Pneumonia 'red flag' symptoms to watch out for after actress Barbie Hsu dies aged 48

The deadly symptoms of pneumonia have been spelled out by an NHS doctor following the sad death of Taiwanese actress Barbie Hsu, who has died at the age of 48 after contracting the lung infection, according to local reports.

The star, one of Asia's most familiar faces and best known for her role in the 2001 series Meteor Garden, is believed to have fallen ill while visiting Japan. Her sister, Dee Hsu, confirmed her death to Taiwan's TVBS News on Monday.

She said in a statement: "During the Lunar New Year, our family came to Japan for vacation. My dearest sister Barbie has unfortunately left us after getting pneumonia, triggered by influenza."

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Hsu played Shanca - a teen from a middle-class family who attends an elite private school and finds herself entangled in a love web with the heirs of wealthy families - in Meteor Garden.

Hsu, who had a history of epilepsy and heart disease, was hospitalised previously due to seizures. She is survived by her husband, South Korean singer DJ Koo, and two children from an earlier marriage.

Last month, as flu cases rose, TV medic Dr Mark Porter, shed light on how to identify if pneumonia is developing from an illness. Writing in The Times, Dr Porter underscored that flu can escalate into complications such as ear infections, febrile convulsions, heart failure, paralysis (Guillain-Barré syndrome) and stillbirth.

"It is the impact on the respiratory system that causes the biggest problems," Dr Porter pointed out.

The expert, recognised for his insights on BBC Breakfast and Good Morning Britain, referred to recent Japanese research which found that one in 300 flu cases turn into pneumonia, with a higher incidence among the elderly.

Dr Porter elaborated: "The odds of recovery vary with the individual and the cause of their pneumonia. Most cases in people with flu are due to secondary bacterial infection and, if sick enough to require hospital admission, then about one in ten will not survive, rising to one in three for those that need intensive care.

"The older you are, and the more underlying health issues you have, the greater the risk," Dr Porter added, emphasising the vulnerabilities among these groups.

The doctor said flu often intensifies the feeling of sickness, making it "so spotting who is developing worrying symptoms of a more serious infection is much harder than in people with milder viral coughs and colds."

"The cough itself is a poor indicator of severity. Innocent viral coughs and colds can easily last two to three weeks, sound "chesty" and produce yellow or green phlegm, while a child with pneumonia may just have a nagging dry cough," he said.

Dr Porter pointed out several red flags to be aware of: "New shortness of breath, particularly if severe enough to be noticeable at rest, should always raise concerns.

"Chest pain, often on taking a deep breath, is another red flag, as is coughing up blood or blood-tinged phlegm. And check your pulse. A resting heart rate consistently more than 100 in an adult is concerning."

Fever is "traditionally another way to differentiate milder viral causes of cough from pneumonia," he went on, because temperatures tend to be higher (38.5C or more) in the latter.

However, unlike most other respiratory viral infections, flu often causes high temperatures, too, Dr Porter cautioned, adding: "It can also make you feel awful, blunt your appetite and confine you to bed, all signs of more worrying infection, further muddying diagnostic waters."

Early detection is crucial, the professional insisted, as many cases of secondary chest infection and pneumonia can be treated with antibiotics at home, leading to a good outcome. He stressed the importance of vigilance, especially for those with underlying health issues such as existing chest disease, which increases the risk of complications.

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