What are the signs of pneumonia? It is a question worth knowing the answer to before you need it, because pneumonia can start like an ordinary winter cough and turn serious in a matter of days. The good news is that the signs are clear once you know them, and acting on them early makes a real difference. World Pneumonia Day falls on Thursday 12 November 2026, with this year’s global theme “A New Era of Pneumonia Control”, so there is no better week to learn what to look for.
The short answer is that the signs of pneumonia are a cough, shortness of breath, a high temperature, chest pain, an aching body, feeling very tired, loss of appetite, wheezing, and feeling confused. The NHS lists these nine signs, and adds that they can start suddenly or build gradually over a few days. No single sign proves pneumonia on its own, and the pattern matters more than any one symptom: a cough that comes with breathlessness and a fever, or chest pain that worsens when you breathe in, deserves medical attention the same day.
The 9 signs of pneumonia
Each sign on its own has many possible causes, from a common cold to a pulled muscle. What should raise suspicion is the combination, or a sign that is getting worse rather than better after a few days. Here is what each sign looks like in everyday life.
1. A cough
A cough is the most common sign of pneumonia, and it is often the first thing people notice. The cough may be dry at first and then start bringing up mucus, which is often yellow or green. Coughing up yellow or green mucus is one of the symptoms the NHS says should prompt an urgent GP appointment or a call to NHS 111. The cough can also be persistent, hanging around for up to three weeks, which is another reason the NHS gives for seeking urgent help. Our guide to how to stop coughing at night covers the practical steps that help with a cough, but a cough that comes with breathlessness or a fever needs a doctor, not just home remedies.
2. Shortness of breath
Feeling short of breath is the sign that most clearly separates pneumonia from a simple cold. You may feel breathless walking up the stairs when that used to be easy, or you may feel short of breath even at rest. Breathing may feel fast or shallow, and some people describe a feeling of not being able to get enough air in. The NHS lists feeling short of breath among the reasons to ask for an urgent GP appointment or get help from NHS 111, and struggling to breathe, choking or gasping and being unable to speak, is a reason to call 999 or go to A and E. If your breathing changes suddenly, do not wait to see if it settles.
3. A high temperature
A high temperature, or fever, is the body’s response to infection, and it is one of the most common signs of pneumonia. You may feel hot and shivery at the same time, or notice sweating that comes and goes. A fever with a cough is more concerning than a fever on its own, and a very high temperature, or feeling hot or cold to the touch with shivering, is a reason to contact your GP urgently. Paracetamol or ibuprofen can help bring a temperature down and ease the aches that come with it, but they do not treat the infection itself, so a fever that will not settle still needs medical advice.
4. Chest pain
Chest pain in pneumonia is usually a sharp or stabbing pain that gets worse when you breathe in deeply or cough. It happens because the lining around the lungs becomes inflamed. The NHS advises seeking urgent help if you have chest pain that comes and goes, or that happens when breathing or coughing. Chest pain is a symptom that should never be ignored, because it has other serious causes too, including heart problems. If the pain is severe, or comes with breathlessness and sweating, call 999 rather than waiting for a routine appointment.
5. An aching body
General aches and pains, the kind that feel like flu, are a common part of pneumonia. Muscles may ache, joints may feel stiff, and the whole body can feel heavy and sore. On its own, an aching body is a vague symptom with many causes, from a viral infection to overdoing it at the gym. It becomes meaningful when it arrives with the other signs on this list, especially a cough, a fever and breathlessness. The aches usually ease as the infection is treated, and paracetamol or ibuprofen can help in the meantime.
6. Feeling very tired
Extreme tiredness is one of the signs people mention most often, and one of the easiest to dismiss. Pneumonia makes the body work much harder than usual: breathing takes more effort, the immune system is fighting an infection, and sleep is broken by coughing. The result is a deep, heavy tiredness that rest does not fix. This is different from ordinary tiredness after a busy day. If you feel exhausted by simple tasks, need to sleep far more than usual, and it comes with a cough or fever, it is worth mentioning to your GP.
7. Loss of appetite
Losing your appetite, and sometimes feeling sick, is a common sign of pneumonia, especially when the illness is more severe. The body diverts energy to fighting the infection, and eating feels like too much effort. This matters because the NHS advises drinking plenty of fluids during recovery, and becoming dehydrated makes the illness worse. A lost appetite for a day or two with a cold is normal, but if you cannot keep fluids down, or you are peeing much less than usual, contact your GP urgently, because that can be a sign of dehydration.
8. Wheezing
Wheezing is a whistling noise when you breathe, caused by narrowed airways. In babies, pneumonia can also cause grunting noises when breathing. Wheezing can happen with asthma and other chest conditions too, so it is not specific to pneumonia, but new wheezing alongside a cough and fever is a reason to seek medical advice. In a baby or young child, fast breathing, grunting, or the skin sucking in under the ribs with each breath are signs to act on urgently, and a baby you cannot wake, or who feels floppy, needs emergency help straight away.
9. Feeling confused
Feeling confused is a sign the NHS says is common in older people with pneumonia, and it can be the only obvious sign in someone over 65. An older person may become suddenly muddled, not know where they are, or behave in a way that is out of character, without much of a cough or a high temperature. This is why families and carers should take a sudden change in an older person’s mental state seriously, even if the other signs seem mild. Sudden confusion is also on the NHS emergency list: call 999 or go to A and E if someone suddenly feels confused and does not know where they are.
How quickly do the signs appear?
The NHS says the symptoms of pneumonia can start suddenly or gradually over a few days, and both patterns are normal. Sometimes pneumonia arrives fast, with a high fever and breathlessness within a day. More often it builds: a cold or flu that seems to be improving, then a new cough, a rising temperature and chest pain a few days later. That second pattern catches people out, because it is easy to assume the original cold is simply lingering. The rule to remember is direction, not speed: a chest infection that is getting worse after a few days, rather than better, needs a doctor. A cough that has lasted up to three weeks is itself a reason to seek urgent help, even if you feel otherwise well.
Pneumonia often follows another infection. The NHS lists flu, respiratory syncytial virus, known as RSV, and COVID-19 as infections that can lead to pneumonia. That is one reason winter is pneumonia season: the viruses that trigger it circulate most in the colder months, and people spend more time indoors together. Pneumonia can also be caused by a fungal infection, though the NHS notes this is rare in healthy people in the UK, and by something getting into the lungs, such as water or food, which doctors call aspiration pneumonia.
What are the signs of pneumonia in children and babies?
Children get pneumonia too, and the signs can look a little different from the adult list. A child may breathe faster than usual, have a cough that will not settle, and a high temperature that does not come down. They may go off their food, become unusually sleepy or irritable, and complain of a tummy ache rather than chest pain. Babies may make grunting noises when they breathe, and their skin may pull in under the ribs with each breath, which is a sign of breathing difficulty.
The global numbers explain why children’s pneumonia matters so much. The World Health Organization says pneumonia is the single largest infectious cause of death in children worldwide. It killed 740,180 children under the age of five in 2019, accounting for 14 per cent of all deaths in that age group, and 22 per cent of all deaths in children aged one to five. Deaths are highest in southern Asia and sub-Saharan Africa, where vaccination rates are lower and malnutrition is more common. The Every Breath Counts Coalition, which coordinates World Pneumonia Day, puts the 2023 toll at 2.5 million lives, including 610,000 children under five, and notes that 60 per cent of all child pneumonia deaths are attributable to malnutrition.
For parents in the UK, the practical message is the same as for adults: act on the pattern, not a single symptom. A child with a cough, a fever and fast breathing needs to be seen the same day, and a baby you cannot wake or who feels floppy needs emergency help immediately. The pneumococcal vaccine, which is part of the routine childhood immunisation programme, protects against one of the most common causes of bacterial pneumonia in children.
Signs in older adults
Older adults are the other group at highest risk, and their pneumonia often looks different. The NHS says people over 65 may need hospital treatment if they develop pneumonia, and they are more likely to become seriously ill. The fever may be lower than expected, or absent altogether, and the cough may be mild. Instead, the warning signs can be new confusion, sudden weakness, drowsiness, or a fall. A temperature that stays low, rather than high, can also be a warning sign in an older person.
This is why a sudden change in an older relative is worth acting on, even when there is no dramatic cough or fever. If a parent or grandparent who is usually sharp becomes muddled, sleepy or unsteady over a day or two, and has any sign of a chest infection, contact their GP urgently or call 111. The Every Breath Counts Coalition notes that more than one in four pneumonia deaths among adults aged over 70 are attributable to air pollution and smoking, which are both risks that build up over a lifetime.
Pneumonia or a cold: how to tell the difference
The hardest question in practice is whether a chesty cough is a cold or something more serious. A cold usually stays in the nose and throat, builds gradually, and lets you carry on, even if you feel rough. Flu arrives faster, hits the whole body, and leaves you exhausted. Pneumonia goes further: the infection reaches the lungs themselves, which is why breathlessness and chest pain are the signs that matter most.
Our guide to how to tell a cold from the flu explains the three-way test the NHS uses, and our guide to treating a cold at home explains what to do for an ordinary cold. The short version for pneumonia is this: a cold that turns into breathlessness, chest pain when breathing or coughing, or a fever that keeps climbing after a few days has stopped being a cold. Coughing up yellow or green mucus, or having a cough that lasts up to three weeks, are also signs to seek urgent help rather than waiting it out.
When to call 111 and when to call 999
Knowing which number to call is part of knowing the signs, so here are the two NHS lists in full.
Ask for an urgent GP appointment or get help from NHS 111 if you have had a cough for up to three weeks, you are coughing up yellow or green mucus, you have chest pain that comes and goes or happens when breathing or coughing, or you are feeling short of breath. You can call 111 or get help from 111 online, and the advice is available day and night.
Call 999 or go to A and E if you are struggling to breathe, choking, gasping and unable to speak, you have pale, blue or blotchy skin, lips or tongue, you are coughing up blood, you suddenly feel confused and do not know where you are, or you cannot wake your baby or they feel floppy. The NHS adds two practical points: do not drive to A and E, ask someone to drive you or call 999 and ask for an ambulance, and bring any medicines you take with you.
What happens after a diagnosis
If your GP thinks you have pneumonia, they will usually start by listening to your chest and asking about your symptoms. You may be sent for a chest X-ray and blood tests to check for other conditions. Pneumonia is usually caused by a bacterial or viral infection, and if bacteria are the cause, you will usually be given antibiotics. Most people get better in two to four weeks, depending on their symptoms, though tiredness can linger longer than the cough.
Some people need hospital treatment, and the NHS lists who that is most likely to be: people over 65, people with cardiovascular disease or a long-term lung condition, babies and young children with pneumonia, people who are very unwell, and people who are not getting better after taking antibiotics. In hospital you will usually be given antibiotics, and sometimes steroids, to treat the infection, and you may also be given oxygen to help you breathe.
If you are given antibiotics to take at home, the NHS advice is to keep taking them until you have finished them all, even if you start to feel better, and to contact your doctor if you do not feel any better after taking them for two to three days. Stopping early can let the infection come back. While you recover, rest until you feel better, stay at home if you have a high temperature, drink plenty of fluids, and take paracetamol or ibuprofen if you have been told you can take them. Cover your mouth and nose with a tissue when you cough or sneeze, put used tissues in the bin quickly, and wash your hands regularly with water and soap. The NHS also says not to take cough medicine, because coughing helps your body get rid of the infection, and not to smoke.
Can pneumonia be prevented?
Pneumonia cannot always be prevented, but several vaccines lower the risk of the infections that cause it. The NHS lists four: the pneumococcal vaccine, recommended for babies, adults over 65, and people at higher risk of pneumococcal infections; the flu vaccine, recommended during pregnancy, for adults over 65, people with certain long-term health conditions, and those at high risk of catching or passing on flu; the RSV vaccine, recommended for adults aged 75 and over, adults aged 65 to 74 who have a weakened immune system or a long-term lung condition, and during pregnancy from 28 weeks onwards to help protect the baby; and the seasonal COVID-19 vaccine for people at increased risk.
Stopping smoking also reduces your chance of getting pneumonia, and the NHS lists it alongside vaccination as the main preventive step you can take yourself. The flu vaccine matters here too: because flu is one of the infections that can lead to pneumonia, the winter flu programme protects against pneumonia indirectly as well. If you are eligible for a free flu jab this winter and have not had it yet, November is a good month to book it.
Why World Pneumonia Day matters
World Pneumonia Day is observed every year on 12 November, and in 2026 the theme is “A New Era of Pneumonia Control”, in recognition of recent progress in vaccines, diagnostic tools and treatments. The day exists because pneumonia is still, in the words of the Every Breath Counts Coalition, the single biggest infectious killer of adults and children, and the fight to reduce deaths from it has never been more urgent.
The numbers behind the day are stark. In 2023 pneumonia claimed 2.5 million lives, including 610,000 children under five, according to the Global Burden of Disease study. The very young and the very old are at greatest risk, and the coalition points to the same causes again and again: low vaccination rates, malnutrition, polluting fuels for cooking and heating, outdoor air pollution and smoking. Sixty per cent of child pneumonia deaths are attributable to malnutrition, and more than one in four pneumonia deaths among adults aged over 70 are attributable to air pollution and smoking.
That is why the signs matter more than the statistics. Most pneumonia deaths are preventable with simple, affordable care, and early recognition is where that care starts. Knowing the nine signs, and knowing when to call 111 or 999, is a small piece of knowledge that can change the outcome for you, your child, or an older relative. This week, ahead of World Pneumonia Day, is a good time to learn them, and to check whether you or someone you care for is due a vaccine.
Frequently asked questions
What are the signs of pneumonia?
The signs of pneumonia are a cough, shortness of breath, a high temperature, chest pain, an aching body, feeling very tired, loss of appetite, wheezing, and feeling confused. The NHS says the signs can start suddenly or build gradually over a few days. No single sign proves pneumonia, and the pattern matters most: a cough with breathlessness and a fever, or chest pain that worsens when you breathe in, needs medical attention the same day.
How do I know if my cough is pneumonia or a cold?
A cold usually stays in the nose and throat, builds gradually, and lets you carry on. Pneumonia reaches the lungs, so breathlessness and chest pain are the signs that matter most. If a cold turns into breathlessness, chest pain when breathing or coughing, or a fever that keeps climbing after a few days, or you are coughing up yellow or green mucus, seek urgent medical help rather than waiting it out.
When should I call 111 about a cough?
Ask for an urgent GP appointment or get help from NHS 111 if you have had a cough for up to three weeks, you are coughing up yellow or green mucus, you have chest pain that comes and goes or happens when breathing or coughing, or you are feeling short of breath. You can call 111 or get help from 111 online, day or night.
When should I call 999 for pneumonia?
Call 999 or go to A and E if you are struggling to breathe, choking, gasping and unable to speak, you have pale, blue or blotchy skin, lips or tongue, you are coughing up blood, you suddenly feel confused and do not know where you are, or you cannot wake your baby or they feel floppy. Do not drive to A and E: ask someone to drive you or call 999 and ask for an ambulance.
Can pneumonia be prevented?
Pneumonia cannot always be prevented, but vaccines lower the risk of the infections that cause it. The NHS lists the pneumococcal vaccine, the flu vaccine, the RSV vaccine and the seasonal COVID-19 vaccine, each recommended for specific groups including babies, adults over 65, pregnant women and people with long-term conditions. Stopping smoking also reduces your chance of getting pneumonia.
Related reading
How Do I Stop Coughing at Night?
How Do I Treat a Cold at Home?
Sources
NHS, Pneumonia: symptoms, treatment, causes and prevention, nhs.uk/conditions/pneumonia
World Health Organization, Pneumonia in children, who.int/news-room/fact-sheets/detail/pneumonia
Every Breath Counts Coalition, World Pneumonia Day, stoppneumonia.org/latest/world-pneumonia-day
This article is for general information only and is not medical advice. If you are worried about your health, speak to your GP or call NHS 111. In an emergency, call 999.
