Chest infection

Signs and symptoms of a chest infection 

The main symptoms of a chest infection can include:

• a persistent cough
• coughing up yellow or green phlegm (thick mucus), or coughing up blood
• breathlessness or rapid and shallow breathing
• wheezing
• a high temperature (fever)
• a rapid heartbeat
• chest pain or tightness when taking a breath
• feeling confused and disorientated

You may also experience more general symptoms of an infection, such as:

• a headache
• fatigue
• sweating
• loss of appetite or joint and muscle pain

What causes chest infections

A chest infection is an infection of the lungs or airways.

The main types of chest infection are:

• bronchitis
• pneumonia

Most bronchitis cases are caused by viruses.

Most pneumonia cases are due to bacteria.

These infections are usually spread when an infected person coughs or sneezes. This launches tiny droplets of fluid containing the virus or bacteria into the air. These droplets can then be breathed in by others.

The infections can also be spread to others. This happens if you cough or sneeze onto your hand, an object or a surface, and someone else shakes your hand or touches those surfaces before touching their mouth or nose.

Certain groups of people have a higher risk of developing serious chest infections, such as:

• babies and very young children
• children with developmental problems
• people who are very overweight
• elderly people
• pregnant women
• people who smoke
• people with long-term health conditions, such as asthma, heart disease, diabetes, kidney disease, cystic fibrosis or chronic obstructive pulmonary disease (COPD)
• people with a weakened immune system – this could be due to a recent illness, a transplant, high-dose steroids, chemotherapy or a health condition, such as an undiagnosed HIV infection

Caring for your symptoms at home 

Many chest infections aren't serious and get better within a few days or weeks. You won't usually need to see your GP, unless your symptoms suggest you have a more serious infection.

While you recover at home, you can improve your symptoms by:

• getting plenty of rest
• drinking lots of fluid to prevent dehydration and to loosen the mucus in your lungs, making it easier to cough up
• treating headaches, fever and aches and pains with painkillers, such as paracetamol or ibuprofen
• drinking a warm drink of honey and lemon to relieve a sore throat caused by persistent coughing
• raising your head up with extra pillows while you're sleeping to make breathing easier
• using an air humidifier or inhaling steam from a bowl of hot water to ease your cough (hot water shouldn't be used to treat young children with a cough, due to the risk of scalds - running hot water briefly in a bathroom, to create steam, and bringing your child into it, after draining the hot water away, might be a safer alternative)
• stopping smoking

Avoid cough medicines, as there's little evidence they work. Coughing actually helps you clear the infection more quickly by getting rid of the phlegm from your lungs.

Antibiotics aren't recommended for many chest infections. They only work if the infection is caused by bacteria, rather than a virus.

Your GP will usually only prescribe antibiotics if they think you have pneumonia, or you're at risk of complications such as fluid building up around the lungs (pleurisy).

If there's a flu outbreak in your local area and you're at risk of serious infection, your GP may also prescribe antiviral medication.

When to see your GP 

You should see your GP if:

• you feel very unwell or your symptoms are severe
• your symptoms are not improving after allowing a reasonable period of time (with a viral bronchitis, the cough generally lasts seven to 10 days, however, 45 per cent of people will still have a cough after two weeks, and 25 per cent will still have a cough after three weeks)
• you feel confused, disorientated or drowsy
• you have chest pain or difficulty breathing
• you cough up blood or blood-stained phlegm
• your skin or lips develop a blue tinge (cyanosis)
• you're very overweight and have difficulty breathing
• you have a weakened immune system
• you have a long-term health condition

It is also important to see your GP if:

• you think your child (under five years of age) has a chest infection
• you're pregnant
• you're 65 or over

and your symptoms are getting worse, or your child’s condition is deteriorating.

Your GP should be able to diagnose you based on your symptoms.

They will also listen to your chest using a stethoscope (a medical instrument used to listen to the heart and lungs).

In some cases, further tests, such as a chest X-ray, breathing tests and testing phlegm or blood samples, may be necessary.

Preventing chest infections 

There are measures you can take to help reduce your risk of developing chest infections and stop them spreading to others.

Stop smoking 

If you smoke, one of the best things you can do to prevent a chest infection is to stop.

Smoking damages your lungs and weakens your defences against infection.

Good hygiene 

Chest infections generally aren't as contagious as other common infections. However, like flu, you can pass them on to others through coughing and sneezing. 

Therefore, it's important to cover your mouth when you cough or sneeze and to wash your hands regularly. Put tissues in the bin immediately. 

Alcohol and diet 

Excessive and long periods of alcohol misuse can weaken your lungs' natural defences against infections. This can make you more vulnerable to chest infections.

To keep your risk of alcohol-related harm low, it is recommended:

• not regularly drinking more than 14 units of alcohol a week
• if you drink as much as 14 units a week, it's best to spread this evenly over three or more days
• it is a good idea to have several days alcohol free each week

Regular or frequent drinking means drinking alcohol most weeks. The risk to your health is increased by drinking any amount of alcohol on a regular basis.

Eating a healthy, balanced diet can help strengthen the immune system, making you less vulnerable to developing chest infections.

Vaccinations 

If you're at an increased risk of chest infections, your GP may recommend being vaccinated against flu and pneumococcal infections (a bacterium that can cause pneumonia).

These vaccinations should help to reduce your chances of getting chest infections in the future.

Flu and pneumococcal vaccinations are usually recommended for:

• babies and young children
• pregnant women (flu jab only)
• people aged 65 and over
• people with long-term health conditions or weakened immune systems

• Flu vaccination 

More useful links

• How to use your health services