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NZ children more at risk of pneumonia

10 November 2011

NZ children more at risk of pneumonia than children in other developed countries

World Pneumonia Day gives reason to reflect on the state of the disease in New Zealand and why our children are worse off than children in other developed countries.

Pneumonia is the leading cause of death among children under 5 years of age and worldwide it kills more than 1.5 million children each year.1

Dr Cameron Grant, Associate Professor in Paediatrics at the University of Auckland and a Paediatrician at Starship, says that while only a small percentage of New Zealand children die from pneumonia, large numbers are hospitalised. Pneumonia as a health issue for New Zealand children is underestimated. It affects more children here than in other developed countries.

“The rates of childhood pneumonia in New Zealand are two to five times higher than in the Australia, England and the United States. We are particularly concerned about the incidences in children under the age of two who are more likely to experience severe disease, disease that is of rapid onset and multiple episodes of pneumonia.”

The incidences of health complications caused by pneumonia are also comparatively high in New Zealand. Rates of bronchiectasis (irreversible lung scarring) are seven times higher among New Zealand children than children living in Europe, with higher risks in Maori and Pacific children.2

In addition to the toll on the health of our youngest New Zealanders, pneumonia treatment for those under 15 years of age is estimated to cost $7 million annually.3 This estimate only includes the costs of hospital admissions, emergency department visits and general practitioner visits. It does not include the many other costs to the child and family.

Immunisation is a good preventative measure and Dr Grant says it is essential to ensure children are vaccinated on time. “As well as vaccinating against pneumococcal disease, other vaccines on the National Immunisation Schedule are just as important. Infections such as measles and pertussis (whooping cough) can result in pneumonia complications and are preventable.”

Top tips for preventing pneumonia:

As the saying goes, prevention is better than cure. Although treatment in New Zealand is highly effective, the disease becomes more difficult to treat if it has been there for longer or occurs repeatedly. Dr Grant’s top tips for preventing pneumonia are:

• Immunisation – as well as ensuring your child is vaccinated on time (with the vaccines on the National Immunisation Schedule) pregnant woman and small children should consider being vaccinated with the flu vaccine.
• Good nutrition – not just for the infant but for pregnant mothers too. Breastfeeding is important.
• Eliminate exposure to cigarette smoke – especially in the home.
• Better housing – eliminate dampness and increase insulation.
• Limit exposure to illness – keep people with colds or other respiratory illness away from young children.
• Easier access to primary care – the requirement for co-payment in primary care can dissuade some poorer people in our community from visiting their family doctor. Because they may be avoiding payment or outstanding bills, parents can inadvertently wait until pneumonia is at an advanced stage before taking sick children to hospital.

What are the signs of pneumonia that parents should look out for?

Children with pneumonia may or may not have a temperature, so it can be difficult to detect. However, Dr Grant notes some important symptoms parents should be vigilant for:

• Fast or difficult breathing
• A painful cough

Dr Grant’s advice is that parents should always be alert. “Basically if your child has an illness that becomes more than just a cold, seek medical attention straight away.

“We advise parents to be aware of fast breathing or more difficult breathing. Children who are having more difficulty breathing use their breathing muscles more. So you see the muscles in their neck tightening, the skin sucking between the ribs when the baby is breathing and the nostrils flaring.”

Dr Grant says fortunately the pneumonia mortality rate in New Zealand is very low because of the high quality of medical care, but as a country there is a great deal of room for improvement in regard to preventative measures.

November 12 is World Pneumonia Day. For more information on the disease visit:


About Dr Cameron Grant

Dr. Cameron Grant is an Associate Professor in the Department of Paediatrics: Child and Youth Health at the University of Auckland and a paediatrician at Starship Children’s Health. He is the Associate Director of Growing Up in New Zealand and of the Centre for Longitudinal Research – He Aka ki Mua, at the University of Auckland. He graduated MBChB from the University of Otago and PhD from the University of Auckland. His postgraduate paediatric training was as a resident at Duke University Medical Center and then a fellow at the Johns Hopkins University.

Dr. Grant returned to the Johns Hopkins University in 2008 as a Fulbright Senior Scholar. In 2008 he became an overseas fellow of the National Institute of Health Research National School of Primary Care (UK).

His teaching skills have been recognised with faculty and university teaching awards including a University of Auckland Teaching Excellence Award for sustained excellence in teaching.

His research focuses on health problems that are common, affect New Zealand children disproportionately, and are preventable by immunisation or improved nutrition. He has published more than 70 refereed research papers, reviews and book chapters.



1 World Pneumonia Day. Available at: Accessed 31 October 2011
2 Twiss J et al. Arch Dis Child. 2005;90:737–740.
3 Grant C, Milne R. What does pneumonia cost New Zealand. In: Asher I, Byrnes C. Trying to catch our breath; the burden of preventable breathing diseases in children and young people. Wellington: Asthma and Respiratory Foundation of New Zealand; 2006:35–39.

Synflorix® (pneumococcal polysaccharide conjugate vaccine, 10-valent adsorbed), is an injection for intramuscular use only. It is available as a prescription medicine for active immunisation of infants and children from the age of 6 weeks up to 5 years against disease caused by Streptococcus pneumoniae serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, and 23F (including invasive disease, pneumonia, and acute otitis media). The vaccination course of Synflorix consists of three doses beginning at 6 weeks of age, with at least 1 month between doses, plus a booster dose at least 6 months after the third dose. Children aged between 2 and 5 years should have two doses with an interval of at least 2 months between doses. Each 0•5mL dose contains: 1mcg of pneumococcal polysaccharide serotypes 1, 5, 6B, 7F, 9V, 14, and 23F and 3mcg of pneumococcal polysaccharide serotypes 4, 18C, and 19F, adsorbed onto 0•5mg aluminium phosphate. Synflorix also contains approximately 13mcg of protei
n D, 8mcg of tetanus toxoid, and 5mcg of diphtheria toxoid, as carrier proteins. Synflorix should not be administered in children who have previously had any allergic reaction to Synflorix or any ingredient in Synflorix. Tell your doctor if your child has a severe infection with a high temperature, has a bleeding problem or bruises easily, has breathing difficulties, is taking any other medicines, or recently received any other vaccine. Common side effects include irritability, fever, drowsiness, loss of appetite, and pain, redness, bleeding or swelling at the injection site. If your infant or child has side effects, see your doctor, pharmacist, or health professional. Additional Consumer Medicine Information for Synflorix is available at Ask your doctor if Synflorix is right for your infant or child. Synflorix is a registered trademark of the GlaxoSmithKline group of companies. Marketed by GlaxoSmithKline NZ Limited, Auckland. TAPS NA 5415.

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