When is a Respiratory Infection an Emergency?
As the world devotes rapt attention with COVID-19, it is important to know what a respiratory infection is and when it is an emergency. The symptoms can be very much like COVID-19 and knowing the differences in symptoms is critical.
Risks of Transmission for Respiratory Infections
The common cold is the most common cause of doctor visits in the United States. URIs (Upper Respiratory Infections) spread from one person to another through airborne germs and hand contact to the nose and then hand contact with another person. (OnHealth 2020)
There is added risk in these situations:
- A sick person coughs or sneezes without covering their nose and mouth and germs become airborne and can land on a person in close contact
- Close contact in high population areas such as schools, day care centers and hospitals
- Our noses and eyes are open portals to our bodies and infection happens when we touch these areas with hands that encounter cold germs
- Touching common objects like doorknobs, keyboards, office machines, toys…viruses can live on these objects
- During cold months when people tend to stay indoors
- Low humidity environments such as homes that have heating systems
- If someone has a weakened immune system due to a chronic health condition
Types of Respiratory Infections
There is a difference between an upper respiratory infection and a lower respiratory infection.
Upper respiratory infections are in the head and involve the sinuses, nose and throat. Lower respiratory infections involve airways and lungs. There are a number of different respiratory infections that we need to be conscious of:
Whooping Cough (Pertussis)
Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it’s marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop.” (Mayo Clinic 2019)
Swine flu viruses do not normally infect humans. However, sporadic human infections with influenza viruses that normally circulate in swine and not people have occurred. When this happens, these viruses are called “variant viruses.” They also can be denoted by adding the letter “v” to the end of the virus subtype designation. Human infections with H1N1v, H3N2v and H1N2v viruses have been detected in the United States. (CDC 2016)
Bird Flu (Avian Flu H5N1)
Avian influenza refers to the disease caused by infection with avian (bird) influenza (flu) Type A viruses. These viruses occur naturally among wild aquatic birds worldwide and can infect domestic poultry and other bird and animal species. Avian flu viruses do not normally infect humans; however, sporadic human infections with avian flu viruses have occurred. (CDC 2019)
Enteroviruses of various types cause about 10 to15 million infections each year in the US, usually in the late summer or early fall. Symptoms are similar to the common cold. The vast majority of children with enteroviruses, such as EV-D68, have mild symptoms and do not need any medical care beyond what is done for the common cold. Enteroviruses can cause serious breathing problems. Infants, children with asthma, and those with weak immune systems have a greater chance of breathing problems and complications, some requiring treatment in the intensive care unit. (Healthy Children 2019)
Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent flu is by getting a flu vaccine each year. (CDC 2019)
Bacterial pneumonia is an infection of your lungs caused by certain bacteria. The most common one is Streptococcus (pneumococcus), but other bacteria can cause it too. If you’re young and basically healthy, these bacteria can live in your throat without causing any trouble. But if your body’s defenses (immune system) become weak for some reason, the bacteria can go down into your lungs. When this happens, the air sacs in your lungs get infected and inflamed. They fill up with fluid, and that causes pneumonia. (Web MD 2018)
Viral pneumonia is an infection of your lungs caused by a virus. The most common cause is the flu, but you can also get viral pneumonia from the common cold and other viruses. These nasty germs usually stick to the upper part of your respiratory system. But the trouble starts when they get down into your lungs. The air sacs in your lungs get infected and inflamed, and they fill up with fluid. Anything that weakens your body’s defenses (immune system) can raise your chances of getting pneumonia. (Web MD 2018)
Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic and often develop from a cold or other respiratory infection or acute bronchitis which is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Acute bronchitis, also called a chest cold, usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks. (Mayo Foundation 2017)
Common Cold (Head Cold)
Common colds are the main reason that children miss school and adults miss work. Each year in the United States, there are millions of cases of the common cold. Adults have an average of 2-3 colds per year and children have even more. Most people get colds in the winter and spring, but it is possible to get a cold any time of the year. (CDC 2019)
Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing. (WHO 2019)
Coronavirus COVID-19 (SARS-CoV-2)
The NIH scientists, from the National Institute of Allergy and Infectious Diseases’ Montana facility at Rocky Mountain Laboratories, compared how the environment affects SARS-CoV-2 and SARS-CoV-1, which causes SARS. SARS-CoV-1, like its successor now circulating across the globe, emerged from China and infected more than 8,000 people in 2002 and 2003. SARS-CoV-1 was eradicated by intensive contact tracing and case isolation measures and no cases have been detected since 2004. SARS-CoV-1 is the human coronavirus most closely related to SARS-CoV-2. In the stability study the two viruses behaved similarly, which unfortunately fails to explain why COVID-19 has become a much larger outbreak. (WHO 2019)
SARS (Severe Acute Respiratory Syndrome)
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known by the provisional name 2019 novel coronavirus (2019-nCoV), is a positive-sense single-stranded RNA virus. It is contagious in humans and is the cause of the ongoing pandemic of coronavirus disease 2019 (COVID-19) that has been designated a Public Health Emergency of International Concern by the World Health Organization (WHO 2019). SARS-CoV-2 has close genetic similarity to bat coronaviruses, from which it likely originated. An intermediate animal reservoir such as a pangolin is also thought to be involved in its introduction to humans. From a taxonomic perspective, SARS-CoV-2 is classified as a strain of the species severe acute respiratory syndrome-related coronavirus (SARSr-CoV). (Wikimedia 2020) The virion (the free form of the virus) is inactivated by soap.
MERS (Middle East Respiratory Syndrome)
Most people confirmed to have the MERS-CoV infection have had severe respiratory illness with symptoms of:
- shortness of breath
Some people also had diarrhea and nausea/vomiting. For many people with MERS, more severe complications followed, such as pneumonia and kidney failure. About 3 or 4 out of every 10 people reported with MERS have died. Most of the people who died had a pre-existing medical condition that weakened their immune system, or an underlying medical condition that has not yet been discovered. Medical conditions sometimes weaken people’s immune systems and make them more likely to get sick or have severe illness. (CDC 2019)
The Right Protocol for Respiratory Illness
As we navigate the world of healthcare, we seek to share important information with our local families. A cold in a healthy person is more than likely not going to turn critical. We all have family members who are young, elderly or who have complicating illnesses. If this is the case, then we need to remain vigilant and seek emergency medical care when symptoms seem to be more than just a minor sneeze or cough.
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