Respiratory Illness Attacks in Many Different Ways

Respiratory illnesses affect millions of people around the world and can result in severely impaired quality of life, lifelong illness, and life-threatening conditions. Here are snapshots of five of the most common conditions.

Chronic obstructive pulmonary disorder (COPD) affects more than 12 million people, claims more than 125,000 lives each year, and is the third-leading cause of death in the U.S., according to the U.S. Centers for Disease Control.

COPD includes chronic bronchitis, where the lining of the airways becomes irritated and inflamed, and emphysema, where the walls between the air sacs in the lungs are damaged. The condition develops slowly (most patients are over 40 when symptoms appear) and gets worse over time. No cure exists, but treatments such as bronchodilators, which relax the muscles around the airways, and inhaled steroids can relieve symptoms. Lifestyle changes like exercise also help patients feel better, remain active, and slow the progression of the disease. Tobacco use, including second-hand smoke, is the primary cause of COPD. Indoor and outdoor air pollution and environmental hazards such as chemical fumes or dust are additional causes.

Asthma, another lifelong illness, inflames and narrows the airways, causing wheezing, breathlessness, chest tightness, and coughing. Asthma continues to increase; it now affects one in 12 adults and one in 10 children in the U.S. It’s unclear why it’s increasing, but we do know that it’s brought on by different triggers, such as allergies, sinus problems, acid reflux, or job conditions, as well as smoking, mold, or pollution. No cure exists, but medications can relieve symptoms. A key factor in treating asthma is identifying the triggers, then reducing or eliminating them so that fewer attacks occur.

Pneumonia is a lung infection caused by bacteria or viruses whose symptoms include coughing, fever, rapid breathing or shortness of breath, chills, or chest pain. It can often be prevented with vaccines and is treatable with antibiotic and antiviral medicines. Adults 65 and older, children under 5, and those with underlying conditions such as diabetes or HIV/AIDS are most at risk. Despite vaccines and medicines, pneumonia causes more deaths annually than any other infectious disease, claiming more than 50,000 lives in the U.S. and more than 1.5 million children under 5 worldwide.

Tuberculosis is a common lung disease throughout the world, causing nearly 1.5 million deaths and sickening millions more each year. Caused by bacteria, it’s spread through the air from person to person. Two TB conditions exist. One is a latent TB infection, which can lay dormant in your body without causing symptoms or sickness. (Knowledge of this condition only comes through a skin test.) The second is active TB disease, where the bacteria grow. Treatment includes a regimen of drugs taken over several months. While declining in the U.S. with less than 12,000 cases annually, TB remains a serious threat, especially for those infected with HIV, as TB is one of the leading causes of death for those with HIV.

Influenza, perhaps the most publicized illness, is a contagious, seasonal disease caused by a virus that can affect anyone regardless of age or health status. Each year, flu leads to 200,000 hospitalizations and 30,000 deaths in the U.S. Most at risk are the elderly, young children, and those with chronic illnesses such as diabetes. An annual flu shot, now recommended for everyone six months of age and older, is the best prevention, as well as good hygiene habits like handwashing.

Respiratory health is critical to our overall well-being. To preserve and maintain it, here are three prudent steps I recommend for patients:

Get immunized. Whether a shot for the flu or pneumonia, vaccines are some of the best preventive measures medicine has available.
Avoid smoking. Tobacco use is the single largest preventable cause of death, disability, and disease. We’ve made progress in reducing smoking, but tobacco use remains a problem: nearly 47 million adults and 3.5 million teens still smoke.
Recognize the six hallmark signs of respiratory illness: cough, shortness of breath, wheezing, coughing up blood, sputum (mucus or phlegm) production, and chest pain — and see a physician if you experience any of these. –
Dr. Ronald Sen is a primary care physician, specialist in pulmonary and critical care medicine, and chief of the Division of Pulmonary Disease at Melrose-Wakefield Hospital in Melrose, Mass. This article is a service of the Mass. Medical Society.