can be effective for many of the bacteria that cause pneumonia.For viral causes of pneumonia, antibiotics are ineffective and should not be used.  There are a few or no treatments for most viral causes of pneumonia.  MD finds out by doing a culture. B.)Antibiotic resistance is growing amongst the bacteria that cause pneumonia.This often arises from the overuse and misuse of antibiotics in and out of the hospital. New and more effective antibiotics are urgently needed.
12. Being on a ventilator raises especially high risk for serious pneumonia.Ventilator-associated pneumonia is more likely to be caused by antibiotic-resistant microbes and can require the highest antibiotic use in the critically ill population.
13. Our changing interactions with the microbial world mean constantly developing new pneumonia risks.Emerging infections can lead to epidemics or pandemics, such as from avian influenza viruses (bird flu), severe acute respiratory system (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) virus, and more. Environmental reservoirs or sources can cause clusters of infection, such as Legionella pneumonia. Bioweapons can cause pneumonia such as from anthrax. Vigilance is needed to prevent pneumonia from becoming an even worse problem than it already is.
14. Patients with pneumonia may need to be hospitalized or even go to the intensive care unit (ICU).After developing pneumonia, it often takes 6-8 weeks until a patient returns to their normal level of functioning and wellbeing.
15. While successful pneumonia treatment often leads to full recovery, it can have longer term consequences.Children who survive pneumonia have increased risk for chronic lung diseases. Adults who survive pneumonia may have worsened exercise ability, cardiovascular disease, cognitive decline, and quality of life for months or years.
16. Pneumonia is a huge burden on our healthcare systems.In the US, pneumonia was one of the top ten most expensive conditions seen during inpatient hospitalizations.  In 2011, pneumonia had an aggregate cost of nearly $10.6 billion for 1.1 million hospital stays.
17. The death rate from pneumonia in the US has had little or no improvement since antibiotics became widespread more than half a century ago.We are not yet winning the battle against pneumonia.
18. Pneumonia does not have effective advocacy.It is not the subject of fund-raising walks or runs. It does not have a ribbon or other symbol around which people rally. It does not get the attention it needs from biomedical scientists or from research funders. More effort is needed now.
19. CDC states in the  best to do is prevention like so many other good resources; CDC stated the following in prevention is the following:   You are more likely to get pneumonia if you smoke or have underlying medical conditions, like diabetes or heart disease. However, you can lower your chances by taking good care of your medical problems, and quitting smoking.

“The holiday season is fast approaching, which has many people feeling increased levels of stress, anxiety, sadness, and loneliness. According to a survey by the American Psychological Association, 38% of people said their stress increased during the holiday season, and a study from the National Alliance on Mental Illness (NAMI) found that almost 64% of people with mental illness said the holidays made their condition worse.

While navigating family dynamics, financial issues, travel, and social gatherings can make it challenging to cope with these ups and downs, there are practical ways we can manage these feelings.”

David Bond, director of behavioral health at Blue Shield of California (https://news.blueshieldca.com/2022/11/30/here-come-the-holidays-tips-to-manage-holiday-stress)

Financial Reasons

The holidays can put a strain on even the most balanced budget. No matter how carefully you plan for the holiday season, the expense of purchasing gifts for family members, friends, colleagues, teachers, and others can be a significant stressor. Other costs such as food, travel, and the seasonal increase in utility bills can add to the stress.

Dealing with Crowds

In addition to stress caused by extra holiday spending, the very act of going shopping during the busiest season of the year can trigger seasonal stress. During the holidays, the stores are crowded, parking at malls and shopping centers is packed, and traffic is fierce. The stress of struggling to get to where you need to go to purchase items for those on your shopping list can really take a toll.

Increased Social Obligations

During the holiday season, there seem to be more demands on your time than at any other time of the year. Between school plays, office parties, cocktail parties, club or association gatherings, open house events, and additional social functions, it can be hard to find a free afternoon or evening to relax and unwind.

Preparing for Company

For many people, the holidays mean preparing for out of town guests. Preparing your house for visiting family members can be very stressful, as can dealing with having houseguests. Whether your relatives will be staying with you for a few days or for an extended period of time, having people in your home especially sleeping over can be stressful.

The Seasonal Stress Factor

Holiday stress can do more than wear down your patience. Juggling shopping, decorating, and cooking with holiday events and school vacations can take an emotional and subsequent physical toll on heart health. This escalates if there’s an additional stress from a death, illness or emotional distress in the family. In fact, emotional stress – such as feelings of anxiety, anger, fear, bereavement or depression – preceded heart attacks in 14 to 18 percent of patients, according to a study conducted by Mittleman and fellow researchers from BIDMC’s Institute for Prevention of Cardiovascular Disease. “Social interaction can boost your health and feelings of well-being as long as it’s positive,” Mittleman explained. However, “If tempers escalate at a family function, the best thing you can do is distance yourself.” Physical stress can also present risks. “We often see people in the hospital’s emergency department after a snow storm,” saidDr. Edward Ullman, a BIDMC cardiologist specializing in Emergency Medicine. “These are frequently individuals who are not in great physical condition, perhaps 50 to 60 years old, who have a significant coronary event when they are shoveling snow.” When it’s cold out, arteries clamp down and blood pressure can go up, according to Ullman. The incidence of heart attacks rises in the early morning, which is when most folks are shoveling snow.

Respiratory Conditions and Medications

Holiday merrymaking with groups of people in confined areas presents ample opportunities to pass along colds, viruses and the flu. The flu and respiratory infections trigger inflammation in the body, which can make plaque within arteries more likely to rupture, blocking arteries and raising the risk for heart attack. The good news is that getting a flu vaccine may protect you from more than just the flu. A recent study conducted in the UK found that a flu vaccination resulted in a 19 percent decrease in heart attack risk during the following year. If you are already fighting a cold, avoid taking decongestants if you have heart disease or high blood pressure. “While decongestants are designed to constrict blood vessels in the nose and airways, they also narrow blood vessels throughout the body,” said Ullman, “which can raise your blood pressure and increase your risk of heart attack or stroke.” Some decongestants, such as Pseudoephedrine, act as stimulants and raise the risk of irregular heartbeat in patients with atrial fibrillation, who are already at higher risk for cardiac dysfunction.

The Mayo Clinic recommends:

“The holidays are a time for family and cheer, but making sure the house is clean, the food is ready, and the presents are wrapped and ready to be opened can be overwhelming. These factors can bring unwanted stress and depression in a time meant for happiness.

Some important, practical tips can help minimize the stress that accompanies the holidays. These tips may even help you enjoy the holidays more than expected.

Through the endless parties, cooking, shopping and cleaning, try taking one of 9 steps to ensure you have a stress-free holiday:

1. Plan ahead.

Between co-workers, friends and family, it’s inevitable that some commitments will end up on the same day. Make sure to plan on what you can attend in person or virtually. If you’re hosting the holidays, create a menu to help you stay organized and make grocery shopping easier.

2. Say no.

With holiday commitments, it is OK to say no to a few or all of them. It also will help relieve some stress. Try sharing your to-do list with other family members.

3. Plan spending.

The holidays mean spending money. Make a budget and stick to it. Spending money on your loved ones is important, but it’s also important to pay your energy bill. Don’t buy gifts that you’ll be paying off for the rest of the year.

4. Create relaxing surroundings.

Turn on some music, light some candles or open the windows on a sunny day. Research has found that listening to music and the scent of citrus can boost feelings of well-being, and vitamin D is always a happiness booster.

5. Maintain healthy habits.

The holidays are notorious for ruining healthy habits. A short workout each morning will help your decision-making throughout the day. Encourage your family to try snow shoeing or sledding to get in extra exercise. Eat healthy snacks like fresh fruit or vegetables throughout the season and to fill up before a dinner party or celebration with tempting, but unhealthy, foods.

6. Share feelings.

Spending a holiday after a loss in the family can be difficult. Accept your feelings and open up about them to others. It may make you feel better to share. Try to switch up old traditions to ease the loss.

7. Respect differences.

Family members will have different viewpoints than your own. Try your best to forgive and forget this holiday season. Focus on your similarities, and replace tension with something productive.

8. Be realistic.

You are only one person, and you can only do so much. Be realistic with how much you can handle this season. Forget about perfection, and relax and enjoy the company surrounding you.

9. Take a break.

Don’t forget about your own needs. Take a nap, go for a short walk, read a book or watch a funny movie. Laughing relaxes the whole body, and can relieve physical tension and stress.

Holidays are meant to be a fun, enjoyable time with friends and family. These tips can help ensure you truly enjoy your holidays when stress starts to set in.

“The primary goal of treatment for Crohn’s disease and ulcerative colitis is to reduce inflammation. Your gastroenterologist will work closely with you to develop a treatment plan that addresses inflammation, helps manage symptoms and reduces flare-ups.

Treatment plans will vary based on your specific condition and the severity of inflammation and symptoms. Generally, Crohn’s and ulcerative colitis are managed with a combination of medication and diet and lifestyle modification. In some cases, when a nonsurgical approach fails to address your condition, your gastroenterologist may recommend surgery.”

Temple Health (https://www.templehealth.org/services/conditions/crohns-disease-versus-ulcerative-colitis)

“Known collectively as inflammatory bowel disease (IBD), Crohn’s disease and ulcerative colitis are painful, medically incurable diseases that attack the digestive system, causing symptoms including abdominal pain, persistent diarrhea, rectal bleeding, fever, and weight loss.

“Soap and water is necessary for effective hand-washing. Most commercially available soaps will work fairly well. The basic chemical structure of soap is what accounts for its effectiveness, so adding things like nice smells or color isn’t going to make you any cleaner. Neither is antibacterial soap, which the FDA recommended against using in 2016. So when it comes to hand-washing, use ordinary soap, and use it well. Most of the effectiveness of this revolutionary practice comes from your own good habits and diligence.  If you’ve ever wondered how to wash your hands properly, a quick rinse does not get rid of germs as effectively as a long, thorough scrub for 20 seconds. So how long should you wash your hands? The Center for Disease Control and Prevention (CDC) hand hygiene guidelines note you should scrub for at least 20 seconds, or about twice as long as it takes to sing “Happy Birthday” to yourself.”

(https://www.joyce.edu/blog/national-handwashing-awareness-week/#handhygiene)

“Following Hand Awareness and continuously keeping the hands clean you will be in virtual isolation regardless of the people around you. Direct contamination (inoculation) of your mucus membranes (eyes,
nose or mouth) is the most common way infectious disease enters your body. Let’s work together to minimize the fear factor of infectious disease pandemics or seasonal.  It would help in prevention of many infectious diseases that could help in the prevention with handwashing!”

Henry the Hand Foundation by Dr. Will Sawyer-Infection Disease Expert (https://henrythehand.com/news-events/national-handwashing-awareness-week/)

“When HIV is left untreated, it can wreak havoc on a person’s immune system. As this happens, the body is less able to fight off infections. AIDS stands for “Acquired Immune Deficiency Syndrome,” which means the immune system has been made less effective by HIV. When this happens, a person is considered to have an acquired immune deficiency or AIDS.

It’s important to note that you cannot have AIDS without being infected with HIV. But people can, and do, live long lives (on treatment) with HIV and never develop AIDS.
Once you have HIV, the virus stays in your body for life. There’s no cure for HIV, but medicines can help you stay healthy.”

AHF (https://hivcare.org/hiv-basics/?gclid=EAIaIQobChMItumtgbjZ-wIVunRvBB1fpwL2EAAYASAAEgIslfD_BwE)

“HIV continues to be a major global public health issue, having claimed 40.1 million [33.6–48.6 million] lives so far.  In n 2021, 650 000 [510 000–860 000] people died from HIV-related causes and 1.5 million [1.1–2.0 million] people acquired HIV.  There is no cure for HIV infection. However, with increasing access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.  There were an estimated 38.4 million [33.9–43.8 million] people living with HIV at the end of 2021, two thirds of whom (25.6 million) are in the WHO African Region.”

World Health Organization-WHO