Asthma
Asthma is defined as a common, chronic respiratory condition
that causes difficulty breathing due to inflammation of the
airways. Asthma symptoms include dry cough, wheezing,
chest tightness and shortness of breath. Dr. Meyer says there
is a major connection between environmental allergies and
asthma. Allergic reactions, infections and pollution can all
trigger an asthma attack.
“Those with persistent asthma often notice a better quality of
life with the help of anti-inflammatory medication,” Dr.
Meyer says. “Everyone who has asthma needs to have a
rescue inhaler to open airways quickly.”
Usually, asthma starts in childhood years and progresses into
adulthood. However, some people in their 60s, 70s and 80s
can get adult onset asthma. Dr. Meyer says asthma is a
reversible obstructive lung disease. He’s seen asthma
patients who are able to improve their breathing flow rates
better than those who have the respiratory disease known as
COPD.
Causes
It isn't clear why some people get asthma and others don't,
but it's probably due to a combination of environmental and
genetic (inherited) factors.
Symptoms
Asthma symptoms vary from person to person. You may have
infrequent asthma attacks, have symptoms only at certain
times — such as when exercising — or have symptoms all the
time.
Asthma signs and symptoms include:
 Shortness of breath
 Chest tightness or pain
 Trouble sleeping caused by shortness of breath,
coughing or wheezing
 A whistling or wheezing sound when exhaling
(wheezing is a common sign of asthma in children)
 Coughing or wheezing attacks that are worsened by
a respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:
 Asthma signs and symptoms that are more frequent
and bothersome
 Increasing difficulty breathing (measurable with a
peak flow meter, a device used to check how well
your lungs are working)
 The need to use a quick-relief inhaler more often
 For some people, asthma signs and symptoms flare
up in certain situations:
Exercise-induced asthma, which may be worse when the air is
cold and dry
Occupational asthma, triggered by workplace irritants such as
chemical fumes, gases or dust
Allergy-induced asthma, triggered by airborne substances,
such as pollen, mold spores, cockroach waste or particles of
skin and dried saliva shed by pets (pet dander).
Treatment
Prevention and long-term control are key in stopping asthma
attacks before they start. Treatment usually involves learning
to recognize your triggers, taking steps to avoid them and
tracking your breathing to make sure your daily asthma
medications are keeping symptoms under control. In case of
an asthma flare-up, you may need to use a quick-relief
inhaler, such as albuterol.
Chronic Obstructive Pulmonary
Disease (COPD)
Chronic obstructive pulmonary disease is an umbrella term
that encompasses several respiratory illnesses that cause
breathlessness, or the inability to exhale normally. People
usually experience symptoms, including shortness of breath,
and normally cough up sputum (mucus from the lungs),
especially in the morning. COPD can be tricky for some
people to identify, because symptoms are often mistaken for
the gradual aging process and body deterioration. In fact,
COPD can develop over the course of several years without
any signs of shortness of breath. For that reason, Dr. Meyer
says COPD often goes undetected for far too long. He says the
disease usually begins while people are in their 30s or 40s
and then peaks during their 50s, 60s and 70s.
“This disease is generally associated with cigarette smoking.
It’s rare to see people with COPD who haven’t been exposed
to some sort of smoking. People can experience varying
severity levels of COPD. At its most severe, it can cause
people difficulty doing every day activities,” Dr. Meyer says.]
Causes
The main cause of COPD in developed countries is tobacco
smoking. In the developing world, COPD often occurs in
people exposed to fumes from burning fuel for cooking and
heating in poorly ventilated homes.
Only about 20 to 30 percent of chronic smokers may develop
clinically apparent COPD, although many smokers with long
smoking histories may develop reduced lung function. Some
smokers develop less common lung conditions. They may be
misdiagnosed as having COPD until a more thorough
evaluation is performed.
Symptoms
COPD symptoms often don't appear until significant lung
damage has occurred, and they usually worsen over time,
particularly if smoking exposure continues. For chronic
bronchitis, the main symptom is a daily cough and mucus
(sputum) production at least three months a year for two
consecutive years.
Other signs and symptoms of COPD may include:
 Shortness of breath, especially during physical
activities
 Wheezing
 Chest tightness
 Having to clear your throat first thing in the morning,
due to excess mucus in your lungs
 A chronic cough that may produce mucus (sputum)
that may be clear, white, yellow or greenish
 Blueness of the lips or fingernail beds (cyanosis)
 Frequent respiratory infections
 Lack of energy
 Unintended weight loss (in later stages)
 Swelling in ankles, feet or legs
People with COPD are also likely to experience episodes
called exacerbations, during which their symptoms become
worse than usual day-to-day variation and persist for at least
several days.
Treatment
A diagnosis of COPD is not the end of the world. Most people
have mild forms of the disease for which little therapy is
needed other than smoking cessation. Even for more
advanced stages of disease, effective therapy is available that
can control symptoms, reduce your risk of complications and
exacerbations, and improve your ability to lead an active life.
Chronic Bronchitis
Bronchitis is an inflammation of the lining of your bronchial
tubes, which carry air to and from your lungs. People who
have bronchitis often cough up thickened mucus, which can
be discolored. Bronchitis may be either acute or chronic.
Often developing from a cold or other respiratory infection,
acute bronchitis is very common. Chronic bronchitis, a more
serious condition, is a constant irritation or inflammation of
the lining of the bronchial tubes, often due to smoking.
Acute bronchitis, also called a chest cold, usually improves
within a week to 10 days without lasting effects, although the
cough may linger for weeks.
However, if you have repeated bouts of bronchitis, you may
have chronic bronchitis, which requires medical attention.
Chronic bronchitis is one of the conditions included in chronic
obstructive pulmonary disease (COPD).
Causes
Acute bronchitis is usually caused by viruses, typically the
same viruses that cause colds and flu (influenza). Antibiotics
don't kill viruses, so this type of medication isn't useful in
most cases of bronchitis.
The most common cause of chronic bronchitis is cigarette
smoking. Air pollution and dust or toxic gases in the
environment or workplace also can contribute to the
condition.
Symptoms
For either acute bronchitis or chronic bronchitis, signs and
symptoms may include:
 Cough
 Production of mucus (sputum), which can be clear,
white, yellowish-gray or green in color — rarely, it
may be streaked with blood
 Fatigue
 Shortness of breath
 Slight fever and chills
 Chest discomfort
If you have acute bronchitis, you might have cold symptoms,
such as a mild headache or body aches. While these
symptoms usually improve in about a week, you may have a
nagging cough that lingers for several weeks.
Chronic bronchitis is defined as a productive cough that lasts
at least three months, with recurring bouts occurring for at
least two consecutive years.
If you have chronic bronchitis, you're likely to have periods
when your cough or other symptoms worsen. At those times,
you may have an acute infection on top of chronic bronchitis.
Treatment
Most cases of acute bronchitis get better without treatment,
usually within a couple of weeks.
Medications
Because most cases of bronchitis are caused by viral
infections, antibiotics aren't effective. However, if your
doctor suspects that you have a bacterial infection, he or she
may prescribe an antibiotic.
In some circumstances, your doctor may recommend other
medications, including:
 Cough medicine. If your cough keeps you from
sleeping, you might try cough suppressants at
bedtime.
 Other medications. If you have allergies, asthma or
chronic obstructive pulmonary disease (COPD), your
doctor may recommend an inhaler and other
medications to reduce inflammation and open
narrowed passages in your lungs.
Therapies
If you have chronic bronchitis, you may benefit from
pulmonary rehabilitation — a breathing exercise program in
which a respiratory therapist teaches you how to breathe
more easily and increase your ability to exercise.
Emphysema
Emphysema is a lung condition that causes shortness of
breath. In people with emphysema, the air sacs in the lungs
(alveoli) are damaged. Over time, the inner walls of the air
sacs weaken and rupture — creating larger air spaces instead
of many small ones. This reduces the surface area of the
lungs and, in turn, the amount of oxygen that reaches your
bloodstream.
When you exhale, the damaged alveoli don't work properly
and old air becomes trapped, leaving no room for fresh,
oxygen-rich air to enter.
Most people with emphysema also have chronic bronchitis.
Chronic bronchitis is inflammation of the tubes that carry air
to your lungs (bronchial tubes), which leads to a persistent
cough.
Emphysema and chronic bronchitis are two conditions that
make up chronic obstructive pulmonary disease (COPD).
Smoking is the leading cause of COPD. Treatment may slow
the progression of COPD, but it can't reverse the damage.
Causes
The main cause of emphysema is long-term exposure to
airborne irritants, including:
 Tobacco smoke
 Marijuana smoke
 Air pollution
 Chemical fumes and dust
Rarely, emphysema is caused by an inherited deficiency of a
protein that protects the elastic structures in the lungs. It's
called alpha-1-antitrypsin deficiency emphysema.
Symptoms
You can have emphysema for many years without noticing
any signs or symptoms. The main symptom of emphysema is
shortness of breath, which usually begins gradually.
You may start avoiding activities that cause you to be short of
breath, so the symptom doesn't become a problem until it
starts interfering with daily tasks. Emphysema eventually
causes shortness of breath even while you're at rest.
Treatment
Emphysema and COPD can't be cured, but treatments can
help relieve symptoms and slow the progression of the
disease.
Lung Cancer
Lung cancer is a type of cancer that begins in the lungs. Your
lungs are two spongy organs in your chest that take in oxygen
when you inhale and release carbon dioxide when you
exhale.
Lung cancer is the leading cause of cancer deaths in the
United States, among both men and women. Lung cancer
claims more lives each year than do colon, prostate, ovarian
and breast cancers combined.
People who smoke have the greatest risk of lung cancer,
though lung cancer can also occur in people who have never
smoked. The risk of lung cancer increases with the length of
time and number of cigarettes you've smoked. If you quit
smoking, even after smoking for many years, you can
significantly reduce your chances of developing lung cancer.
Causes
Smoking causes the majority of lung cancers — both in
smokers and in people exposed to secondhand smoke. But
lung cancer also occurs in people who never smoked and in
those who never had prolonged exposure to secondhand
smoke. In these cases, there may be no clear cause of lung
cancer.
Symptoms
Lung cancer typically doesn't cause signs and symptoms in its
earliest stages. Signs and symptoms of lung cancer typically
occur only when the disease is advanced.
Signs and symptoms of lung cancer may include:
 A new cough that doesn't go away
 Coughing up blood, even a small amount
 Shortness of breath
 Chest pain
 Hoarseness
 Losing weight without trying
 Bone pain
 Headache
Treatment
Lung cancer is treated in several ways, depending on the type
of lung cancer and how far it has spread. People with non-
small cell lung cancer can be treated with surgery,
chemotherapy, radiation therapy, targeted therapy, or a
combination of these treatments. People with small cell lung
cancer are usually treated with radiation therapy and
chemotherapy.
Surgery. An operation where doctors cut out cancer tissue.
Chemotherapy. Using special medicines to shrink or kill the
cancer. The drugs can be pills you take or medicines given in
your veins, or sometimes both.
Radiation therapy. Using high-energy rays (similar to X-rays)
to kill the cancer.
Targeted therapy. Using drugs to block the growth and
spread of cancer cells. The drugs can be pills you take or
medicines given in your veins.
Doctors from different specialties often work together to
treat lung cancer. Pulmonologists are doctors who are
experts in diseases of the lungs. Surgeons are doctors who
perform operations. Thoracic surgeons specialize in chest,
heart, and lung surgery. Medical oncologists are doctors who
treat cancer with medicines. Radiation oncologists are
doctors who treat cancers with radiation.
Pneumonia
Pneumonia is a common lung disease caused by an infection
in the air sacs in the lungs. The infections can be bacterial,
viral or fungal. Most people can recover in one to three
weeks, but for certain people, pneumonia can be extremely
serious and even life-threatening.
“The very young and the very old are more at-risk for
pneumonia and complications associated with pneumonia.
Patients can be at increasingly susceptible to pneumonia,
based on their smoking history or just their overall immune
status. If they are frail or sickly, they can develop pneumonia
more readily than young, healthy, well-nourished people,” Dr.
Meyer says.
Symptoms, which include cough, fever, shaking chills and
shortness of breath, can range from mild to severe. Dr. Meyer
says it’s really important for adults over 65 or those with
other chronic disease to get the pneumococcal pneumonia
vaccine. Additional suggested ways to prevent this respiratory
condition include washing hands frequently and getting the
flu shot
Causes
Many germs can cause pneumonia. The most common are
bacteria and viruses in the air we breathe. Your body usually
prevents these germs from infecting your lungs. But
sometimes these germs can overpower your immune system,
even if your health is generally good.
Pneumonia is classified according to the types of germs that
cause it and where you got the infection
Symptoms
The signs and symptoms of pneumonia vary from mild to
severe, depending on factors such as the type of germ
causing the infection, and your age and overall health. Mild
signs and symptoms often are similar to those of a cold or flu,
but they last longer.
Signs and symptoms of pneumonia may include:
 Chest pain when you breathe or cough
 Confusion or changes in mental awareness (in adults
age 65 and older)
 Cough, which may produce phlegm
 Fatigue
 Fever, sweating and shaking chills
 Lower than normal body temperature (in adults
older than age 65 and people with weak immune
systems)
 Nausea, vomiting or diarrhea
 Shortness of breath
Newborns and infants may not show any sign of the infection.
Or they may vomit, have a fever and cough, appear restless
or tired and without energy, or have difficulty breathing and
eating.
Treatment
Treatment for pneumonia involves curing the infection and
preventing complications. People who have community-
acquired pneumonia usually can be treated at home with
medication. Although most symptoms ease in a few days or
weeks, the feeling of tiredness can persist for a month or
more.
Specific treatments depend on the type and severity of your
pneumonia, your age and your overall health. The options
include:
Antibiotics. These medicines are used to treat bacterial
pneumonia. It may take time to identify the type of bacteria
causing your pneumonia and to choose the best antibiotic to
treat it. If your symptoms don't improve, your doctor may
recommend a different antibiotic.
Cough medicine. This medicine may be used to calm your
cough so that you can rest. Because coughing helps loosen
and move fluid from your lungs, it's a good idea not to
eliminate your cough completely. In addition, you should
know that very few studies have looked at whether over-the-
counter cough medicines lessen coughing caused by
pneumonia. If you want to try a cough suppressant, use the
lowest dose that helps you rest.
Fever reducers/pain relievers. You may take these as needed
for fever and discomfort. These include drugs such as aspirin,
ibuprofen (Advil, Motrin IB, others) and acetaminophen
(Tylenol, others).
Tuberculosis
Tuberculosis (TB) is a potentially serious infectious disease
that mainly affects your lungs. The bacteria that cause
tuberculosis are spread from one person to another through
tiny droplets released into the air via coughs and sneezes.
Once rare in developed countries, tuberculosis infections
began increasing in 1985, partly because of the emergence of
HIV, the virus that causes AIDS. HIV weakens a person's
immune system so it can't fight the TB germs. In the United
States, because of stronger control programs, tuberculosis
began to decrease again in 1993, but remains a concern.
Many strains of tuberculosis resist the drugs most used to
treat the disease. People with active tuberculosis must take
several types of medications for many months to eradicate
the infection and prevent development of antibiotic
resistance
Causes
Tuberculosis is caused by bacteria that spread from person to
person through microscopic droplets released into the air.
This can happen when someone with the untreated, active
form of tuberculosis coughs, speaks, sneezes, spits, laughs or
sings.
Although tuberculosis is contagious, it's not easy to catch.
You're much more likely to get tuberculosis from someone
you live with or work with than from a stranger. Most people
with active TB who've had appropriate drug treatment for at
least two weeks are no longer contagious.
Symptoms
Although your body may harbor the bacteria that cause
tuberculosis (TB), your immune system usually can prevent
you from becoming sick. For this reason, doctors make a
distinction between:
Latent TB. In this condition, you have a TB infection, but the
bacteria remain in your body in an inactive state and cause no
symptoms. Latent TB, also called inactive TB or TB infection,
isn't contagious. It can turn into active TB, so treatment is
important for the person with latent TB and to help control
the spread of TB. An estimated 2 billion people have latent
TB.
Active TB. This condition makes you sick and in most cases
can spread to others. It can occur in the first few weeks after
infection with the TB bacteria, or it might occur years later.
Signs and symptoms of active TB include:
 Coughing that lasts three or more weeks
 Coughing up blood
 Chest pain, or pain with breathing or coughing
 Unintentional weight loss
 Fatigue
 Fever
 Night sweats
 Chills
 Loss of appetite
Treatment
Tuberculosis can also affect other parts of your body,
including your kidneys, spine or brain. When TB occurs
outside your lungs, signs and symptoms vary according to the
organs involved. For example, tuberculosis of the spine may
give you back pain, and tuberculosis in your kidneys might
cause blood in your urine.
Medications are the cornerstone of tuberculosis treatment.
But treating TB takes much longer than treating other types
of bacterial infections.
For active tuberculosis, you must take antibiotics for at least
six to nine months. The exact drugs and length of treatment
depend on your age, overall health, possible drug resistance
and the infection's location in the body.
Influenza
Influenza is a viral infection that attacks your respiratory
system — your nose, throat and lungs. Influenza is commonly
called the flu, but it's not the same as stomach "flu" viruses
that cause diarrhea and vomiting.
For most people, influenza resolves on its own. But
sometimes, influenza and its complications can be deadly.
People at higher risk of developing flu complications include:
 Young children under age 5, and especially those
under 2 years
 Adults older than age 65
 Residents of nursing homes and other long-term
care facilities
 Pregnant women and women up to two weeks
postpartum
 People with weakened immune systems
 People who have chronic illnesses, such as asthma,
heart disease, kidney disease, liver disease and
diabetes
 People who are very obese, with a body mass index
(BMI) of 40 or higher
Though the annual influenza vaccine isn't 100 percent
effective, it's still your best defense against the flu.
Causes
Flu viruses travel through the air in droplets when someone
with the infection coughs, sneezes or talks. You can inhale the
droplets directly, or you can pick up the germs from an object
— such as a telephone or computer keyboard — and then
transfer them to your eyes, nose or mouth.
People with the virus are likely contagious from the day or so
before symptoms first appear until about five days after
symptoms begin. Children and people with weakened
immune systems may be contagious for a slightly longer time.
Influenza viruses are constantly changing, with new strains
appearing regularly. If you've had influenza in the past, your
body has already made antibodies to fight that particular
strain of the virus. If future influenza viruses are similar to
those you've encountered before, either by having the
disease or by vaccination, those antibodies may prevent
infection or lessen its severity.
But antibodies against flu viruses you've encountered in the
past can't protect you from new influenza subtypes that can
be very different immunologically from what you had before.
Symptoms
Initially, the flu may seem like a common cold with a runny
nose, sneezing and sore throat. But colds usually develop
slowly, whereas the flu tends to come on suddenly. And
although a cold can be a nuisance, you usually feel much
worse with the flu.
Common signs and symptoms of the flu include:
 Fever over 100.4 F (38 C)
 Aching muscles
 Chills and sweats
 Headache
 Dry, persistent cough
 Fatigue and weakness
 Nasal congestion
 Sore throat
Treatment
Usually, you'll need nothing more than bed rest and plenty of
fluids to treat the flu. But in some cases, your doctor may
prescribe an antiviral medication, such as oseltamivir
(Tamiflu) or zanamivir (Relenza). If taken soon after you
notice symptoms, these drugs may shorten your illness by a
day or so and help prevent serious complications.
Oseltamivir is an oral medication. Zanamivir is inhaled
through a device similar to an asthma inhaler and shouldn't
be used by anyone with respiratory problems, such as asthma
and lung disease.
Antiviral medication side effects may include nausea and
vomiting. These side effects may be lessened if the drug is
taken with food. Oseltamivir has also been associated with
delirium and self-harm behaviors in teenagers.
Some strains of influenza have become resistant to
amantadine and rimantadine (Flumadine), which are older
antiviral drugs.
Common Cold
The common cold is a viral infection of your nose and throat
(upper respiratory tract). It's usually harmless, although it
might not feel that way. Many types of viruses can cause a
common cold.
Children younger than 6 are at greatest risk of colds, but
healthy adults can also expect to have two or three colds
annually.
Most people recover from a common cold in a week or 10
days. Symptoms might last longer in people who smoke. If
symptoms don't improve, see your doctor.
Causes
Although many types of viruses can cause a common cold,
rhinoviruses are the most common culprit.
A cold virus enters your body through your mouth, eyes or
nose. The virus can spread through droplets in the air when
someone who is sick coughs, sneezes or talks.
It also spreads by hand-to-hand contact with someone who
has a cold or by sharing contaminated objects, such as
utensils, towels, toys or telephones. If you touch your eyes,
nose or mouth after such contact or exposure, you're likely to
catch a cold.
Symptoms
Symptoms of a common cold usually appear one to three
days after exposure to a cold-causing virus. Signs and
symptoms, which can vary from person to person, might
include:
 Runny or stuffy nose
 Sore throat
 Cough
 Congestion
 Slight body aches or a mild headache
 Sneezing
 Low-grade fever
 Generally feeling unwell (malaise)
The discharge from your nose may become thicker and
yellow or green in color as a common cold runs its course.
This isn't an indication of a bacterial infection.
Treatment
There's no cure for the common cold. Antibiotics are of no
use against cold viruses and shouldn't be used unless there's
a bacterial infection. Treatment is directed at relieving signs
and symptoms.
Severe acute respiratory syndrome
(SARS)
Severe acute respiratory syndrome (SARS) is a contagious and
sometimes fatal respiratory illness. SARS first appeared in
China in November 2002. Within a few months, SARS spread
worldwide, carried by unsuspecting travelers.
SARS showed how quickly infection can spread in a highly
mobile and interconnected world. On the other hand,
concerted international cooperation allowed health experts
to quickly contain the spread of the disease. There has been
no known transmission of SARS anywhere in the world since
2004.
Causes
SARS is caused by a strain of coronavirus, the same family of
viruses that causes the common cold. Until now, these
viruses have never been particularly dangerous in humans,
although they can cause severe disease in animals. For that
reason, scientists originally thought that the SARS virus might
have crossed from animals to humans. It now seems likely
that it evolved from one or more animal viruses into a new
strain.
Symptoms
SARS typically begins with flu-like signs and symptoms —
fever, chills, muscle aches and occasionally diarrhea. After
about a week, signs and symptoms include:
 Fever of 100.5 F (38 C) or higher
 Dry cough
 Shortness of breath
Treatment
In spite of a concerted global effort, scientists have yet to find
an effective treatment for SARS. Antibiotic drugs don't work
against viruses, and antiviral drugs haven't shown much
benefit.