The sudden death of popular Taiwanese actress-host Barbie Hsu, which was confirmed on Monday (Feb 3), came as a shock to many.
At just 48 years old, the mother of two died of pneumonia — an infection causing inflammation of the lung or lungs — which had reportedly developed from a flu while recently holidaying in Japan.
But how could the ‘simple’ flu lead to death?
Influenza, also called the flu, is a contagious viral infection that affects the respiratory tract: the nose, throat and lungs.
Symptoms of influenza typically include a fever, fatigue, body ache, cough and sore throat. While most cases are not life-threatening, serious complications such as pneumonia can arise, according to the Ministry of Health.
Young children aged below five, adults aged 65 and above, pregnant women and individuals with lung and heart diseases or chronic conditions are more vulnerable to developing complications from the flu.
Barbie reportedly had a history of heart disease and epilepsy. It was previously revealed that she had nearly died during childbirth, and had suffered two miscarriages.
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How dangerous is pneumonia?
Pneumonia is an infection that can be caused by viruses, bacteria, fungi or other germs.
The lungs’ air sacs can fill with fluid or pus, making it difficult for oxygen to reach the blood, according to HealthHub. With little oxygen in the blood, your body cells cannot function properly.
Pneumonia may lead to complications including lung injury or infection, respiratory failure or sepsis (the body’s extreme response to an infection), states the US Centers for Disease Control and Prevention.
Dr Philip Eng, a respiratory physician at Mount Elizabeth Hospital who specialises in the treatment of respiratory disorders such as pneumonia, tells AsiaOne that symptoms of pneumonia include fever, cough with phlegm and breathlessness — similar to influenza symptoms.
“It is not easy for the lay person to recognise influenza that has progressed to pneumonia,” he said, but explained that simple influenza which remains in the upper respiratory tract does not cause breathlessness or chest pain.
A doctor can suspect that influenza has caused pneumonia by clinical auscultation (or listening to internal sounds of the body) and may also order a chest X-ray to confirm the presence of influenza pneumonia.
Dr Eng added that pneumonia is the second leading cause of death in Singapore, coming just behind cancer.
Of the 26,888 deaths recorded in 2023, 23.5 per cent of them were due to pneumonia, according to HealthHub.
While this may sound alarming, Dr Eng says that death from pneumonia is “uncommon overall” unless an individual is aged above 65 or has comorbid illness (coexisting medical conditions) such as asthma, cancer, stroke or heart disease.
Are people more likely to fall sick overseas?
In the wake of Barbie’s death in Japan, some may wonder if travelling may put one at more risk of catching the flu.
Dr Sharen Tian, a family physician at Raffles Medical, shared that travellers are at an increased risk of exposure to infectious diseases caused by bacteria, viruses and parasites.
Infections can easily spread in crowded places such as tourist attractions and public transport, she shared, and jet lag causes disruptions in sleep patterns and may weaken the immune system.
Similarly, Dr Eng said that one is “more likely to fall ill” when travelling, especially for Singaporeans travelling to colder countries during the peak travel season of December.
Travelling in an enclosed space in the plane is a risk factor for the transmission of influenza, he added, and viruses such as the influenza virus live longer in the cold. People also tend to spend a lot of time indoors in enclosed spaces to escape the low temperatures.
What precautions should people take?
Dr Eng advises individuals to take precautions with their health by wearing masks and isolating themselves when unwell as well as practising good hand hygiene at all times.
One should also avoiding travelling if unwell, especially if they are elderly or have comorbid illness.
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He stressed the importance of getting vaccinated against the flu even if one is not travelling as other travellers or tourists may bring the flu virus back.
“Flu vaccination should be an annual exercise especially if one is elderly or has risk factors,” said Dr Eng, adding that it is “effective against severe disease and death from flu”.
Dr Tian recommends visiting a doctor to discuss necessary vaccinations and health advice tailored to the travel destination at least four to six weeks prior to travelling.
She also reminded travellers to be mindful of food and water safety, and consume only bottled or filtered/treated water. Raw or undercooked dishes should be avoided.
Travellers can also prepare a travel health kit equipped with essential medications, first aid supplies, and their own prescription medicine if any.
Lastly, Dr Tian advised travellers to get travel insurance that covers medical care and emergencies overseas.
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lim.kewei@asiaone.com
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