Bronchitis

Bronchitis is inflammation of the bronchial tubes — the airways that carry air into the lungs. There are two main forms. Acute bronchitis is a short-term inflammation, most commonly caused by a viral respiratory infection, that typically resolves within 3 weeks. It is one of the most frequent reasons for medical consultations in Nigeria. Chronic bronchitis is a long-term condition defined as a productive cough lasting at least 3 months per year for two or more consecutive years. Chronic bronchitis is a component of chronic obstructive pulmonary disease (COPD) and is strongly linked to smoking and persistent exposure to indoor air pollution.

Acute bronchitis symptoms: • Persistent cough: initially dry, then producing yellow, green, or clear mucus (phlegm) • Low-grade fever and chills • Sore throat • Runny or blocked nose • Fatigue and general malaise • Chest discomfort or mild tightness • Mild shortness of breath with exertion • Mild wheezing in some people The cough typically lasts 3 weeks but can persist up to 8 weeks as the airways recover. Chronic bronchitis symptoms: • Daily productive cough with phlegm: the defining feature • Progressive shortness of breath, initially only on exertion • Frequent respiratory infections • Wheezing • Reduced exercise tolerance over time • In advanced disease: cyanosis (blue lips/fingernails), ankle swelling, and severe breathlessness at rest

Acute bronchitis is caused by: • Viral infections: responsible for over 90% of cases (influenza, rhinovirus, RSV, coronavirus, parainfluenza) • Bacterial infections: uncommon, but Bordetella pertussis (whooping cough) can cause prolonged bronchitis • Irritant exposure: cigarette smoke, chemical fumes, dust Chronic bronchitis is caused by: • Long-term cigarette smoking: the overwhelmingly dominant cause • Prolonged exposure to indoor air pollution: particularly cooking smoke from wood, charcoal, or kerosene in poorly ventilated homes (extremely common in Nigeria) • Occupational dust and chemical exposure (miners, farmers, construction workers) • Recurrent respiratory infections in childhood

Acute bronchitis: • Recent cold or upper respiratory infection • Smoking or exposure to second-hand smoke • Weakened immune system • Exposure to indoor cooking smoke • Close contact with infected individuals Chronic bronchitis: • Cigarette smoking: the single most important risk factor • Indoor air pollution from biomass fuel combustion (a major risk in Nigerian households) • Occupational exposure to dust, fumes, and chemicals • History of frequent childhood respiratory infections • Air pollution in urban areas • Low socioeconomic status and crowded living conditions

Acute bronchitis complications: • Secondary bacterial pneumonia: the main serious complication • Prolonged or recurrent bronchitis episodes, especially in smokers and immunocompromised individuals Chronic bronchitis complications (COPD): • Respiratory failure: severely low oxygen and/or high carbon dioxide • Cor pulmonale: right-sided heart failure from chronic low oxygen • Pulmonary hypertension • Frequent severe exacerbations requiring hospitalisation • Significant disability and reduced quality of life • Increased susceptibility to pneumonia • Death: COPD is a leading cause of death worldwide

Preventing acute bronchitis: • Wash hands frequently, especially during cold and flu season • Avoid close contact with people who have respiratory infections • Get annual influenza vaccination and ensure pertussis vaccination is up to date • Avoid smoking and second-hand smoke Preventing chronic bronchitis: • Never start smoking; quit smoking as early as possible if you currently smoke • Improve kitchen ventilation: use improved cookstoves, open windows while cooking, or switch to gas or electric • Wear appropriate respiratory protection in dusty or chemical-heavy workplaces • Seek early medical care for recurring respiratory symptoms