A cough is one of the most common reasons people visit a doctor. But not every cough is a cause for panic, and not every cough is pneumonia.According to Dr. Harshil Alwani, Consultant, Pulmonology, CK Birla Hospitals, Jaipur, most coughs that follow a viral infection, allergy, or common cold usually fade within a week or ten days. These often come with mild throat irritation or a stuffy nose, and improve gradually with rest and hydration.Pneumonia, however, is an entirely different story. The cough becomes harsher, more painful, and often brings up thick yellow or green sputum. Fever, chills, chest pain, and breathlessness are telltale signs that something deeper is going on. In severe cases, people may experience fatigue, confusion, or rapid breathing, especially older adults or those with chronic conditions. These are definite red flags that need urgent attention.Not Always The Textbook SymptomsWhat makes pneumonia particularly tricky, says Dr. Alwani, is that it doesn’t always appear with dramatic symptoms.“In elderly individuals, or those with diabetes, heart disease, or weak immunity, pneumonia can present very quietly, sometimes just as low energy, loss of appetite, or mild breathlessness,” he explains. “That’s why subtle changes shouldn’t be ignored.”A chest X-ray is the simplest and most reliable way to confirm pneumonia. In unclear cases, a CT scan can give a clearer picture, while blood tests like CRP or procalcitonin help determine whether the infection is bacterial (which may require antibiotics) or viral (where supportive care is enough).Why Children Are Especially at RiskChildren, unfortunately, bear a large part of the global pneumonia burden.Dr. Srikanta J.T., Consultant, Paediatric Interventional Pulmonology, Aster CMI Hospital, Bangalore, points out that pneumonia is riskier for children because their immune systems are still developing and their lungs are smaller. “Their bodies can’t fight infections as strongly as adults can,” he explains.Malnutrition, lack of vaccination, and exposure to polluted air or cigarette smoke heighten the risk. In 2016 alone, India recorded over 1.58 lakh deaths among children under five due to pneumonia, with a death rate of 6.3 per 1,000 live births.Poor sanitation, crowded homes, and delayed access to medical care make matters worse. “Children from low-income families are especially vulnerable,” Dr. Srikanta notes. “Simple steps like breastfeeding, timely vaccination, and clean air can save countless young lives.”Why India Is Still a HotspotTwo-thirds of all pneumonia and diarrhoea-related deaths occur in just 15 countries — and India is among them. Experts say the problem is linked to a mix of environmental and socioeconomic factors.Overcrowded urban slums, polluted air, malnutrition, and poor healthcare access mean infections spread faster and treatment often comes too late. In rural areas, limited healthcare facilities and awareness make early diagnosis difficult.“The situation worsens when antibiotics are used carelessly,” warns Dr. Srikanta. “We’re now seeing more drug-resistant pneumonia cases in children — infections that don’t respond to standard treatment, forcing doctors to use stronger, costlier drugs.”The Role of Pollution and Climate ChangeRising air pollution and erratic weather are adding new challenges. Dirty air filled with smoke, dust, and harmful gases irritates the lungs, lowering their ability to fight infections. Sudden temperature shifts, like hot days followed by chilly nights, weaken immunity, helping bacteria and viruses thrive.Floods, droughts, and poor air quality also limit access to clean water and nutrition, further increasing children’s vulnerability. “Cleaner energy and better air control aren’t just climate goals anymore,” Dr. Srikanta stresses. “They’re essential to protecting children’s lungs.”New Hope: Vaccines and AwarenessFortunately, progress is being made. New and updated vaccines are offering stronger protection against the bacteria that cause pneumonia. Governments and health organisations are expanding immunisation drives to reach children in remote and low-income regions. Awareness campaigns are also encouraging parents to complete all vaccine doses on time.Experts say these combined efforts, along with better nutrition, hygiene, and early treatment — are gradually reducing pneumonia deaths worldwide. But there’s still a long way to go.When to See a DoctorDr. Alwani advises not to “wait it out” if a cough lasts more than a week, worsens, or is accompanied by fever, fatigue, or breathlessness. “Timely medical evaluation can prevent complications and even save lives,” he says.For prevention, he recommends staying well-hydrated, eating a balanced diet, resting adequately, and avoiding cigarette smoke or polluted environments. “The goal isn’t just to treat pneumonia — it’s to strengthen your lungs and immunity so you don’t get it in the first place.”
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