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A chest infection is not a precise medical diagnosis. It can be caused by viruses, bacteria, or in very rare cases, fungi, and it can affect any part of your airways and lungs. Acute bronchitis means infection of the upper airways:, the trachea and the bronchi.
Acute bronchitis can also develop into pneumonia, so these conditions can occur simultaneously. Both will cause coughing, and you may cough up green or yellow sputum with either disease.
People often are unsure about what to do if they think they have a chest infection rather than just a simple cold. After all, coughing is a very common symptom, so when should you worry about it being something more serious? In this article, I’ll be answering the questions that patients most commonly ask about chest infections and giving you my best advice on what to do if you have one.
Everyone’s anxiety levels remain greatly elevated at the moment due to the chest and whole body infection with the coronavirus, COVID-19. Originating in China, this virus has now spread across the world, such that the WHO has declared the situation to be a Public Health Emergency of International Concern (PHEIC) in the same way as they did for the Ebola, Zika and swine flu outbreaks. Interestingly any new human influenza outbreak is automatically a PHEIC so no declaration is needed. On March 11 2020 the COVID-19 outbreak was declared a pandemic. On 30 March 2020 the UK went into ‘lockdown’ to try to prevent further spread and protect NHS resources from being overwhelmed. At the time of updating this article there have been over 310 thousand cases of COVID-19 infection confirmed the UK with nearly 47 thousand deaths. The elderly and people with other health issues have been the most vulnerable but there has also been a disproportionate number of deaths in people from black, Asian and other minority ethnic groups. This has rightly prompted a deep look into why this might be and action taken to protect vulnerable groups. Clearly this is a call to be sensible and take the precaution of coughing into a tissue and binning it carefully together with scrupulous hand hygiene; social distancing and wearing masks on public transport and in shops is mandatory. There is, however, absolutely no need to panic.
Here are the answers to the questions that patients most commonly ask about chest infections and our best advice on what to do if you have one.
Bronchitis is almost always caused by viruses, and contrary to popular belief, the colour of the sputum is no guide as to whether the cough is caused by a virus or bacteria.
Bronchitis usually starts off with a dry, persistent cough, and is rarely associated with a fever. If one is present it is usually mild (especially if the cause is viral). If you have a high fever and feel unwell, it is more likely (but not certain) that your chest infection is caused by a bacterial infection. Another suggestive sign is suddenly feeling worse after you thought you were on the mend. This is often a sign that you had a viral infection that weakened your lungs’ defenses, allowing a bacterial infection to develop.
Since chest infections can vary in severity, treatment is largely about how ‘ill’ you are. Since bronchitis is usually viral, antibiotics are only needed in a small percentage of cases, but full-blown pneumonia affects the alveoli of the lungs – the parts of the lungs that take in oxygen and get rid of carbon dioxide. This can cause real breathing difficulty, and can in some cases be dangerous.
It is important to remember that if you have previously been completely healthy, it is unlikely that a chest infection will be more than a nasty cold. Flu (influenza) is a much more virulent, nasty virus which has ‘whole body effects’ such as muscle aches and exhaustion, with or without a cough and sore throat.The COVID-19 virus has similar ‘whole body effects’, but will only make people very unwell in around 5% of cases with a global mortality rate of about 3%. It does not seem to affect young people but rather can be serious in older people and those with other illnesses which may affect their immune systems or their lungs.
People who have other chest and general health problems, such as asthma or chronic lung disease, are much more vulnerable to ‘a cold going to the chest’. Most people do not even need to see a doctor, but below are the warning signs of a dangerous chest infection.
Some people develop airway spasms a bit like asthma when they have a cold, and they may get better more quickly with an inhaler which relaxes the airways. Coughing at night may be an indicator of this. Do speak with Dr Morton’s if you feel this might be the case, as our doctors may be able to prescribe you an inhaler if you need one.
If you have fever, or feel particularly unwell, you should rest at home. You may continue to work if you are only mildly unwell, but with the current COVID-19 concerns you should probably work from home as regardless of its cause, your condition may be contagious. Viruses are usually spread in tiny water droplet particles after sneezing and coughing, and then by skin to skin contact if your hands are contaminated with such bodily fluids. Take appropriate precautions:
If you have a loss of appetite, don’t worry! Just eat lightly and only small amounts frequently – the reduced food intake is not harmful in the short term. It is, however, very important to stay hydrated. The best way to know if you are well hydrated is to inspect your urine. If it is dark you are dehydrated, so drink enough fluid so that it is very light coloured.
If you are in pain or discomfort, use simple analgesia such as paracetamol or ibuprofen, provided you have no conditions or risk factors that preclude these medications. If you smoke, now is a great time to stop!
What about cough medicines, you ask? Well, as well as often being expensive, there is little evidence that they actually work. Drinking a warm drink of honey and lemon has been shown to be equally effective. Raise your head up with extra pillows while you are sleeping to make breathing easier.
If you develop any of the above symptoms, you should seek urgent medical attention as soon as possible. Currently, people who are unwell are being advised to ring NHS 111 to be told where (if needed) they should attend for viral swabs to be taken. At Dr Morton’s we are able to send a swab to your home for you to take yourself, with the result to be uploaded securely into your medical record. Of course, it is vital that we follow the guidance of NHS England and report any positive cases. Ring us if you are worried.
This page was last updated on 09/08/2020