“Chest infection” is not a precise medical term,and it is widely used when someone simply has a nasty cough and is bringing up phlegm. Chest infections can be caused by viruses, bacteria or (in very rare cases) fungi, and can affect any part of your lungs. If an infection involves the small air sacs (alveoli), where oxygen passes from the air into the blood vessels and carbon dioxide goes in the opposite direction, this is called pneumonia. Pneumonia can be caused by viruses. However, bacterial pneumonia is quite common and due to the seriousness of this condition antibiotics are usually prescribed.

There is currently a great deal of concern about chest and whole body infection with the coronavirus, COVID-19. Originating in China, this virus is now spreading across the world, such that the WHO 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 2019 it was declared a pandemic which simply means that it is an infection spreading throughout the world. At the time of writing this article there have been almost 500 cases of COVID-19 infection confirmed in the whole of the UK with just 8 deaths, all in elderly patients or people with other health issues. 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; but beyond that there is absolutely no need to panic.

How do you tell if you have pneumonia rather than a milder upper respiratory tract infection like acute bronchitis?

Sometimes it can be hard to tell whether a patient has pneumonia or an upper respiratory tract infection like acute bronchitis. The gold standard method to tell the difference is to have a chest x-ray, however, it is not always convenient and, although the radiation dose from an x-ray is small, taking x-rays unnecessarily should be avoided. Most of the time doctors rely on the patient’s symptoms and history when determining which disease they have, and therefore what is the best treatment.

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.

Pneumonia is often initially observed through a fever above 38.5°C. Patients with pneumonia have air sacs that are full of fluid. Therefore, it is difficult for gas exchange between the blood and the air to occur. This may lead to patients feeling out of breath, and consequentially they may breathe faster and have a high heart rate. An additional symptom that is more suggestive of pneumonia than bronchitis is a sharp pain in the chest with breathing in. It can be anywhere, but usually occurs only on one side. It is caused by the infection in the lung causing inflammation of the smooth lining of the surface of the lung, which then irritates the corresponding smooth lining of the inside of the chest cavity. This is called pleurisy.

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When the doctor examines the chest, he or she might find signs that are very, very suggestive of pneumonia. These include hearing “crackles” in the area of the lung where the infection is, and dullness when the chest is tapped with the fingers instead of a hollow sound. The lack of resonance indicates a buildup of fluid and inflammatory products in the normally very aerated lung tissue. There may also be changes in the way your voice feels and sounds when your chest is examined with hands and stethoscope.

What treatment can I expect for pneumonia?

How can I stop myself from getting a chest infection?

There are measures you can take to help reduce your risk of developing chest infections, and to stop them spreading to others. Pneumonia usually develops after you get a viral infection, so taking steps to reduce your chances of getting sick will cut your risk of developing this disease. Sensible precautions include:

• good hygiene – although chest infections aren’t generally as contagious as other common infections such as flu, you can catch them from others when they cough and sneeze. Avoid close contact with unwell people.
• stop smoking – if you smoke, one of the best things you can do to prevent a chest infection is to stop. Smoking damages your lungs and weakens your defenses against infection.
• alcohol and diet – excessive and prolonged alcohol misuse can weaken your lungs’ natural defenses against infections and make you more vulnerable to chest infections. If you drink alcohol, do not exceed the recommended daily limits (three to four units a day for men and two to three units a day for women). Eating a healthy balanced diet can help strengthen the immune system, making you less vulnerable to developing chest infections.
• vaccinations – if you are at an increased risk of chest infections, your GP will recommend being vaccinated against flu and pneumococcal infections (a bacterium that can cause pneumonia). These vaccinations should help reduce your chances of getting chest infections in the future. Unfortunately there is currently no vaccine for COVID-19, although you may depend that the pharmaceutical companies are doing their best to produce one.

Flu and pneumococcal vaccinations are usually recommended for:

• babies and young children
• pregnant women (flu jab only)
• people aged 65 and over
• people with long-term health conditions or weakened immune systems

So, don’t panic; and wash your hands.