Pneumonia is an infection in your lungs. It is caused by different germs, usually bacteria or a virus and sometimes fungi.¹  Our lungs are made up of lots of little air sacs (alveoli). Pneumonia causes these to become inflamed and fill with fluid and pus, making it harder to breath.^1,4

In general, your body prevents these germs from reaching the air sacs in your lungs. But if your body is not able to fight off the germs, you can get pneumonia. Such as when your immune system is weakened or during a bout of cold or the flu.⁴

Pneumonia can be spread from person to person through physical contact, coughing and sneezing.³

People with pneumonia often have cold or flu symptoms before they start to get worse.¹ 

Symptoms can range from mild to severe, depending on factors such as your age, the type of pneumonia you have, or your overall health.^1,3

The most common symptoms are:^1,3

• High fever and chills

• Cough, sometimes with phlegm

• Shortness of breath 

• Chest pain

• Fatigue

Pneumonia can also follow a bout of a cold or the flu.¹ People can have symptoms of a cold or flu, that may become better, then start to get worse a few days or weeks after.¹  If you or someone in your care is not recovering and symptoms get worse, it could be pneumonia.

In older people, fever and cough aren’t always present. In fact, confusion and disorientation can be the more common warning signs.⁵

The common symptoms of pneumonia such as fever, cough and chills don't always appear in older and frail people. Warning signs can be quite non-specific making it difficult to diagnose.⁵ 

Symptoms in older and frail people include:

• Confusion or worsening confusion

• Falls

• Reduced appetite

• Urinary incontinence

• Tiredness

• Rapid breathing

Pneumonia can progress quickly and cause severe complications, especially among older people and those with a risk condition. So, it is vital to get medical attention as soon as you think you, or someone in your care may have pneumonia.

See your doctor right away if you, or your child:

• have a cold that doesn’t get better with rest and treatment, or, if the symptoms get worse
• have severe symptoms such as chest pain, confusion or rapid breathing
• have trouble breathing
• your baby looks very ill, has a high fever, may not be feeding, and is breathing quickly

In severe cases, you or your child might need to go to the hospital.

Older adults are more than 5 times as likely to be hospitalised with pneumococcal pneumonia than younger adults.⁶

Your doctor will listen to the lungs for crackling or other abnormal sounds.⁴ If these are present, they may request a few other tests to confirm their diagnosis^1,4. These include:

• Chest X-ray to see what your lungs look like
• A blood test to check for signs of infection

There are several kinds of germs that can cause pneumonia.¹ They include:

• Bacteria – examples are Streptococcus pneumoniae and Haemophilus influenzae

• Viruses – examples are influenza (commonly known as the flu), coronavirus and respiratory syncytial virus

• Fungi – these are a less common cause, mostly affect people with a fragile immune system.

Many cases of community-acquired pneumonia are due to the bacteria, Streptococcus pneumoniae, also known as “pneumococcal pneumonia”.¹

Pneumonia can occur anytime of the year. Community-acquired pneumonia can be more common during cold and flu season.²  A cold or flu can weaken the immune system and even damage the airways. This creates an opportunity for bacteria to cause infection in the lungs.³

In the community, these germs are often spread by touching contaminated objects, sharing eating or drinking utensils and through breathing infected droplets in the air from someone coughing or sneezing.³

Staying home when sick, hand hygiene, avoiding touching your face, and coughing or sneezing into your elbow are just some things that can help to reduce the spread.

Pneumonia can affect anyone at any age. Some people are more likely to get pneumonia or develop a more severe illness because of their age or risk conditions.^1,3

The two age groups are at higher risk because of their weaker immune systems are:

• Babies 12 months and under.

• People 70 years of age and older.

Other risk factors and groups at risk include:

• Smoking or being exposed to tobacco smoke.

• Respiratory conditions (such as asthma, chronic obstructive pulmonary disease).

• Chronic medical conditions (such as diabetes, heart disease, liver disease, kidney disease).

• Weak immune system (caused by conditions such as HIV/AIDS, receiving chemotherapy for cancer, use of steroids for a long time, having no spleen, or organ transplants).

• Being on a ventilator (machine used to help you breathe).

• Having recently had the cold or flu.

• Aboriginal and Torres Strait Islander people.

• Māori and Pacific Islander people.⁷

Complete the Pneumonia Risk Quiz to help understand your risk and start a conversation with your doctor.

There are several reasons why people 70 years and older are more likely to develop pneumonia:⁸

• Weaker immune system. As we age, our immune defence system doesn't work at 100%, leaving you more vulnerable to infection.

• Ineffective ability to cough out germs. One of the ways our body gets rid of harmful germs in our airways is by trapping them in mucous and coughing it out. Inability to do this well can increase the chance of harmful germs reaching the lungs.

• Higher likelihood of having other health conditions that make you more vulnerable. Certain conditions like chronic obstructive pulmonary disease, heart failure, diabetes, conditions that weaken your immune system and some forms of cancer have been shown to increase a person's risk.

Complete the Pneumonia Risk Quiz to help understand your risk and start a conversation with your doctor.

Most people’s symptoms can improve in days from starting treatment but, it could take weeks or months for a full recovery.⁴ People might continue to have a cough and experience fatigue for weeks or months.¹ It is vital to listen to your body and get lots of rest.
It can take weeks or months for you to feel yourself again. 

Pneumonia can sometimes lead to severe complications.⁹
Tissues in your body (especially in your heart and brain) might not receive the oxygen they need. Pneumonia can lead to:⁹

• fluid or pus build up around the lungs

• bacteraemia (infection in the blood), which can spread to other organs

• worsening of other illness or conditions that you may have such as heart failure, arrhythmias (abnormal heart rhythm) and may lead to heart attack.

• hospitalisation and even death.

Pneumonia can progress quickly and cause such complications, especially in those with a risk condition. It is essential to see your doctor as soon as you think you, or someone in your care may have pneumonia.

• Avoid contact with sick people; if you are sick, limit contact with others as much as possible.

• Practice good hand hygiene, wash your hands regularly with soap and water.

• Cough and sneeze into a tissue or your arm sleeve (instead of your hands).

• Limit exposure to cigarette smoke; stop smoking (if you smoke).

• Keep up with your health visits.

• Get enough sleep, eat a healthy diet, and exercise to help you stay well.

• Talk to the doctor or nurse about prevention options, including vaccination.