How are lower respiratory tract infections transmitted?

In whom are lower respiratory tract diseases more common?

Lower respiratory tract infections can be seen in all age groups. Viral bronchiolitis is the most common lower respiratory tract infection in children aged two years and younger. It is the most common cause of hospitalization in pediatric wards during the winter season. Bronchiolitis, by definition, is inflammation of the bronchioles, which are the small airways in the lungs. Usually the cause is acute viral infections.

Pneumonia is inflammation of the lung tissue. It occurs due to various microorganisms, especially bacteria. In children; Being under 2 years old, Low birth weight, Premature birth, Inability to breastfeed, Inadequate nutrition, Vitamin D deficiency, Low socioeconomic level, Crowded living conditions, Inability to benefit from health services adequately, Presence of underlying chronic diseases, Congenital heart, lung diseases, Inadequate vaccination, non-application of measles pertussis vaccines, Air pollution, especially smoking, Maternal age and education

In adults; Advanced age, Chronic (chronic) diseases -Lung diseases (COPD, bronchiectasis, lung cancer), Heart diseases, Kidney diseases, Liver diseases, Diabetes, Nervous system diseases, Situations that cause swallowing difficulties (muscle, nerve esophagus diseases), Immunity system diseases (AIDS, blood and lymph node cancers), Smoking, Alcohol intake, Vomiting, Past long-term surgeries, Influenza outbreaks

In addition, allergic individuals, especially children, have frequent respiratory tract infections if they are not diagnosed and necessary precautions are not taken and regular treatments are not applied. Often these children are labeled as low-resistant, vulnerable, and use antibiotics unnecessarily too often. For this reason, in the presence of frequent respiratory tract infections, it is appropriate for parents and follow-up physicians to act consciously that the child may be allergic and to refer them to a specialist physician in the early period.

How are lower respiratory tract infections transmitted?

Of course, it is transmitted through the respiratory route. Acute bronchitis usually occurs with or following an upper respiratory tract infection. People who have cold and flu, those who stay indoors for a long time and those who work in places without ventilation are more risky, and people who smoke also get bronchitis more easily.

In some types of pneumonia, there is a risk of direct transmission from sick people to healthy people. However, the disease mostly occurs when germs from the patient’s own mouth, throat or digestive tract reach the lungs. These microbes, which do not normally cause disease, cause pneumonia in people with weakened body defenses. Therefore, risk factors that break the person’s body resistance play a role in the emergence of pneumonia rather than transmission.

Influenza and similar viral respiratory infections that predispose to pneumonia are very contagious. They can be spread by sneezing and coughing, and they can be passed to other people through items such as glasses, handkerchiefs, cutlery, door handles, which are contaminated with mouth and nose secretions. Some respiratory infections, such as tuberculosis, are transmitted by droplets.

Respiratory secretions are thrown into the air in the form of droplets when sick people cough, sneeze, talk. Healthy individuals become infected by inhaling these droplets, which also contain the tuberculosis bacillus (microbe). Not everyone who is infected will develop the disease. The ingested bacilli remain hidden in the body without making the person sick and cause disease when the body’s resistance drops.

What can be done at home for lower respiratory tract diseases?

The basis of treatment is rest, plenty of fluid intake, reduction of fever and relief of symptoms.

Each patient should rest for at least 1 week. Resting at home, not returning to work or school before the discomfort ends will both ensure the recovery of the patient and prevent the spread of the disease to the environment.

Antibiotics are of no use in the treatment of viral infection. Antibiotic only in the presence of bacteria attached to it, which we call secondary infection; It should be used if sinusitis, bronchitis, pneumonia have developed due to this.

Mild fever is the body’s defense mechanism and it is not necessary to reduce it. In the presence of high fever, especially in young children and the elderly, fever should be reduced. However, aspirin should never be used in children to reduce fever. Since the use of aspirin in viral infections may cause ‘Reye’s Syndrome’, which ends with brain damage and liver damage, aspirin should not be used for reducing fever (or even if it is not necessary) between the ages of 0-18.

Drinking 1.5-2 liters of water is very important in terms of replacing the fluid lost through sweat and softening the secretions. At least 1.5-2 liters of warm water should be consumed daily.

If you have a cough, simple measures to take at home when the cough first starts include:

If the cough increases at night – especially in sinopulmonary infections, it may increase due to post-nasal drip during the first hospitalization – the head of the bed should be elevated and if necessary, a double pillow should be used.

The nose must be kept open. If the nose remains blocked, mouth breathing will occur and the throat will dry out and the cough will increase.

If the cougher smokes himself, it would be appropriate not to smoke or drink near him and to stay away from all kinds of sharp odors during this period.

Again, heavy exertion can trigger coughing, the patient with cough should avoid heavy exertion.

If there is reflux that triggers cough, precautions should be taken for this as well, if the diagnosis has been made before, the physician should be informed and the treatment should be reviewed.

If the cough exceeds 2 weeks and/or increases, the physician should be consulted again.

Can lower respiratory infections be fatal?

Lower respiratory tract infections can be fatal. WHO reported that 17 million people died from infectious diseases in 1995, 25% of which were from lower respiratory tract infections.

Lower respiratory tract infections are responsible for the deaths of at least 4 million children each year, especially in children under the age of 5, in underdeveloped and developing countries. This figure constitutes approximately 30% of the childhood mortality rate. Low birth weight, malnutrition, crowded living conditions increase the risk of death in children. In adults, advanced age, chronic diseases, existing COPD, lung diseases such as bronchiectasis, lung cancer, immune system diseases such as AIDS, blood and lymph node cancers, Smoking, Alcohol consumption, Past long-term operations cause lower respiratory tract infections to be fatal.

Pneumonia, one of the lower respiratory tract infections, is among the most common diseases that cause the most deaths in the world and in our country. It is the fifth leading cause of death in Turkey. In particular, pneumonia can be more deadly in infants, children, the elderly, and people with another known illness. Between 10 and 12 million children under the age of 5 die from pneumonia each year around the world. 90% of these deaths occur in developing countries. In our country, pneumonia is responsible for 48% of infant deaths aged 1-12 months. This rate is 42% in the one to four age group.

In COPD, which is an important health problem and the 3rd most common cause of death, acute attacks are detected 2-4 times a year, and the most common cause of COPD deaths is lower respiratory tract infections leading to acute attacks, namely COPD exacerbations. Especially in recent years, after the outbreaks of new microbiological factors such as bird flu, SARS, swine flu, and their effect on the lower respiratory tract, unfortunately, related deaths have been observed.

exp. Dr. Sevin Karalar

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