Respiratory tract infections

We are all happy with the fact that European countries are lifting restrictions for Covid-19, but humans must not forget that although the Covid-19 virus caused a dramatic worldwide pandemic, many other respiratory diseases are caused by other viruses and bacteria that affect the respiratory system.

The story is the same and repeats itself in a similar way. Like different versions with a different leading character, some more friendly, some more nasty.

Covid-19 is a nasty one, but there were many other viruses before, many others continue to exist (including the Covid-19 virus), and new ones will certainly appear.

Respiratory tract infections (RTIs) are infections of parts of the body involved in breathing, such as the sinuses, throat, airways, or lungs.

Most infectious respiratory diseases (like with Covid-19) are spread from person to person, which means that if one person in a school, workplace, home, or community gets an infectious respiratory disease, they can spread it to others. The spread may occur through the air or from direct or indirect contact with an infected individual.

Many of the germs that cause respiratory (breathing) diseases are spread by droplets that come from coughing and sneezing. These germs usually spread from person to person when uninfected persons are in close contact with a sick person.

Viral pathogens are the most common cause of respiratory infection; causative agents include rhinoviruses, respiratory syncytial virus, influenza virus, parainfluenza virus, human metapneumovirus, measles, mumps, adenovirus, and coronaviruses.

Viral respiratory tract infections are a leading cause of morbidity and mortality worldwide, representing an enormous economic and disease burden.

With the pandemic, people have learned that viruses replicate in the respiratory tract, are transmitted by the respiratory secretions and that transmission depends on many variables such as environmental factors like humidity and temperature, crowding of people and host factors.

Respiratory tract infections may range from asymptomatic to acute life-threating disease, posing a major health threat to young children, the elderly, and immunocompromised people. Now that it seems the pandemic is “on the mend”, it is important to keep in mind that, unfortunately, Covid-19 is not the only virus that kills…

General rules for prevention of ALL infectious respiratory diseases

▪ Get vaccinated. It is always better to prevent a disease rather than treat it after it occurs.
▪ Wash your hands. Handwashing with soap is always preferred, but hand-sanitiser works well when needed.
▪ Cover coughs and sneezes. Cover the mouth with a tissue and throw it in the bin. And wash your hands.
▪ Stay home while sick. Staying home and away from other members of the household as much as possible will help stop the infection from spreading to others.
▪ Keep your home clean. Prioritise cleaning for health, not appearance. Disinfecting doorknobs and other high touch surfaces, replacing used hand towels and keeping physical distance from sick individuals will help stop the spread of disease.
▪ Additional protective measures. In some instances, additional preventive measures, such as wearing face masks and social distancing are required to help stop widespread community transmission of the infection and protect more susceptible individuals like patients with cardiovascular and chronic respiratory diseases.

Recent studies found that personal measures to protect against Covid-19 (including wearing facemasks, hand hygiene and physical distancing) prevented not only the Covid-19 transmission, but the transmission of acute respiratory infections as well, during the 2020/2021 and 2021/2022 flu seasons.

Findings suggested that personal protective measures with high feasibility and acceptability could be implemented during the influenza epidemics to reduce transmission, particularly in populations at the highest risk of developing severe complications. Therefore, the utility of these measures in people who are at risk of severe complications should be seriously considered in the future.

High compliance to the use of personal preventive measures in public might reduce the incidence of all respiratory viral infections and hospitalisation rates, with no need for additional quarantine, isolation, or contact screening.

Is this the end of the Covid-19 pandemic?

“I wouldn’t call it that at the moment. Certainly, we are in a phase of the pandemic where we might try and achieve moving away from the acute emergency that the pandemic has brought, but it will be a long time before we can pretend that the virus isn’t there anymore,” said Dr Catherine Smallwood, WHO’s Covid-19 incident manager for the European region.

“The goal for this year would be to exit that ‘emergency’ phase, but it will depend on how it evolves around the world. In countries that have already lifted measures, the virus will, of course, take advantage of that. There will be an increased incidence and possibly increased mortality,” she added.

Dr Smallwood says that even if there are no red flags at the moment, the World Health Organisation is constantly monitoring changes to the virus.

The current risk is for those in the population who remain vulnerable to the illness, the unvaccinated who have comorbidities and those who are immunocompromised, for whom vaccination does not work.

And Dr. Smallwood continued: “I think that we should all be extremely aware that there remain vulnerable people in our populations that may be extremely anxious by the recent announcements that more of these simple measures have been lifted. I think it’s on each of us to really think about our responsibility towards those people.”

We are all happy to be able to start “forgetting about Covid-19”, but we should keep in mind that the preventive measures that were implemented during the pandemic have also worked to diminish the number of infections, hospitalisations and deaths as a result of seasonal influenza and other respiratory infections.

We should all learn from this and, in the future, use adequate prevention for the circumstances and the characteristics of the individuals involved.

We must not forget that masks continue to be used in healthcare environments, public transports and when dealing with vulnerable people.

Prevention is always better than cure!

Best healthy wishes,
Dra. Maria Alice Pestana Serrano e Silva
|| [email protected]

Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos