What Is Upper Respiratory Tract Infection?

INTRODUCTION

Dear Reader you may have just heard about upper respiratory tract infection (URTI). It may have been diagnosed in you or your loved one. And you are wondering, “what is upper respiratory tract infection”?

Upper respiratory tract infections are extremely common throughout the world. They are one of the commonest reasons for patients to present to Healthcare facilities. URTIs cause a lot of suffering, inconvenience and economic loss.

Before we go deeper into the discussion on URTI, let us present items that can be acquired online to treat upper respiratory tract infection symptoms. These are items that every household should have handy, or be able to acquire without a hassle.

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UPPER RESPIRATORY TRACT INFECTION

This name differentiates it from Lower Respiratory Tract Infection (LRTI). LRTI affects the lungs and connected parts inside the chest. LRTIs include pneumonia (discussed in more detail here on this website).

URTI, in contrast, affects the breathing mechanism from the neck upwards. It is an infection of the throat and associated organs, the nostrils, the sinuses, etc.

But it needs to be mentioned that occasionally, when someone presents with a respiratory tract infection, it is difficult to locate precisely whether it is in the upper or lower tract. However, the symptoms of the two conditions are different (see two paragraphs down).

VIRAL UPPER RESPIRATORY TRACT INFECTION

This accounts for more than nine out of ten (9/10) cases of URTIs. The overwhelming majority of URTIs are of viral origin. This is true for all parts of the world.

Viruses are the smallest of microorganisms. And viruses do not cause pus formation.

Common viruses causing URTIs include parainfluenza virus, influenza virus, common cold and respiratory syncytial virus (RSV).

UPPER RESPIRATORY TRACT INFECTION SYMPTOMS

Firstly, because this is an infection, there will be a fever. The fever can range from mild to high, depending on the exact cause and other factors.

Other generalised or systemic symptoms include general feeling of being unwell or lethargy. There is frequently a headache too. There may be loss of appetite.

Symptoms localised to the upper respiratory tract include swelling and congestion. Accompanying this is secretions, which can be copious.

There may be irritation, localised discomfort or pain. Swallowing may be painful.

There may be a cough (mild to moderate). And there is frequently sneezing. Hoarseness of the voice occurs if the vocal chords are affected.

BACTERIAL UPPER RESPIRATORY INFECTION

As said before, this is the rarer form of URTI. It accounts for less than ten percent of cases. But it is important to recognise it early.

Bacterial upper respiratory tract infection presents with similar symptoms to the viral form. But the fever is moderate to high, while in viral URTI it is mild to moderate. And the patient looks more toxic, more sick.

The hallmark of bacterial infections anywhere in the body, is pus formation or “suppuration”. It does not have to be a lot of pus. But it will usually manifest itself somehow.

In bacterial infection, the respiratory secretions are not clear. Rather, they are yellowish or greenish. On the throat or tonsils, a whitish or creamy coating points towards the presence of bacterial infection.

UPPER RESPIRATORY TRACT INFECTION TREATMENT

Because upper respiratory tract infections are in the majority caused by viruses, they are self limiting. That is, they settle on their own. This happens in a matter of days.

The median duration of viral URTIs is 7-10 (seven to ten) days. They do not go beyond two weeks, unless

  • it’s an unusual virus like H1N1 or COVID-19
  • there be secondary bacterial infection

Treatment of URTIs is only supportive, to relieve symptoms. Examples of treatments include (and sometimes these are combined in polycomponent formulations):

1. decongestant. The function of this is to reduce swelling in the tubes and passages, and to allow secretions to flow freely. This is the cornerstone of treatment and brings a lot of relief.

The decongestant can be taken by mouth if there are no contraindications such as hypertension. Or it can be applied locally through spray or drops.

A very important warning about spray or drops, is that they should NEVER be used for more than 4 days. Prolonged use can cause rebound congestion, a very serious condition that will need Specialist ENT referral.

2. Anti-fever and anti-pain medication. In combination preparations, paracetamol is the most frequently used. But also aspirin or other nonsteroidals.

3. Vitamin C. Helps the body to fight off the virus. The minimum adult dose for this purpose is 300mg daily.

4. Antihistamine. Helps with itch, cough, irritation. It has some decongestant properties. (Commonest side-effect: drowsiness)

5. Caffeine. Helps relieve lethargy associated with URTI. Has some antiallergic and decongestant properties.

Antibiotics should not be used to treat URTIs, unless the symptoms and signs point to a bacterial cause of infection. Where there are signs of suppuration, the infection should be hit early and hard with antibiotics. A notable example is bacterial sinusitis which can have serious consequences.

CONCLUSION

Upper respiratory tract infections are extremely common. They are easily recognisable and can be self-diagnosed without a professional. They spread very easily from person to person.

Because more than ninety percent of cases are caused by viruses, URTIs are self limiting. Treatment is largely supportive, addressing the symptoms. Antibiotic use is usually inappropriate.

In the case where bacterial infection is suspected from the start or secondarily, antibiotics can be used.

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