Childhood pneumonia cases up 50% in 10 years, NHS data shows

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By Nicola Davis

A&E admissions highest in deprived areas of England as bronchiolitis drives increase

Emergency hospital admissions for children with pneumonia have risen by more than 50% in England over the past decade, figures suggest, with admission rates highest in more deprived areas.

According to NHS Digital data analysed by the charities Unicef and Save the Children, between April 2018 and March 2019 there were 56,210 emergency admissions in England for pneumonia in those aged 18 or younger, using a definition that included a type of lower respiratory tract infection called bronchiolitis. In contrast, there were 36,862 such admissions between April 2008 and March 2009.

The charities said the current figure was equivalent to six children being taken to hospital every hour.

The data reveals the rise to be primarily driven by a large rise in bronchiolitis, with small increases in other diagnoses including viral pneumonia and influenza with pneumonia.

When the team scrutinised recent data, it found rates of hospital admissions of children were higher in more deprived areas of England.

Kevin Watkins, the Save the Children chief executive, said: “I would describe pneumonia as the ultimate disease of poverty, both in the UK and globally.”

While overall across England in 2018-19, just over 450 of every 100,000 children registered with GPs were admitted to hospital with pneumonia as an emergency, the rate was more than twice as high for NHS Scarborough and Ryedale clinical commissioning group, at 1,058 per 100,000. NHS Oldham CCG had the second-highest rate of 993.7 per 100,000.

The team said it was still unpicking why rates were higher in more deprived regions. However, according to the World Health Organization, crowded housing, indoor air pollution, parental smoking, lack of breastfeeding, and malnutrition are among the factors known to increase the risk of pneumonia in children.

Watkins urged parents to be aware of the symptoms of pneumonia in children, including breathing difficulties, fever, coughing and not feeding properly, noting delays in diagnosis and treatment could result in a case becoming serious.

Since 2006, as part of the childhood vaccination programme, children under the age of two in the UK have received a pneumococcal vaccine known as PCV, which protects against 13 different strains of Streptococcus pneumoniae. These bacteria are a common cause of pneumonia, although it can also be caused by certain fungi and viruses.

The data shows emergency child hospital admissions from bacterial pneumonia alone have fallen. However, PCV is among the childhood vaccines for which take-up has fallen across England in recent years, alarming experts who say children are being left unprotected against serious illnesses including measles.

While the charities said the hospital figures largely appeared to be driven by a rise in the viral infection bronchiolitis – which is not protected against by PCV – experts urged parents to make sure their child had been vaccinated against both pneumonia and flu.

Anthony Harnden, a professor of primary care at Oxford University, who was not involved with the work, stressed the need for prevention.

“While there may be multiple reasons why bronchiolitis in children is rising in the UK, such as lower thresholds for hospital referral and diagnosis, these figures only reinforce the need for parents to get their children immunised with the pneumococcal vaccine and the influenza vaccine to reduce their risk,” he said.

“Moreover, there will be future vaccines to protect against respiratory syncytial virus, a major cause of bronchiolitis.”