Overview of Bronchitis

Chronic bronchitis lasts a long time, and is more common among smokers. People with chronic bronchitis have a cough with mucus most days for 3 months a year for 2 consecutive years. If you have been diagnosed with chronic bronchitis, you should visit a specialist to be evaluated.

Visit the American Academy of Family Physicians’ website to watch a video about bronchitis.

Another kind of lung infection that parents should know about is bronchiolitis (BRAHN-kee-oh-LIE-tus). Infants can be diagnosed with bronchiolitis, a viral infection, which can obstruct the small airways and may require treatment. Learn more about bronchiolitis by visiting the National Institutes for Health website.

Causes of Bronchitis Several types of viruses, most often: 1) Respiratory syncytial (sin-SIH-shull) virus (RSV) Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a respiratory virus that infects the lungs and breathing passages. Most otherwise healthy people recover from RSV infection in 1 to 2 weeks. However, infection can be severe in some people, such as certain infants, young children, and older adults. In fact, RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under 1 year of age in the United States. In addition, RSV is more often being recognized as an important cause of respiratory illness in older adults. 2) Adenovirus Clinical features: Adenoviruses most commonly cause respiratory illness; however, depending on the infecting serotype, they may also cause various other illnesses, such as gastroenteritis, conjunctivitis, cystitis (bladder infection), and rash illness. Symptoms of respiratory illness caused by adenovirus infection range from the common cold syndrome to pneumonia, croup, and bronchitis. Young infants and especially patients with compromised immune systems are more susceptible to severe complications of adenovirus infection. Acute respiratory disease (ARD), which was first recognized among military recruits during World War II, can be caused by adenovirus infections.

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The viruses: Adenoviruses are medium-sized (90-100 nm), nonenveloped icosohedral viruses containing double-stranded DNA. There are at least 52 immunologically distinct types that can cause human infections. Adenoviruses are unusually stable to chemical and physical agents and to adverse pH conditions, thus allowing for prolonged survival outside of the body.

Epidemiologic features: Although epidemiologic characteristics of the adenoviruses vary by type, all are transmitted by direct contact, fecal-oral transmission, and occasionally waterborne transmission. Some types can establish persistent asymptomatic infections in tonsils, adenoids, and intestines of infected hosts, and shedding can occur for months or years. Some adenoviruses (e.g., serotypes 1, 2, 5, and 6) have been shown to be endemic in parts of the world where they have been studied, and infection is usually acquired during childhood. Other types cause sporadic infection and occasional outbreaks; for example, epidemic keratoconjunctivitis is associated with adenovirus serotypes 8, 19, and 37. Epidemics of febrile disease with conjunctivitis are associated with waterborne transmission of some adenovirus types, often centering around inadequately chlorinated swimming pools and small lakes. ARD is most often associated with adenovirus types 4 and 7, and more recently adenovirus 14, in the United States. Enteric adenoviruses 40 and 41 cause gastroenteritis, usually in children. For some adenovirus serotypes, the clinical spectrum of disease associated with infection varies depending on the site of infection; for example, infection with adenovirus 7 acquired by inhalation is associated with severe lower respiratory tract disease, whereas oral transmission of the virus typically causes no or mild disease. The typical incubation period for gastroenteritis is 3-10 days; for respiratory tract infections it is between 2 and 14 days Outbreaks of adenovirus-associated respiratory disease have been more common in the late winter, spring, and early summer; however, adenovirus infections can occur throughout the year.

Diagnosis: Antigen detection, polymerase chain reaction assay, virus isolation, and serology can be used to identify adenovirus infections. Adenovirus typing is usually accomplished by hemagglutination-inhibition and/or neutralization with type-specific antisera or by hexon gene sequence molecular methods. Since adenovirus can be excreted for prolonged periods, the presence of virus does not necessarily mean it is associated with disease.

Treatment: Most infections are mild and require no therapy or only symptomatic treatment. Because there is no virus-specific therapy, serious adenovirus illness can be managed only by treating symptoms and complications of the infection.

Prevention: Vaccines were developed for adenovirus serotypes 4 and 7, but were available only for preventing ARD among military recruits, however, vaccine production was stopped in 1999. Strict attention to good infection-control practices, including contact and droplet precautions, is effective for stopping nosocomial outbreaks of adenovirus-associated disease, such as epidemic keratoconjunctivitis. Maintaining adequate levels of chlorination is necessary for preventing swimming pool-associated outbreaks of adenovirus conjunctivitis, and frequent hand hygiene is recommended in group child care settings.

Signs and Symptoms of Bronchitis

• Cough that produces mucus (may be without mucus the first few days)
• Soreness in the chest
• Fatigue
• Mild headache
• Mild body aches
• Low-grade fever (less than 102°F)
• Watery eyes
• Sore throat

See a Healthcare Provider if You or Your Child has:

• Temperature higher than 100.4° F
• A fever and cough with thick or bloody mucus
• A chronic heart or lung problem
• Shortness of breath or trouble breathing
• Symptoms that last more than 3 weeks
• Repeated episodes of bronchitis/bronchiolitis

If your child is younger than three months of age and has a fever, it’s important to always call your healthcare provider right away.

Your healthcare provider can determine if you or your child has acute bronchitis, chronic bronchitis, bronchiolitis, or another type of respiratory infection. Then a decision can be made about possible needed treatment.

Antibiotics are Needed When…

Antibiotics Will Not Help if…

Each time you or your child takes an antibiotic, the bacteria that normally live in your body (on the skin, in the intestine, in the mouth and nose, etc.) are more likely to become resistant to antibiotics. Common antibiotics cannot kill infections caused by these resistant germs.

Antibiotic Resistance

Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm.

Antibiotic resistance has been called one of the world's most pressing public health problems. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates, and co-workers - threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat. For this reason, antibiotic resistance is among CDC's top concerns.

Antibiotic resistance can cause significant danger and suffering for children and adults who have common infections, once easily treatable with antibiotics. Microbes can develop resistance to specific medicines. A common misconception is that a person's body becomes resistant to specific drugs. However, it is microbes, not people, that become resistant to the drugs.

If a microbe is resistant to many drugs, treating the infections it causes can become difficult or even impossible. Someone with an infection that is resistant to a certain medicine can pass that resistant infection to another person. In this way, a hard-to-treat illness can be spread from person to person. In some cases, the illness can lead to serious disability or even death.

Antibiotic use promotes development of antibiotic-resistant bacteria. Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria.

While antibiotics should be used to treat bacterial infections, they are not effective against viral infections like the common cold, most sore throats, and the flu. Widespread use of antibiotics promotes the spread of antibiotic resistance. Smart use of antibiotics is the key to controlling the spread of resistance.

Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm. Bacteria can do this through several mechanisms. Some bacteria develop the ability to neutralize the antibiotic before it can do harm, others can rapidly pump the antibiotic out, and still others can change the antibiotic attack site so it cannot affect the function of the bacteria.

Antibiotics kill or inhibit the growth of susceptible bacteria. Sometimes one of the bacteria survives because it has the ability to neutralize or escape the effect of the antibiotic; that one bacterium can then multiply and replace all the bacteria that were killed off. Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant. In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria. The DNA that codes for resistance can be grouped in a single easily transferable package. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA.

The Food and Drug Administration's (FDA's) Center for Veterinary Medicine (CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will result in the development of resistant strains of bacteria, complicating clinicians' efforts to select the appropriate antimicrobial for treatment.

How to Feel Better

Children and adults with viral infections, which antibiotics cannot treat, usually recover when the illness has run its course. Colds, a type of viral infection, can last for up to two weeks. You should keep your healthcare provider informed if your or your child’s illness gets worse or lasts longer than expected. Over-the-counter medicines may help relieve some symptoms.

For upper respiratory infections, such as sore throats, ear infections, sinus infections, colds, and bronchitis, try the following:

• Get plenty of rest
• Drink plenty of fluids
• Use a clean humidifier or cool mist vaporizer

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• Avoid smoking, second-hand smoke, and other pollutants (airborne chemicals or irritants)
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever

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  For babies 6 months of age or younger, parents should only give acetaminophen for pain relief. For a child 6 months of age or older, either acetaminophen or ibuprofen can be given for pain relief. Be sure to ask your child’s healthcare provider for the right dosage for your child’s age and size. Do not give aspirin to your child because Reye’s syndrome, a rare but very serious illness that harms the liver and brain. Learn more about Reye’s syndrome.

  The Consumer Healthcare Products Association (CHPA), a group that represents most of the makers of nonprescription over-the-counter (OTC) cough and cold medicines, recommends that these products not be used in children under 4 years of age. The Food and Drug Administration (FDA) supports this recommendation. Overuse and misuse of OTC cough and cold medicines in young children can result in serious and potentially life-threatening side effects.

For children and adults, over-the-counter pain relievers, decongestants and saline nasal sprays may help relieve some symptoms. Remember, always use over-the-counter products as directed. Many over-the-counter products are not recommended for children younger t han certain ages.

Over-the-counter medicines may help relieve symptoms such as runny nose, congestion, fever and aches, but they do not shorten the length of time you or your child is sick.

Learn more by reading below about over-the-counter medicines. Here are some helpful tips for how to feel better depending on how you or your child feels.

Sore Throat

• Soothe a sore throat with ice chips, sore throat spray, or lozenges (do not give lozenges to young children)
• Use a clean humidifier or cool mist vaporizer

• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever

Ear Pain

• Put a warm moist cloth over the ear that hurts
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever

Runny Nose

• Use a decongestant or saline nasal spray to help relieve nasal symptoms

Sinus Pain/Pressure

• Put a warm compress over the nose and forehead to help relieve sinus pressure
• Use a decongestant or saline nasal spray
• Breathe in steam from a bowl of hot water or shower
• Take acetaminophen, ibuprofen or naproxen to relieve pain or fever

Cough

• Use a clean humidifier or cool mist vaporizer or breathe in steam from a bowl of hot water or shower.

  Parents might consider clearing nasal congestion in infants with a rubber suction bulb. Also, a stuffy nose can be relieved with saline nose drops.

  Cough and cold symptoms usually go away without treatment after a certain amount of time. Over-the-counter cough and cold medicines will not cure the common cold, but may give some temporary relief of symptoms. Parents should consult their child’s healthcare provider if they have any concerns or questions about giving their child a medication. Parents should always tell their child’s healthcare provider about all prescription and over-the-counter medicines they are giving their child.

  Some cough and cold medicines contain more than one active ingredient. Also, follow directions carefully to avoid giving too much medication; the right amount of medication often depends on your child’s age and weight.

Over-the-Counter (OTC) Medicines

For children and adults, over-the-counter pain relievers, decongestants and saline nasal sprays may help relieve some symptoms. Remember, always use over-the-counter products as directed. Not all products are recommended for children younger than certain ages. Overuse and misuse of OTC cough and cold medicines in young children can result in serious and potentially life-threatening side effects.

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These medicines may help relieve symptoms such as runny nose, congestion, fever and aches, but they do not shorten the length of time you or your child is sick.

Preventing Acute Bronchitis

• Avoid smoking
• Avoid exposure to second hand smoke and do not expose children to second hand smoke
• Practice good hand hygiene
• Keep you and your child up to date with recommended immunizations