Respiratory tract infections 

Introduction 

Respiratory tract infections (RTIs) are any infection of the sinuses, throat, airways or lungs.

They're usually caused by viruses, but can be caused by bacteria.

RTIs are thought to be one of the main reasons why people visit their GP or pharmacist. The common cold is the most widespread RTI.

Healthcare professionals generally make a distinction between:

• upper respiratory tract infections – which affect the nose, sinuses and throat
• lower respiratory tract infections – which affect the airways and lungs

Children tend to get more upper RTIs than adults because they haven't built up immunity (resistance) to the many viruses that can cause these infections.

How respiratory infections spread

RTIs can spread in several ways. If you have an infection such as a cold, tiny droplets of fluid containing the cold virus are launched into the air whenever you sneeze or cough. If these are breathed in by someone else, they may also become infected.

Infections can also be spread through indirect contact. For example, if you have a cold and you touch your nose or eyes before touching an object or surface, the virus may be passed to someone else when they touch that object or surface.

The best way to prevent spreading infections is to practise good hygiene, such as regularly washing your hands with soap and warm water.

Read more about preventing germs from spreading.

Upper respiratory tract infections

Common upper respiratory tract infections include:

• the common cold
• tonsillitis – infection of the tonsils and tissues at the back of the throat
• sinusitis – infection of the sinuses
• laryngitis – infection of the larynx (voice box)
• flu

A cough is the most common symptom of an upper RTI. Other symptoms include headaches, a stuffy or runny nose, a sore throat, sneezing and muscle aches.

Lower respiratory tract infections

Common lower RTIs include:

• flu – which can affect either the upper or lower respiratory tract
• bronchitis – infection of the airways
• pneumonia – infection of the lungs
• bronchiolitis – an infection of the small airways that affects babies and children aged under two
• tuberculosis – persistent bacterial infection of the lungs

As with upper RTIs, the main symptom of a lower RTI is a cough. However, it's usually more severe and you may bring up phlegm and mucus. Other possible symptoms are a tight feeling in your chest, an increased rate of breathing, breathlessness and wheezing.

Managing your symptoms at home

Most RTIs pass without the need for treatment and you won't usually need to see your GP. You can treat your symptoms at home by taking over-the-counter painkillers such as paracetamol or ibuprofen, drinking plenty of fluids and resting.

In most cases, antibiotics aren't recommended because they're only effective if the infection is caused by bacteria.

The symptoms of an upper RTI usually pass within one to two weeks.

When you should see your GP

Visit your GP if:

• your symptoms suggest you may have pneumonia – for example, if you're coughing up bloody mucus and phlegm
• you have a pre-existing heart, lung, liver or kidney condition
• you have a long-term lung condition, such as chronic obstructive pulmonary disease (COPD) or asthma
• you have a condition that affects your nervous system, such as multiple sclerosis
• you have cystic fibrosis or bronchiectasis
• you have a weakened immune system
• your cough has persisted for more than three weeks, you're losing weight, you have chest pain or if there are any lumps in your neck

It's also recommended that you visit your GP if you're over 65 years of age and you have a cough and two or more of the factors listed below, or you're over 80 years of age and have a cough and one of the following factors:

• you've been admitted to hospital at some point during the past year
• you have type 1 diabetes or type 2 diabetes
• you have a history of heart failure
• you're currently taking a type of steroid medication known as oral glucocorticoids – for example, prednisolone

You can also ask your GP about any vaccines you can have to help protect against some RTIs. See the 'Adults' tab on The NHS vaccinations schedule page for more information about these.