Six signs it’s pneumonia, not just the flu

You may worry about getting the flu. But your doctor worries about something worse: a bacterial co-infection.

It happens when the flu–a viral infection in your upper respiratory tract–drops into your lungs. There, it turns into a bacterial infection in your lower respiratory tract. In other words, you get pneumonia.

And pneumonia is the real killer.

In fact, it’s a leading cause of death in older people. Regardless of underlying acute infections or chronic diseases.

Many experts expect this year to turn into the worst flu season in a decade. But the deadliest flu epidemic of the century killed millions of Americans in 1918. Almost all of those who died had actually developed bacterial pneumonia. In 2009, the influenza A virus (H1N1) caused bacterial pneumonia in more than one-third of those who died.

I often wonder about those who end up with bacterial pneumonia when they started out with a simple viral infection of the upper respiratory tract.

The respiratory tract is one of the major interfaces between your body and the outside environment. The surface of your respiratory tract, if laid out flat, is larger than a tennis court. That is a lot of surface to protect.

Special cells line the respiratory passages. And these cells help repel invaders. Many of the cells also have cilia, or little hairs, that constantly sweep contaminants away. They also back up the respiratory tract. You can literally “cough them up” in sputum.

Heavy smokers lose the hairs on these special cells. Their cells become “flattened out” into squamous cells. (These squamous cells can also turn into the most common cancers of the lung.) Not surprisingly, smokers tend to have trouble fighting off colds. This happens because the special cells in their respiratory passages can’t push out the invaders.

Of course, your immune system also helps defend against bacterial infections. Lymphoid tissues and white blood cells attack and eliminate invading particles, such as viruses and bacteria.

There’s also special tissue surrounding your throat that’s very useful. Air passes through your nose and mouth. Food and water also passes through your mouth. But for any invader to get from the upper to the lower respiratory tract, it must first pass Waldeyer’s Ring.

And–no–Waldeyer’s Ring is not the treasure sought on some journey into a semi-mythical land.

It’s a highly adaptive part of your anatomy. And it protects you from respiratory infections. That is, unless, it’s been surgically removed!

You see, Waldeyer’s Ring is a circle of lymphoid tissue that surrounds the interior of your throat. It consists of two tonsils, two adenoids, and smaller collections of lymphoid white blood cell tissues.

You don’t really notice them much until they become inflamed. When you get a cold and fight off an infection, immune cells proliferate. The tissues in Waldeyer’s Ring swell.

Unfortunately, many doctors consider these tissues expendable. In the 1940s, 1950s, and beyond, the philosophy ran rampant. We now have entire generations of aging Americans who grew up in the age of the tonsillectomy and adenoidectomy.

Did you–like the kids in Cheaper by the Dozen–get a routine tonsillectomy in childhood? If so, will you fall prey to pneumonia or bacterial co-infections more easily? Now, that is a good question that ought to be researched. Of course, we now have antibiotics to “protect” us in the absence of our own natural immune tissues. But we know how that has been working out lately.

If you had your tonsils removed, it’s a good idea to watch out for pneumonia if you get the flu.The signs of pneumonia vary from mild to severe. Some of the signs to watch out for include:

  • High fever 
  • Shaking chills 
  • A productive cough with thick or bloody phlegm
  • Shortness of breath with normal daily activities
  • Chest pain when you breathe or cough
  • Feeling suddenly worse after the flu

If you’re an older adult, you may have fewer and milder symptoms. Remember there is such a thing as “walking pneumonia.” You may even have a lower than normal temperature. Older adults who catch pneumonia also sometimes have sudden changes in mental awareness, or sudden mental “brightness.”

If you’re one of the lucky ones and still have your Waldeyer’s Ring intact…consider yourself the lucky owner of a valued treasure indeed!