Q: Have there been more cases of pneumonia than usual this flu season? I know so many people who were ill for many weeks with pneumonia both here and on the Mainland. My second question is about the pneumonia vaccine, which involves two shots a year apart. Is this shot only for older people or can young adults or even children benefit from vaccine protection?
Dr. Scott Hoskinson, infectious disease, Hawaii Permanente Medical Group/Pacific Permanente Group: I’m sorry to hear about your friends getting sick during this flu season, but it seems like it might be an unfortunate coincidence. The Centers for Disease Control and Prevention has not reported a significant increase in pneumonia after documented influenza for this 2018-19 flu season. There’s been the usual increase in pneumonia, which is present each flu season, but compared to last year there have actually been fewer overall cases of pneumonia and deaths from pneumonia and influenza.
Regarding your second question, it’s important to know that there are two commonly used pneumonia shots: Pneumovax23 and Prevnar13. They are both meant to prevent serious infections by the bacteria streptococcus pneumoniae. Children are routinely vaccinated in childhood with Prevnar13, which is the stronger of the two vaccines. Routine vaccination of children with the older Pneumovax23 is not recommended and not felt to be of enough value for otherwise healthy children.
For healthy adults under age 65, they are not felt to be at enough risk of infection from streptococcus pneumoniae that routine vaccination with either shot is of value.
If adults have a problem with their immune system, then one or both shots could be recommended depending on the degree of immune system problem. Once we reach 65 years of age, our immune systems have weakened, and the risk of infection with streptococcus pneumoniae increases. As a result, those ages 65 and over benefit from getting both shots.
The last point is to remember that other types of bacteria besides streptococcus pneumoniae can cause pneumonia. It’s important to receive the above vaccines as recommended by your personal physician, but you can still get pneumonia from infections with other bacteria.
Q: What causes sinusitis and how is it treated?
Dr. David Crow, otolaryngologist: Sinusitis is an infection of the sinuses. It often starts when some kind of irritation or inflammation — like a cold, allergy, smoking or pollution — causes the channels that drain the sinuses to swell and become blocked, making it hard to clear mucus. This fluid can then become infected, leading to congestion, pain, and pressure.
If someone gets frequent sinus infections, they may have chronic sinusitis. In these cases, your physician may want to examine your nasal and sinus cavities with an endoscope and take samples of any pus draining from the sinuses. Possible treatments could include antibiotics, nasal saline flushes, and a topical nasal steroid. If those treatments aren’t effective, surgery may be necessary to fix the problem.
* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.