Pneumonia overtakes heart disease as Malaysia’s top killer

[WORLD] Last year, pneumonia was responsible for approximately 18,181 deaths in Malaysia, accounting for 15.2% of all medically certified fatalities. Despite this alarming statistic, many still view pneumonia as merely a mild complication of the flu.

Efforts to raise public awareness about the seriousness of pneumonia have faced challenges, in part due to the fact that its symptoms often resemble those of more common respiratory conditions. However, unlike seasonal colds, pneumococcal pneumonia can lead to severe complications, such as sepsis, lung abscesses, and respiratory failure—outcomes that highlight the critical need for early detection and prevention.

Pneumococcal pneumonia, caused by the Streptococcus pneumoniae bacteria, is a life-threatening lung infection that can strike suddenly and progress rapidly. According to the Department of Statistics, pneumonia has, for the first time in over two decades, surpassed heart disease as the leading cause of death in Malaysia.

This shift in health trends mirrors global patterns in countries with aging populations, where infectious diseases are re-emerging as significant threats. The World Health Organization (WHO) has identified pneumococcal disease as a priority for immunization programs, particularly in countries like Malaysia, where urbanization and intergenerational living conditions may accelerate transmission.

Dr. Roslina Abdul Manap, Chairman of the Lung Foundation of Malaysia, noted that Malaysia's population is aging at an unprecedented rate, with 11.6% of citizens aged 60 and above in 2024. By 2050, this figure is projected to rise to 23.4%. “This demographic shift presents a major public health challenge, as older individuals are more vulnerable to severe respiratory infections," she said.

Adding to the concern is the high prevalence of comorbidities—nearly 40% of Malaysians over 50 suffer from at least one chronic condition, according to the National Health and Morbidity Survey. These underlying health issues can obscure pneumonia symptoms or hasten their progression, causing many patients to seek treatment only at later, more critical stages.

“Pneumococcal pneumonia is particularly dangerous for the elderly because their immune systems are weakened, and symptoms may not be as pronounced as they are in younger adults,” Dr. Roslina explained to Bernama. This delayed recognition often leads to severe complications, hospitalization, or even death.

“As we age, our immune defenses naturally weaken, making it harder to fend off infections like pneumococcal pneumonia,” she added. “Once the bacteria invade the lungs and bloodstream, they can cause serious illness, and older adults are at greater risk of death.”

Dr. Roslina also emphasized that individuals with weakened immune systems or underlying conditions such as diabetes, high blood pressure, heart disease, or chronic lung conditions face heightened risks.

Healthcare providers are increasingly advocating for routine pneumonia screenings in high-risk groups, similar to regular diabetes or hypertension checks. Such initiatives could help reduce hospitalizations, which are putting additional strain on Malaysia's healthcare system—particularly as respiratory wards face bed shortages during peak infection seasons.

Though influenza and pneumococcal pneumonia share certain symptoms, the latter is more severe and often more difficult to diagnose. Affected individuals may experience a high fever, persistent cough with phlegm, breathing difficulties, and chest pain. “In some cases, confusion or extreme fatigue may be the only indicators, especially among older adults,” Dr. Roslina said.

She also noted that pneumococcal pneumonia can occur year-round, spreading through airborne droplets from coughing or sneezing. High-density environments such as airports, crowded public areas, and even hospitals are prime locations for transmission. Vaccination remains the most effective defense against pneumococcal pneumonia.

“Pneumonia is a major health concern during haj gatherings, often leading to hospitalizations due to the overcrowding, close contact, and high potential for airborne transmission,” Dr. Roslina pointed out.

The Ministry of Health has collaborated with religious authorities to promote pre-pilgrimage vaccinations, but uptake has been inconsistent. Cultural misconceptions and concerns about side effects continue to persist, despite clinical evidence that the pneumococcal vaccine can reduce hospitalization rates by up to 75% among vulnerable populations.

Dr. Roslina also highlighted that studies have shown that receiving both the flu and pneumococcal vaccines together is both safe and effective. “With more Malaysians receiving flu shots ahead of the travel season, it's a good opportunity to consult with your doctor about getting vaccinated against pneumococcal pneumonia at the same time,” she advised.

In addition to health protection, the government offers financial incentives for vaccinations, allowing individuals to claim up to RM1,000 in tax relief for vaccination expenses incurred for themselves, their spouse, children, parents, or grandparents. This includes pneumococcal vaccinations.