Pneumonia: symptoms, treatment, recovery time and whether it is contagious

The NHS says symptoms of pneumonia can start suddenly or gradually over a few days. NHS inform says they can develop over 24 to 48 hours or more slowly, and that pneumonia is more widespread in autumn and winter.

• a cough

• shortness of breath

• a high temperature

• chest pain

• an aching body

• feeling very tired and loss of appetite

• making wheezing noises when you breathe (babies may make grunting noises)

• feeling confused, which is common in older people

NICE Clinical Knowledge Summaries describes pneumonia as an infection of the lung tissue in which the air sacs become filled with microorganisms, fluid and inflammatory cells, affecting how the lungs work. Asthma + Lung UK calls pneumonia a type of chest infection and says that if you have asthma, COPD or another lung condition you are more likely to get seriously ill or need hospital treatment.

NHS inform says pneumonia is not usually passed from one person to another, so it is safe to be around others, including family. However, people with a weakened immune system should avoid close contact with a person with pneumonia until they start to get better.

The NHS notes that you can sometimes get pneumonia if you have another infection such as flu, respiratory syncytial virus (RSV) or COVID-19, and those infections can spread. The NHS advises covering your mouth and nose with a tissue when you cough or sneeze, binning tissues quickly and washing hands regularly.

The NHS says that if pneumonia is caused by bacteria you will usually be given antibiotics. If you are given antibiotics to take at home, keep taking them until finished even if you feel better, and contact your doctor if you do not feel any better after 2 to 3 days. NHS inform says to speak to your GP if symptoms have not improved within 3 days of starting antibiotics.

The NHS lists reasons you may need hospital treatment: being over 65, having cardiovascular disease or a long-term lung condition, a baby or young child with pneumonia, being very unwell, or not getting better after antibiotics. In hospital you will usually be given antibiotics, sometimes steroids, and oxygen to help breathing, with a chest X-ray and blood tests. NHS inform adds intravenous antibiotics and fluids, and, in very serious cases, a ventilator in a high dependency or intensive care unit.

The NHS says that, depending on symptoms, most people get better in 2 to 4 weeks. Asthma + Lung UK says recovery is different for everybody, that most people feel better 2 to 4 weeks after starting treatment, and that it can take up to 6 months or more to fully recover. NHS inform says full recovery can take up to 3 months.

NHS inform says your GP may arrange follow-up tests if symptoms have not improved, have come back, you smoke or you are over 50. Some people are advised to have a flu or pneumococcal vaccination after recovering.

The NHS says pneumonia is usually caused by a bacterial or viral infection. NHS inform says it is commonly caused by Streptococcus pneumoniae bacteria, and lists other bacteria such as Haemophilus influenzae and Staphylococcus aureus, viruses and, rarely, fungi.

The NHS says a baby or young child with pneumonia may need treatment in hospital, and to call 999 if you cannot wake your baby or they feel floppy. Asthma + Lung UK says pneumonia can make it harder for a child to breathe and that babies and children under 5 are more at risk.

NICE Clinical Knowledge Summaries says pneumonia should be considered in a feverish child with a fast breathing rate (60 breaths per minute or more), signs of increased work of breathing, crackles in the chest or blue colouring. Children assessed as low risk may be treated at home with advice on when to seek help.

The sources read for this guide do not give pregnancy-specific treatment advice. The NHS says that the flu vaccine is recommended during pregnancy and that the RSV vaccine is recommended during pregnancy from 28 weeks onwards to help protect the baby after birth, which may reduce infections that can lead to pneumonia. Seek urgent advice from your midwife, GP or NHS 111 if you have breathing difficulty or chest pain in pregnancy.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have had a cough for up to 3 weeks, are coughing up yellow or green mucus, have chest pain that comes and goes or happens when breathing or coughing, or feel short of breath.

Call 999 or go to A&E, according to the NHS, if you are struggling to breathe (choking, gasping and unable to speak), have pale, blue or blotchy skin, lips or tongue, are coughing up blood, suddenly feel confused, or cannot wake your baby or they feel floppy. Do not drive to A&E; ask someone to drive you or call 999.

The NHS lists vaccines that help protect against infections that can cause pneumonia.

• pneumococcal vaccine, recommended for babies, adults over 65 and people at higher risk of pneumococcal infections

• flu vaccine, recommended during pregnancy, for adults over 65, people with certain long-term conditions and those at high risk

• RSV vaccine, recommended for adults aged 75 and over, adults 65 to 74 with a weakened immune system or a long-term lung condition, or during pregnancy from 28 weeks

• COVID-19 seasonal vaccine for people at increased risk

• stopping smoking also reduces your chance of getting pneumonia

On the NHS, pneumonia is assessed by a GP or NHS 111, with hospital admission for people at higher risk. NICE Clinical Knowledge Summaries describes using the CRB-65 score (confusion, breathing rate, blood pressure and age 65 or over) to decide whether to treat at home or refer to hospital. Private GP appointments and chest imaging are available to people who choose to pay or have insurance, but any sign of severe breathlessness, confusion or blue lips should still lead to 999.