What Is Bronchitis?

Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes, the tubes that carry air to your lungs, become inflamed. (For more information on the bronchial tubes and the airways, see the Diseases and Conditions Index How the Lungs Work article.) People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath. Overview There are two main types of bronchitis: acute (short term) and chronic (ongoing). Acute Bronchitis Infections or other factors that irritate the lungs cause acute bronchitis. The same viruses that cause colds and the flu often cause acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria cause acute bronchitis. Acute bronchitis lasts from a few days to 10 days. However, the cough that occurs may last for several weeks after the infection is gone. Several factors increase the risk for acute bronchitis. Examples include tobacco smoke (including secondhand smoke), air pollution, dust, and fumes. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis. Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that need medical care. Chronic Bronchitis Chronic bronchitis is an ongoing, serious condition. It occurs when the lining of the bronchial tubes is constantly irritated and inflamed. Bronchitis is "chronic" if you have a cough with mucus on most days for at least 3 months a year and 2 years in a row (without another apparent cause). Smoking is the main cause of chronic bronchitis.

Viruses or bacteria can easily infect the irritated bronchial tubes. When this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis also have periods when symptoms get much worse than usual. Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting cigarette smoking and avoiding secondhand cigarette smoke, can help people live better with this condition. The chance of complete recovery is low for people who have severe chronic bronchitis. Bronchitis Acute bronchitis | Chronic bronchitis | Preventing bronchitis Bronchitis means swelling in your air passages (bronchi). Bronchi are the air passages that connect your windpipe (trachea) with tiny air sacs (alveoli) in your lungs. The air sacs are where your body absorbs the oxygen your breathe in. Bronchitis is an inflammation of the bronchi. This inflammation means the walls of your bronchi are swollen and filled with extra sticky mucus. Airflow into and out of your lungs is partly blocked because of the swelling and extra mucus in your bronchi. There are two kinds of bronchitis:

Acute bronchitis: bronchitis that makes your sick for a while, then goes away Chronic bronchitis: bronchitis that doesn't go away

1. Airway that's red & swollen from bronchitis 2. Normal airway, no swelling

Acute bronchitis
Acute bronchitis, swelling in your bronchi, is usually caused by viruses- the same viruses that give you the common cold. The viruses attack the insides of your airways and infect them. Your airways react by getting red and swollen, and by making extra mucus.
Symptoms of acute bronchitis

If you have acute bronchitis, you probably feel the symptoms of a cold, plus:

you cough up extra mucus wheezing in your chest- it feels harder to breathe

Treating acute bronchitis

Most of the time, acute bronchitis goes away on its own, as long as you take good care of yourself. Get lots of rest, drink plenty of water, and try to cough up the mucus. If you smoke, cut down or stop when you have bronchitis- this will allow your lungs to recover much faster.
See your doctor if:

your symptoms last for more than one month you have trouble breathing when you lie down you cough up blood or a bad-tasting mucus (sticky fluid form your lungs) you have swollen feet you feel sick, weak, and have a high fever you have had acute bronchitis many times - this could signal that you have a chronic (long-term) problem in your lungs

If you get medical treatment, the doctor may prescribe inhaled corticosteroids, the kind of medicine people with asthma take to reduce the swelling in their airways. If the doctor finds that your bronchitis is caused by bacteria, s/he will prescribe antibiotics. If you already have a chronic lung disease like asthma or COPD and you get bronchitis, follow the instructions in your written action plan. This may mean taking more of your medicines. Pay close attention to your symptoms and see your doctor or go to emergency if breathing is difficult. Back to Top

Chronic bronchitis
If you have chronic bronchitis:

the cells lining the inside of the bronchi are continuously red & swollen the airways in your lungs have become narrow and partly clogged with mucus

With chronic bronchitis, the mucus cannot be cleared. Instead of helping to clean the lungs, the mucus blocks your airways. The mucus is thicker and more difficult to cough up. This means it's easier for bacteria to settle in your lower airways and become infected. Chronic bronchitis is ususally caused by cigarette smoke. It can also be caused by other things. The main symptoms of chronic bronchitis are:

A persistent cough (cough that won't go away) Extra mucus (phlegm) in the lungs

Chronic bronchitis is part of a breathing disease called COPD (Chronic Obstructive Pulmonary Disease). Read more about chroncic bronchitis in our COPD section.

Diagnosing chronic bronchitis/ COPD

Treatment for chronic bronchitis/ COPD Medications for chronic bronchitis/ COPD Breathing techniques for people with chronic bronchitis/ COPD Living with chronic bronchitis/ COPD Get help for chronic bronchitis/ COPD

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Preventing bronchitis
The best way to prevent bronchitis it to stay away from smoke- don't smoke, and don't go near second-hand smoke. If you smoke, quit - it's not easy, but it's the best thing you can do to slow down the damage in your lungs. You can prevent acute bronchitis (the kind that comes form a virus) by fighting germs: wash your hands properly and often.

What Is Asthma? Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Asthma affects people of all ages, but it most often starts in childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children. Overview The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. This makes the airways swollen and very sensitive. They tend to react strongly to certain substances that are breathed in. When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows to your lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow your airways. This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are irritated. Asthma

Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine. At other times, symptoms continue to get worse. When symptoms get more intense and/or additional symptoms appear, this is an asthma attack. Asthma attacks also are called flareups or exacerbations. It's important to treat symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can cause death. Outlook Asthma can't be cured. Even when you feel fine, you still have the disease and it can flare up at any time. But with today's knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma. For successful, comprehensive, and ongoing treatment, take an active role in managing your disease. Build strong partnerships with your doctor and other clinicians on your health care team.

What is asthma? Asthma is a chronic (long-term) disease that makes it hard to breathe. At its worst, asthma can be fatal. For example, in 2003, asthma killed 287 Canadians 1. Asthma can't be cured, but it can be managed. With proper treatment, people with asthma can lead normal, active lives. If you have asthma, your airways (breathing passages) are extra sensitive. When you are around certain things, your extra-sensitive airways can: Become red and swollen - your airways get inflamed inside. They fill up with mucus. The swelling and mucus make your airways narrower, so it's harder for the air to pass through. Become "twitchy" and go into spasm - the muscles around your airways squeeze together and tighten. This makes your airways narrower, leaving less room for the air to pass through. The more red and swollen your airways are, the more twitchy they become.

Normal airways Airways of a person without asthma

Airways of a person with asthma - redness and swelling (inflammation)

Airways of a person with asthma - tightened muscles (bronchospasm)

In people without asthma, the muscles around the airways are relaxed, allowing the airways to stay open. There is no swelling or mucus inside the airways.

In people with asthma, the inside of the airways can get red, swollen, and filled with mucus.

In people with asthma, the muscles around the airways can spasm and squeeze tighter. This leaves less room for air to pass through.

What sets off your asthma symptoms?

Many different things can set off your asthma symptoms. Each person with asthma has her own set of asthma inducers and asthma triggers. Asthma inducers: If you breathe in something you're allergic to- for example, dust or pollen- or if you have a viral infection- for example, a cold or the flu- your airways can become inflamed (red and swollen). Asthma triggers: If you breathe in an asthma trigger like cold air or smoke, or if you exercise, the muscles around your airways can go into spasm and squeeze together tightly. This leaves less room for air to pass through. It's important for every person with asthma to know what they triggers and inducers are, so they can avoid them.

What causes asthma? Who is at risk of getting it?

Doctors know that there are some things that make a person more likely to get asthma: Family history: if people in your family have allergic diseases like asthma, hay fever (allergic rhinitis), or eczema, there is a higher chance you will have asthma. Air pollution indoors and out: some research shows that people who live near major highways and other polluted places are more likely to get asthma. Also, kids who grow up in a home with mould or dust may be more likely to get asthma.

Work-related asthma (occupational exposure): People who work in certain types of jobs can get asthma from things they work with. For example:

Laboratory workers can get asthma from lab animals: rats, mice, guinea-pigs Spray painters can get asthma from isocyanates Grain handlers can get asthma from grain dust Crab processors can get asthma from crab dust

The Canadian Centre for Occupational Health and Safety, a government agency, offers more information on occupational asthma.

Second-hand smoke: Kids whose mothers smoked while pregnant, who grow up in a smoky house, or whose grandmothers smoked, are all more likely to get asthma. Read more about how smoking while pregnant hurts the baby Signs and symptoms of asthma

Diagnosis

Different people have different signs and symptoms of asthma. Asthma signs and symptoms are also variable - they can change over time or depending on the situation. People with asthma often have one or more these symptoms:

Wheezing Chest tightness Coughing Feeling short of breath

Breathing problems can be caused by different conditions. If you have these signs and symptoms, or if you think you might have asthma, see your doctor. It's important for you to go to the doctor for a full investigation of your symptoms. Once your doctor has all the facts, she will be able to make a diagnosis. Then your condition can be properly treated. Signs and symptoms of a serious asthma emergency Call 911 and keep taking your rescue medication (blue puffer) if you see these symptoms:

Struggling for breath Blue rescue inhaler doesn't help It's hard to speak- you can't finish a sentence Sucking in skin above breastbone and between ribs Nostrils flaring out Pale, grey, sweating Blue lips or nail beds Really tired, lethargic Unconscious (fainted)

How to manage your asthma

You can prevent breathing problems by controlling your asthma on an ongoing basis. 1. 2. 3. 4. 5. Work with doctor to get your asthma under control Follow your written asthma action plan Avoid your asthma triggers: smoke, cold air, etc. Avoid your asthma inducers: allergies, viruses, etc. Use your asthma medications as prescribed

1. Work with your doctor to get your asthma under control

For most people with asthma, it's possible to achieve good asthma control. If you have asthma attacks or feel your asthma symptoms a lot, your asthma is probably not as controlled as it could be. See you doctor, and ask for help to achieve better asthma control.
Signs of good asthma control

You know your asthma is under control if:

You have daytime symptoms less than four times per week You don't miss school or work because of asthma symptoms Your physical activity is not limited by asthma Nighttime symptoms disturb your sleep less than once per week You have not had to take your asthma rescue medicine (blue inhaler) more than three times a week, except before exercising.

Signs of poor asthma control

Asthma symptoms may get worse slowly. By knowing the early warning signs of poor asthma control, you can help to prevent an asthma episode. Here are some symptoms that mean your asthma is out of control:

You wake up at night because of coughing, wheezing or feeling short of breath more than one time per week

Your rescue inhaler (blue puffer) doesn't work quickly or completely to remove your asthma symptoms You are using your rescue medication more than three times a week (except during exercise) Your asthma symptoms are stopping you from doing regular activities like exercise

If you have any one of these signs, see your doctor. Follow your doctor's advice as written in your asthma action plan. If you don't have an asthma action plan, print one out and ask your doctor to help you complete it. Your doctor can explain what you should do if you are running into problems with your asthma. You can also ask a Certified Asthma Educator to explain how to use your asthma action plan to manage your asthma symptoms.

2. Follow your written asthma action plan

To take the guesswork out of managing your asthma, use an asthma action plan. (Click here to get an asthma action plan - PDF) Studies show that people who use their asthma action plan have better asthma control. Your asthma action plan tells you:

What symptoms you should watch for What your symptoms mean How to adjust your medication according to your symptoms When to call the doctor or 911

Ask your doctor to fill out an asthma action plan for you. Make sure you understand what the plan says. If you have any questions, ask your doctor. You can also discuss your action plan with a Certified Asthma Educator, a healthcare professional with special training in asthma management.

Download your asthma action plan (PDF).

Asthma diary card

This asthma diary card can help you keep track of your symptoms; use it to record your symptoms every day. Working with your doctor or Certified Asthma Educator, you can use your diary card to see if there is a pattern to your asthma symptoms- are certain days, or certain times

of the day, worse for your asthma? The diary card can also let you know if changes to your asthma medications are relieving your symptoms. Download your asthma diary card (PDF) Top of page

3. Avoid your asthma triggers

The best way to control you asthma is to make sure you stay away from triggers. Asthma triggers are things that make your asthma symptoms worse by irritating your airways. Asthma triggers make the muscles around your airways squeeze tightly.
Asthma triggers cause symptoms that:

Usually come on suddenly May not last very long May be easy to relieve with a blue rescue inhaler

Each person will have his own set of asthma triggers. Some common asthma triggers are: fumes, smoke, and exercise. The table below offers more information on asthma triggers:
Common asthma triggers, and how to avoid them

Trigger Exercise Exercise is a trigger for many people if asthma is not under good control

What you can do

Make sure you have good asthma control before exercising Warm up slowly before exercising; cool down afterwards Keep your blue rescue medication close by Follow your asthma action plan; take your blue rescue medication before or during exercise Slowly exercise for longer and longer, to get in better shape Read more about Exercise and asthma Drape a scarf loosely over your nose and mouth, to warm and humidify the air before you breathe it in. You could also buy a cold-weather face mask made for this purpose.

Cold air (i.e. outdoors, or at an ice rink)

Breathe through your nose; your nose can warm and humidify the air If your doctor recommends it, take a puff of your blue rescue inhaler (shortacting bronchodilator) before you go outside Follow these Smog Smart strategies to protect your breathing on smog days

Smog Smog can happen anytime of the year, but it's most common from May to September. Smog can trigger asthma symptoms right away. It can also trigger symptoms that you notice later on, even the next day.More about smog Other pollution and fumes There are many sources of fumes, indoors or outdoors: Smoke from fireplaces, grills, wood heaters and chimneas contains many harmful chemicals. Wood smoke can cause asthma symptoms right away and make asthma worse over time. Exhaust fumes from cars and trucks can also trigger asthma symptoms and cause long-term damage to lungs. Household chemicals with strong fumes (for example, oven cleaners) can trigger symptoms.

If at all possible, do not heat your home with wood. If you must heat with wood, follow these tips to reduce wood smoke. Avoid outdooir bonfires, chimineas, and other open burning. If possible, avoid spending a lot of time in places that are less than 150 metres (500 feet) from a busy road or that are near a road used by diesel trucks. (A busy road is a road that has 15 000 vehicles or more per day). Use safe, environementally-friendly cleaning products like vinegar and baking soda, instead of harsh chemicals Wear a protective mask when dealing with chemicals. On very hot, humid days, especially days that are also smoggy, stay indoors in an air-conditioned room Avoid using perfumes, and ask the people you work with and live with to avoid them as well. Make sure your soap, body lotion, shampoo, detergent, etc. are scent free. Read more about scents. Take your blue rescue medication as directed Try some relaxation and breathing techniques

Hot, humid air Scents Chemicals from perfume and cologne, fabric softener, air fresheners (and many other products) can make asthma worse. Read more on scents and how to avoid them Emotional upsets, anxiety Feeling stressed, laughing or crying can make asthma worse.

Feeling anxious about getting an asthma attack can also make your asthma worse. A Certified Asthma Educator can help you understand your asthma, what to expect, and what to do if you feel symptoms coming on. If you know what to do if you are having breathing problems, you can feel more in control and less anxious. Hormones Some women notice worsening asthma symptoms at the time of their period. Pregnancy also can affect asthma symptoms Smoke and second-hand smoke from cigarettes, cigars, pipes and marijuana. Smoke hangs around long after the cigarette is out, and the leftover smoke can make asthma worse. Smoke gets in people's clothes and hair, in fabric, in furniture, in walls, in stuffed animals. Smoke can't be cleared out of a room by just opening a window or smoking near a fireplace. Smoke that's trapped in all these places continues to make asthma worse, even after the cigarette is put out.
Other asthma triggers

Ask a Certified Asthma Educator for help in dealing with anxiety about asthma. If you have a lot of stress and your asthma is getting worse often, see your doctor for more advice on how to cope. People who learn how to relax and control their stress can have less asthma symptoms. Follow your asthma action plan if you're having trouble. Pay special attention to your asthma during pregnancy Don't smoke. If you do smoke, quit. Avoid second-hand smoke: make your home & car smoke-free, avoid smoke at work, and stay away from smoky places like bars and clubs. Read more about second-hand smoke

Most people's triggers are inhaled (breathed in). But asthma symptoms may also be triggered by things you eat, drink, or swallow, like medication, for example:

Sulphites (used to preserve some food, like dried fruit and red wine) MSG (a flavour enhancer for some food) Aspirin (never let a child or teen take aspirin)

Some people with asthma also have food allergies. People with any allergy that causes anaphylactic shock should keep their epinephrine kit (EpiPen, EpiPen Jr., Twinject) with them at all times.

What Is COPD? COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time. COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD. Overview To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes, or airways. The airways are shaped like an upside-down tree with many branches. At the end of the branches are tiny air sacs called alveoli (al-VEE-uhl-eye). The airways and air sacs are elastic. When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sac deflates and the air goes out. In COPD, less air flows in and out of the airways because of one or more of the following:

The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed (swollen).

The airways make more mucus than usual, which tends to clog the airways. Healthy Alveoli and Damaged Alveoli

The illustration shows the respiratory system and images of healthy alveoli and alveoli damaged by COPD. In the United States, the term "COPD" includes two main conditions emphysema (em-fi-SE-ma) and chronic obstructive bronchitis (bron-KI-tis). In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. In chronic obstructive bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term "COPD" is more accurate. Outlook COPD is a major cause of disability, and it's the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. An additional 12 million likely have the disease and don't even know it. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.

Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn't passed from person to personyou can't catch it from someone else. COPD has no cure yet, and doctors don't know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.

Emphysema Emphysema is a chronic (long-term) lung disease that can get worse over time. It's usually caused by smoking. Having emphysema means some of the air sacs in your lungs are damaged, making it hard to breathe. Emphysema is part of a lung disease known as COPD. We offer lots of information on COPD, including emphysema, in our COPD section. What causes emphysema? Emphysema can be caused by one or a combination of these things:

1. Healthy alveolus 2. Alveolus with emphysema

Cigarette smoking: Most cases of emphysema are caused by cigarette smoking. Cigarette smoke reaches deep into the lungs and causes permanent damage. If you have emphysema from cigarettes, the best way to stop your lung damage is to quit smoking as soon as possible. It's never too late to quit smoking.

Alpha-1 Antitrypsin deficiency: Some people have emphysema because of a rare genetic disorder called Alpha-1 Antitrypsin deficiency. People with Alpha-1 are missing an enzyme that protects their lungs. Some people with Alpha-1 deficiency get emphysema without ever having smoked. Other people get emphysema from the combination of smoking and having Alpha-1 deficiency. Air pollution, including second-hand smoke: There is some evidence that air pollution can contribute to people getting emphysema, especially in people who also smoke.

Signs and symptoms of emphysema

Shortness of breath - feeling like you can't get your breath out A barrel-shaped chest Wheezing Feeling tired (fatigue) Losing weight without trying

People might think that feeling short of breath is a normal sign of aging- but it's not. If you have these signs and symptoms, see your doctor. Ask for spirometry, a simple test that measures how much air you move out of your lungs. These signs and symptoms will not go away over time- they will get worse. The sooner you see the doctor, the sooner you can find out how to feel better. Learn more about the signs and symptoms of emphysema, now called COPD. How is emphysema diagnosed? To figure out if you have emphysema, your doctor many do some of these tests:

Physical exam, including listening to your lungs and breathing sounds Spirometry- this test measures how much air you can move out of your lungs Chest x-ray Blood tests

Read more about tests to diagnose emphysema (COPD). Treatment for emphysema There is no cure for emphysema, but it is possible to slow down the disease and make it easier to live with the symptoms.

Some treatments for emphysema:

Quitting smoking, and staying away from smoky places. By quitting smoking, you can slow down emphysema. Learn how to quit smoking. Taking medications, which may include pills, puffers, and supplemental oxygen Joining a pulmonary rehabilitation class, a specialised exercise program

Read more about treatment for COPD (including emphysema). What can I expect with emphysema? People with emphysema can live for a long time after they are diagnosed. If you have emphysema, how long you'll live depends on many things:

What age you were diagnosed at How bad your lung damage is Whether you keep smoking, cut back or quit (cutting back is a start, quitting is the best!) What kind of medical care and treatment you get What other health problems you might have

People with emphysema eventually die from it, or from a complication of it. Complications of emphysema:

Recurring chest infections, including pneumonia, the flu, cold, etc. Pulmonary hypertension: abnormally high blood pressure in the arteries of the lungs Cor pulmonale: enlargement and strain on the right side of the heart. This can lead to heart failure.

If you have emphysema and you smoke, it's important to quit smoking. See your doctor to get proper treatment, so that you'll live as long and as comfortable a life as possible. Lots of people with emphysema/COPD find ways to enjoy a happy and productive life despite their disease. It's also important to talk to your doctor and family about what kind of care you will need in future years, and what you can do now to get ready for the future. Why quitting smoking helps improve emphysema symptoms Emphysema gets worse over time if you continue to smoke or breathe dirty air. The damage doesn't stop until you stop smoking and stop breathing dirty

air. By quitting smoking now, you can't undo the damage that's already done, but you can protect your lungs from any more damage. Where can I get more information, help and support? If you or someone you love has COPD (emphysema), you can get free, confidential advice and support through our BreathWorks COPD helpline. A nurse or respiratory therapist with expert knowledge of COPD (emphysema) will answer your questions. Call the Lung Association's free BreathWorks COPD Helpline: 1-866717-2673.

What Is Pneumonia? Pneumonia (nu-MO-ne-ah) is an infection in one or both of the lungs. Many small germs, such as bacteria, viruses, and fungi, can cause pneumonia. The infection causes your lungs air sacs, called alveoli (al-VEE-uhl-eye), to become inflamed. The air sacs may fill up with fluid or pus, causing

symptoms such as a cough (with phlegm), fever, chills, and trouble breathing. Overview Pneumonia and its symptoms can vary from mild to severe. Many factors affect how serious pneumonia is, such as the type of germ causing the infection and your age and overall health. Pneumonia tends to be more serious for:

Infants and young children. Older adults (people 65 years or older). People who have other health problems like heart failure, diabetes, or COPD (chronic obstructive pulmonary disease). People who have weak immune systems as a result of diseases or other factors. These may include HIV/AIDS, chemotherapy (a treatment for cancer), or an organ or bone marrow transplant.

Outlook Pneumonia is common in the United States. Treatment for pneumonia depends on its cause, how severe your symptoms are, and your age and overall health. Many people can be treated at home, often with oral antibiotics. Children usually start to feel better in 1 to 2 days. For adults, it usually takes 2 to 3 days. Anyone whose symptoms get worse should be checked by a doctor. People who have more severe symptoms or underlying health problems may need treatment in a hospital. It may take 3 weeks or more before they can go back to their normal routines. Fatigue (tiredness) from pneumonia can last for a month or more.

Tuberculosis What is TB? Tuberculosis (TB) is an infectious disease caused by a germ called the tubercle bacillus. Tuberculosis is contagious - anyone can catch it. Some people are more at risk of catching TB than others. The TB germ enters your body as you breathe. It usually settles in your lungs. From there, it can spread to other parts of your body, including your central nervous system, your bones, and your joints. In Canada, TB control is very good, but there are still Canadians who get TB. Across the world, TB is considered one of the deadliest infectious diseases, especially in developing countries. In many places, the TB epidemic is made worse by the HIV/ AIDS epidemic. Read more about the world TB epidemic and how the Lung Association is involved in fighting TB. TB can occur in animals, too. Inactive TB: TB infection When you are first infected with the TB germ, you don?t usually get sick right away. But the germ stays in your body, in an inactive state. This is called inactive TB. The TB germ can become active at any time in your life. When the germ becomes active, it causes the disease known as tuberculosis or TB. If you have inactive TB, you can take medicine to prevent the TB germ from becoming active and giving you TB disease. Active TB : TB disease Active TB means the TB germ in your body has become active, and has caused the disease TB. You will have symptoms of active TB disease, including cough, fever, weight loss, and more. Not all people with inactive TB infection will get active TB. Most often people get the disease if they are older, or if they have another disease that lowers their ability to fight infections. Active TB disease can be treated with medicines. How is TB spread?

When a person with active TB breathes out, for example by coughing, sneezing or talking, the TB germs go from their lungs into the air. Other people become infected by breathing in the air that is carrying the TB germ. Only people who have the active form of TB of the lungs can spread the infection. People who have inactive TB infection cannot pass TB to another person. TB is most often spread to people who spend a lot of time with a person with active TB, especially those who live in the same house. Who is at risk of getting TB? In Canada, TB is not very common, but it still exists. Certain people are more at risk of catching TB:

People who have lived or worked in countries where TB is common Aboriginal Canadians People with HIV or AIDS Elderly people Homeless people People who live in crowded housing, in unhygienic conditions Health professionals

Signs & symptoms

Diagnosis

Inactive TB does not give you symptoms you can notice. Active TB (TB disease) gives you symptoms you can notice. TB symptoms may not appear until the disease has already caused damage. Symptoms of active TB:

A cough that lasts two weeks or more, especially if you cough up fluid or blood comes from your lungs when you cough Fever Weight loss Night sweats Loss of appetite

Many of these symptoms can be confused with other illnesses. If you have these symptoms, of if you think you might have TB, see you doctor. Your doctor can give you tests to see if you have TB, and make a TB diagnosis. Treatment Active TB treatment | Medicines | Side effects| When to see your doctor | Drug-resistant TB Treatment for inactive TB If you an inactive TB infection the doctor may prescribe medicine to get rid of your body's TB germs and to stop the germs from causing active TB disease in the future. INH (isoniazid) is the medicine people usually take for inactive TB. A person with inactive TB needs to take INH for as long as their doctor tells them, usually many months. It's very important to take your TB medicines exactly as your doctor says, for as long as your doctor says. Take all your medicine even if you are feeling better. Warning: If you stop taking your TB medicine before it?s time:

The TB infection could come back Your infection could turn into active TB disease You could accidentally make the TB germ even stronger. When people take a little medicine to fight TB, but they don't take enough to kill the TB germ, then the TB germ gets stronger and becomes resistant to the usual TB medicines. This is dangerous.

Treatment for active TB People with active TB of the lungs may need to go into the hospital for a few weeks. At the hospital, they will be given medicines to fight TB. Once a person with active TB has taken medicine for a few weeks, they stop being contagious: they can't pass the germ to other people anymore. After a few weeks of taking medicine, they can usually return to work, school and other activities. People with active TB usually feel better after taking medicine for a few weeks. It is very important to continue to take medications for as long as the

doctor says, even if you do not feel sick. Otherwise, the TB disease may not be cured and can come back again. Warning: If you stop taking your TB medicine before it's time:

The active TB disease could come back You could spread TB to other people You could accidentally make the TB germ even stronger. When people take a little medicine to fight TB, but they don't take enough to kill the TB germ, then the TB germ gets stronger and becomes resistant to the usual TB medicines. This is dangerous.

Back to Top Medicines that treat TB Medicines to treat TB are free in Canada. See you doctor or nurse to get your free TB medicines. It takes more than one medicine to kill the active TB germ. Usually, doctors prescribe two medicines : isoniazid (INH) and rifampin (RMP). There are also other medicines that treat TB. Here is a list of the most common medicines that treat TB: Chemical name Isoniazid (INH) Rifampin (or Rifampicin) Ethambutol Pyrazinamide More about TB medicines:

Brand name Isotamine Rifadin, Rimactane, Rofact Myambutol, Etibi Tebrazid

Take your medicine exactly as your doctor says, usually for six to nine months Tell your doctor about any other medications you may be taking Tell you doctor if you are pregnant or if you become pregnant while you're taking the medicine Ask your doctor or pharmacist to explain the side effects of TB medicines See your doctor if you notice certain side effects, listed below Take all the medication that you are prescribed even if you are feeling better

Side effects of TB medicines

If you're taking medicines to fight TB, you might notice side effects. There are not many serious side effects from TB medicines, and not many people get them. If you're taking rifampin, you might notice these side effects:

Your urine, saliva or tears may look orange. This is a normal reaction to this medicine. Rifampin might permanently stain your contact lenses, so avoid wearing contact lenses while you?re taking it. The birth control won't work properly (will be less effective) when you take rifampin. If you are on the birth control pill and take rifampin, you should also use another method of birth control (for example, condoms), to be sure you don?t get pregnant.

If you're taking isoniazid, your doctor may prescribe vitamin B6 to reduce its side effects. Ask your doctor, nurse, or pharmacist to explain about other side effects that you might get from TB medicines. See your doctor if you have any of these side effects:

Skin redness Itching Nausea (feel sick to your stomach) Vomiting Loss of appetite Stomach pains Stomach cramps You feel tired, have low energy Pain in your joints or muscles Changes in how you see colours, red and green Numbness or painful tingling in your hands or legs

The TB shot (vaccine) There is a vaccine (a shot) to prevent TB. It's called Bacille Calmette-Guerin, or BCG for short. The main use of BCG is to protect newborn babies in communities with very high rates of TB. The BCG vaccine doesn?t work as well in adults. It?s rarely used in Canada. Drug-resistant TB Sometimes the TB germ becomes resistant to two of the best TB medicines, isoniazid (INH) and rifampin (RMP). The strains (types) of TB that can't be

cured by the usual medicines are called drug-resistant. Drug-resistant TB is a serious sickness. People with drug-resistant TB can?t be cured by taking the usual medicines. Instead, they need to take stronger medicines. They also need special medical care. People with drug-resistant TB can pass along their dangerous drug-resistant TB germs to other people, making others seriously sick. Drug resistant tuberculosis germs are created when patients do not take all of the medicine their doctor prescribed. When people take a little bit of medicine, but not enough to kill the TB germs, the TB germs actually become stronger. You can help stop TB from become drug-resistant by taking all your medicine exactly as the doctor says. Take your medicine even if you fell better.