Pneumonia

Definition

Pneumonia is the inflammation of tissue in the lungs (alveoli). It is triggered by bacterial infection and causes the alveoli to fill with fluid. The main symptoms include a cough, difficulty breathing and/or feeling breathless, increased heart rate, chest pain, fever, sweating and shivering. The most common cause of infection which leads to pneumonia is inhaling the bacteria streptococcus pneumoniae, though other bacteria and viruses may also cause pneumonia.

People at a greater risk of contracting pneumonia are young children and infants, elderly people, smokers, people with pre-existing health conditions and people with a compromised immune system. A person who has recently been ill, as a result of having flu for instance, will have a weakened immune system and will be at greater risk of developing pneumonia. Pneumonia is a greater problem during autumn and winter. This is thought to be because pathogens, such as the influenza virus, spread readily at low temperatures causing a greater number of predisposing infections during winter time.

History

Hippocrates gives a written account of pneumonia in approximately 460-370 BC. He calls the old disease ‘peripneumonia’ and describes its recognisable symptoms: fever, chest pain and cough.

A series of discoveries made by researchers over time led to our understanding of the cause of pneumonia today. In 1875 Edwin Klebs discovered bacteria in the bronchi (the main airways in the lungs) of patients with pneumonia. In 1881 two researchers, George Sternberg and Louis Pasteur, independently isolated the bacteria that is now known as streptococcus pneumoniae, and showed its pathogenic potential in animals through experiments using rabbits. The work of Carl Friedlander and of Albert Fraenkel in the following years helped prove that this bacteria was causing the disease pneumonia itself.

Pneumonia was a major killer in Britain during the late 19th and early 20th centuries. A person with bad health is at risk of developing pneumonia. Poor diet, lack of access to healthcare and the spread of infectious disease during this time meant that illness was extremely common, which in turn increased the likelihood of people contracting pneumonia. In particular, young children are a risk group for pneumonia. Their vulnerability to illness is why pneumonia affected this age group so significantly during the burial registers’ lifetime.

Flu is associated with pneumonia because those who have had flu are more susceptible to developing pneumonia. During the influenza pandemic of 1918-19, there was corresponding epidemic in Britain in pneumonia. This is reflected within the Leeds General Cemetery burial registers; the period in which the highest number of people were attributed the cause of death pneumonia was 1910-19. The First World War had created food shortages which led to undernourishment, particularly in children. This is considered to have been a contributing factor in the fatality of pneumonia during this time.

Although air pollutants have not been definitively proven as a cause of pneumonia, studies indicate that exposure to emissions increases a person’s risk of developing pneumonia. The increased levels of air pollution caused by industrialisation in Britain may have contributed to the increased number of fatalities from pneumonia in the late 19th century.

Today pneumonia is treated with antibiotics. Nonetheless, the disease is still persistent and some antibiotic resistant strains have developed.

Pneumonia is one of the top ten most common causes of death recorded in the Leeds General Cemetery burial registers . To find out more, visit the Leeds General Cemetery Burial Registers Index. Select ‘View key statistics’ to generate charts displaying the breakdown of who this disease affected.

Written by Imogen Gerard and Kelsie Root, as part of their internship with the AHRC project, 'Living with Dying: Everyday Cultures of Dying within Family Life in Britain, 1900-50s', summer 2017.