Control of Acute Respiratory Infection: Report by Group G - JU

This report, submitted by Group G, delves into the control of acute respiratory infections (ARI), a significant cause of morbidity, particularly in children. It covers various aspects, including epidemiological determinants such as agent factors and modes of transmission, detailed clinical assessments of common respiratory illnesses like the common cold, pharyngitis, pneumonia, and bronchitis, and a classification of ARIs into upper and lower respiratory tract infections. The report also discusses diagnostic methods, highlighting the importance of respiratory exams and lung function tests. Furthermore, it outlines ARI control programs, emphasizing the identification of ARI in children at the community level and appropriate therapy. Treatment strategies for upper respiratory tract infections, including common colds and pharyngitis, are detailed, along with preventive measures. The report concludes by emphasizing the importance of controlling ARIs to reduce morbidity and mortality, especially in vulnerable populations.

A Report on
Control of Acute Respiratory Infection
Submitted by:
Group G ( 1625 , 1626 , 1627 , 1628 , 1629 , 1630 , 1631 , 1632 , 1633 , 1635 , 2088 , 2191 )
Under the supervision of,
Most. Zannatul Ferdous
Lecturer, Department of Public Health & Informatics,
Jahangirnagar University, Savar, Dhaka .

Declaration
This report entitled “Control of Respiratory Infection” is submitted to, Most. Zannatul Ferdous,
Lecturer, Department of Public health and informatics is carried out by the members of Group
G on 30 December 2020 and has not been submitted to any other university or institute.

Acknowledgement
At the first and foremost, I wish to express all of my devotion and reverence to the Almighty
Allah, most merciful and beneficent creator who has enabled us to perform this report.
Next, We would like to thank to our honorable Lecturer, Most. Zannatul Ferdous, Dept. of
Public Health & Informatics, Jahangirnagar University, who gave us the opportunity to finish
this report.
We would also like to convey our highest thanks to our all group members.

Contents
Abstract…………………………………………………………………………………….. 1
Introduction………………………………………………………………………………… 2
Epidemiological Determinants…………………………………………………………….. 3
Clinical
Assessment…………………………………………………………………………………. 3-6
Classification of ARI………………………………………………………………………. 7
Diagnosis of ARI…………………………………………………………………………… 7
ARI Control Programmes…………………………………………………………………. 8
Treatment of ARI…………………………………………………………………………. 9-16
Prevention of ARI…………………………………………………………………………. 17
Conclusion………………………………………………………………………………….. 18
Refferences…………………………………………………………………………………. 19

1
Abstract
Acute respiratory tract infections (ARTIs) are responsible for considerable morbidity in the
community, but little is known about the presence of respiratory pathogens in asymptomatic
individuals. We realized that asymptomatic persons could have a little infection and thus act as a
source of transmission.
This study confirms that most ARTIs are viral and supports the reserved policy of prescribing
antibiotics. In both case and control subjects, rhinovirus was the most common pathogen. Of
bacterial infections, only group A β-hemolytic streptococci were more common in case patients than
in control subjects. Furthermore, we demonstrated that asymptomatic persons might be a neglected
source of transmission.

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Introduction
Acute respiratory infection is a serious infection that prevents normal breathing function. It usually
begins as a viral infection in the nose, trachea (windpipe), or lungs. It can affect just upper respiratory
system, which starts at sinuses and ends at vocal chord or just lower respiratory system which starts
at vocal chords and ends at lungs. It prevents the body from getting oxygen and can result death.
Also ARI are infectious, which mean they can spread from one person to another. The infection is
particularly dangerous for children, older adults and people with immune system disorders.

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Epidemiological Determinants
Agent factors:
• The microbial agents that cause ARI are numerous which includes bacteria and viruses.
• Even within species they show wide diversity of antigenic type.
• Severity of illness is determined by whether secondary bacterial infection occurs or not.
• The manifestations include influenza, sinusitis, acute otitis media, Nasopharyngitis, Onsillitis,
epiglottitis, laryngitis, Tracheitis, acute bronchitis, bronchiolitis and pneumonia.
Mode of Transmission:
• The most common modes of transmission are: Airborne droplets spread when the sick person
coughs or sneezes, and inhaled into the lungs (breathed in) by a susceptible person; direct oral contact
with someone who has pneumonia (e.g. through kissing).
• Chain of transmission is maintained by direct person-person contact.
Clinical Assessment:
Common cold:
• Nasal congestion
• Watery discharge
• Mouth breathing
• Change in Ton of voice
• Shore throat
• Headache
• Slight fever

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Pharyngitis:
• Sneezing
• Runny nose
• Headache
• Cough
• Fatigue
• Body aches
• Chills
• Fever
Epiglottitis:
• Fever
• Severe sore throat.
• Abnormal, high-pitched sound when breathing in (stridor)
• Difficult and painful swallowing
• Drooling
• Anxiety
Laryngitis:
• Hoarseness.
• Weak voice or voice loss.
• Tickling sensation and rawness in your throat.
• Sore throat.
• Dry throat.
• Dry cough.

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Pneumonia:
• Sweating or chills
• Shortness of breath that happens while doing normal activities or even while
resting
• Chest pain that’s worse when you breathe or cough feelings of tiredness or fatigue
• Loss of appetite
• Nausea or vomiting
• Headaches
• Children under 5 years old may have fast breathing or wheezing.
• Infants may appear to have no symptoms, but sometimes they may vomit, lack
energy, or have trouble drinking or eating.
• Older people may have milder symptoms. They can also exhibit confusion or a
lower than normal body temperature.
Tuberculosis:
• A cough that lasts more than three weeks
• Loss of appetite and unintentional weight loss
• Pain in chest
• Sweating at night
• Fever
• Chills
• Night sweats
Bronchitis:
• 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.

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Cough:
• A runny or stuffy nose
• Wheezing and shortness of breath
• Heartburn or a sour taste in mouth
• Sneezing
• Mild fever
• Tiredness
Sinusitis:
While the causes of acute and chronic sinusitis can be quite different, the symptoms are often the
same.
• Nasal obstruction
• Facial pain or pressure
• Fatigue
• Bad breath
• Ear pressure
• Headaches
• Unusual tastes and smells
• Drainage of a thick discolored discharge from the nose
Lung cancer:
• A cough that doesn’t go away after 2 or 3 weeks
• A long-standing cough that gets worse
• Chest infections that keep coming back
• Coughing up blood
• An ache or pain when breathing or coughing
• Persistent breathlessness
• Persistent tiredness or lack of energy
• Loss of appetite or unexplained weight loss
• Wheezing
• A hoarse voice
• Swelling of your face or neck
• Persistent chest or shoulder pain

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Asthma:
• Shortness of breath
• Chest tightness or pain
• Wheezing when exhaling, which is a common sign of asthma in children
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• Coughing or wheezing attacks that are worsened by a respiratory virus
Emphysema:
• Frequent coughing or wheezing.
• A cough that produces a lot mucus.
• Shortness of breath, especially with physical activity.
• A whistling or squeaky sound when you breathe.
• Tightness in your chest.
Classification of ARI:
Upper respiratory tract infections (AURI): Include common cold, pharyngitis, laryngitis,
Tracheitis, epiglottitis and otitis media.
Lower respiratory tract infections (ALRI): Include bronchitis, bronchiolitis and
pneumonias. It is currently the leading cause of death in young children in Low Income Countries
the World Health Organization (WHO) estimates that one-third of all deaths in children below the
age of five years (4.3 million deaths in real terms in 1993) are due to ARI.
Diagnosis of acute respiratory infection:
In a respiratory exam, the doctor focuses on your breathing. They will check for fluid and
inflammation in the lung by listening for abnormal sounds in your lungs when you breathe. The
doctor may peer into your nose and ears, and check your throat. If your doctor believes the infection
is in the lower respiratory tract, and X –ray or CT scan may be necessary to check the condition of
the lungs. Lung function tests have been useful as diagnostic tools. Pulse oximetry, also known as
pulse ox, can check how much oxygen gets into the lungs. A doctor may also take a swab from your
nose or mouth, or ask you to cough up a sample of sputum (material coughed up from the lungs) to
check for the type of virus or bacteria causing the disease.

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ARI control programmes:
ARI control programme is the part of RCH programme. And this programme Includes some
important activities such as-:
ARI control in children:
• ARI is an episode of acute symptoms & signs resulting from infection of any part of respiratory
tract & related structures
• Constitutes 22-66% of outpatients & 12-45% of inpatients
• In India: 10-50 children die per 10,000 episodes of ARI
• ARI control programmes.
• Crux of the program is to identify children with ARI at the community level by training the field
workers to recognize easily & reliably identifiable clinical signs of ARI & early reference.
WHO protocol comprises 3 steps:
Step 1: Case finding & Assessment
• Cough & difficult breathing in children < 5 years age
• Fever is not an efficient criteria. ‘
Step 2: Case Classification
• Children grouped into 2:
• Infants < 2months & Older children
• Specific signs to be looked: In younger children like feeding difficulty,lethargy,
hypothermia, convulsions.
In infants < 2 months
•Pneumonia is diagnosed if RR 60/min with other clinical signs
•All should be hospitalized
•All should receive IV medications
•Minimum duration of 10 days
•Combination of Ampicillin& Gentamicin
Step 3: Institution of appropriate therapy

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Treatment of ARI:
Upper respiratory tract infections:
Upper respiratory infections such as cough and cold or rhinitis, pharyngitis /tonsillitis, sinusitis are
common causes of morbidity in children. These are mostly caused by viruses and are self-limiting
conditions. Important bacterial infections of upper respiratory tract include streptococcal sore throat
and diphtheria.
Common cold:
No specific treatment is required. However, the mother is counselled to bring the child immediately
if she notices fast breathing or difficulty in feeding or if child becomes sicker. The following
measures can be taken by the mother of any child with cough or cold.
 Saline nose drops can be tried for relief of nasal congestion when it interferes with feeding.
 Paracetamol can be used for reduction of high fever when this distresses the child and for relief
of pain.
 Safe remedies for cold /sore throat: Cough syrups or anti-histamines or decongestants are not
recommended to be given.
Safe, soothing remedies are useful for both a cough and sore throat. Remedies which are safe,
culturally acceptable and available at home should be given. Common safe remedies for cough And
sore throat include ginger, honey, Tulsi or herbal tea. These can be given to infants age > 6 Months.
For younger infants breast milk is the best remedy. OTC Cough or Cold remedies contain atropine,
codeine, alcohol or high doses of antihistamines which may sedate the child sufficiently to interfere
with feeding and the child’s ability to clear secretions from the lungs.
Treatment of pharyngitis:
The appropriate treatment for pharyngitis varies depending on its underlying cause. For bacterial
infections, a doctor may prescribe a person a course of oral antibiotics, such as amoxicillin or
penicillin. The antibiotics aim to prevent complications, such as rheumatic fever or kidney disease,
not to treat the sore throat. It is essential to complete the entire course of antibiotics to ensure the
infection has cleared and to prevent reinfection. Viral pharyngitis does not respond to antibiotics,
but will typically clear up on its own. However, over-the-counter medications, such as
acetaminophen or ibuprofen, can help reduce pain and fever. Home remedies that may help speed
up recovery include:
• Getting plenty of rest
• Staying hydrated
• Using a humidifier to add moisture to the air
• Sucking on ice chips or throat lozenges to soothe the throat
• Gargling with salt water

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• Drinking warm beverages, such as tea, lemon water, or broth.
Treatment of Diphtheria:
Diphtheria is an acute infectious disease caused by Corynebacterium diphtheria which mostly occurs
in unimmunized or partially immunized children. The usual presentation is fever, toxaemia and sore
throat.
• The patient should be admitted and isolated from other patients.
• Diphtheria antitoxin 40.000units is given I.M or I.V.
• Crystalline penicillin is given to eradicate the bacteria (100,000 IU/kg q 6hrly for 10- 14 days).
• Good supportive care is required to maintain nutrition and airway.
• Monitoring for complications especially myocarditis and neuropathy should be done.
Treatment of Sinusitis:
1. Antibiotics: Antibiotics are standard treatments for bacterial sinus infections. Antibiotics are
usually taken from 3 to 28 days, depending on the type of antibiotic. Because the sinuses are
deepseated in the bones, and blood supply is limited, longer treatments may be prescribed for people
with longer lasting or severe cases. Overuse and abuse of antibiotics have been causing a major
increase in antibiotic resistance. Therefore, patients with sinus symptoms should consider taking an
antibiotic only if symptoms (including discolored nasal discharge) persist beyond 7-10 days.
2. Nasal decongestant sprays: Topical nasal decongestants can be helpful if used for no more than
three to four days. These medications shrink swollen nasal passages, facilitating the flow of drainage
from the sinuses. Overuse of topical nasal decongestants can result in a dependent condition in which
the nasal passages swell shut, called rebound phenomenon.
3. Antihistamines: Antihistamines block inflammation caused by an allergic reaction so they can
help to fight symptoms of allergies that can lead to swollen nasal and sinus passages.
4. Nasal decongestants and antihistamines: Over-the-counter combination drugs should be used
with caution. Some of these drugs contain drying agents that can thicken mucus. Only use them
when prescribed by your allergist.
5. Topical nasal corticosteroids: These prescription nasal sprays prevent and reverse inflammation
and swelling in the nasal passages and sinus openings, addressing the biggest problem associated
with sinus infection. Topical nasal corticosteroid sprays are also effective in shrinking and
preventing the return of nasal polyps. These sprays at the normal dose are not absorbed into the
blood stream and could be used over long periods of time without developing “addiction.”
6. Nasal saline washes: Nasal rinses can help clear thickened secretions from the nasal passages.
7. Surgery: If drug therapies have failed, surgery may be recommended as a last resort. It is usually
performed by an otolaryngologist. Anatomical defects are the most common target of surgery.

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Treatment of Lower respiratory tract
Lower respiratory infections such as cough and cold, Tuberculosis and pneumonia are common
causes of morbidity in children.
1. Treatment of Latent TB: If you have become infected with TB, but do not have the active
TB disease you should get preventive therapy. This treatment kills germs that could cause problems
if the disease becomes active. The most common preventive therapy is a daily dose of the antibiotic
isoniazid (INH) taken as a single daily pill for six to nine months. You are not contagious if you
have latent TB.
2. Treatment of Active TB: If you have an active TB disease you will probably be treated with
a combination of antibacterial medications for a period of six to 12 months. The most common
treatment for active TB is isoniazid INH in combination with three other drugs—rifampin,
pyrazinamide and ethambutol. You may begin to feel better only a few weeks after starting to take
the drugs but treating TB takes much longer than other bacterial infections. You must continue taking
your medication as prescribed for the entire time your doctor indicates or you could get sick again,
have a harder time fighting the disease in the future and spread the disease to others. Not completing
your entire course of medication could also contribute to drug-resistant TB.
3. Treatment of Drug resistant TB: Drug-resistant TB means that some drugs initially used
to treat TB will no longer be able to fight the TB germs in your body. TB that is resistant to more
than one drug, called multidrug-resistant TB (MDR TB) is very dangerous. The treatment for this
type of TB takes much longer, 20 to 30 months to complete, and you may experience more side
effects.
4. Managing TB: You must finish your medicine and take the drugs exactly as prescribed. If you
stop taking the drugs too soon you can become sick again and potentially spread the disease to others.
Additionally, by taking the drugs incorrectly, TB germs that are still alive may become drug-
resistant, making it harder for you to get better next time. While you are in treatment for active TB
disease, you will need regular check-ups to make sure your treatment is working. Everyone is
different, but there are side effects associated with taking the medications, including:
• Upset stomach, nausea and vomiting or loss of appetite
• Tingling or numbness in the hands or feet
• Itchy skin, rashes or bruising
• Changes in your eyesight or blurred visions
• Yellowish skin or eyes
• Dark-colored urine
• Weakness, fatigue or fever that for three or more days It is important to tell your
doctor or TB nurse immediately if you begin having any unusual symptoms while
taking medicine for either preventive therapy or for active TB disease. TB drugs
can be toxic to your liver, and your side effects may be a warning sign of liver
damage. If you are having trouble with tingling and numbness, your doctor may

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prescribe a vitamin B6 supplement while you are in treatment. It may also be
possible to change TB medications if your side effects are serious.
Tips for taking TB medicine: If you are taking TB medicine on your own, it's important to
get into a routine. Here are some ways to help you remember to take your TB medicine:
• Take your medicine at the same time every day.
• Each day when you take your medicine mark it off on a calendar.
• Get a weekly pill dispenser that has a section for each day of the week. Put your
pills in it.
• Ask someone close to you to check in daily to make sure you have taken your
medicine.
• Ask your healthcare provider what you should do if you forget to take your pills.
Sometimes it is helpful to have support in sticking to the long treatment timeline.
You may be offered assistance through a program called Directly Observed
Therapy (DOT). This means a healthcare worker will come to you to administer
your medication and eliminate the concern of forgetting to take the treatment.
Treatment of Pneumonia:
Treatment may include antibiotics for bacterial pneumonia. No good treatment is available for most
viral pneumonias. They often get better on their own. Flu-related pneumonia may be treated with an
antiviral medicine. Other treatments can ease symptoms. They may include:
• Plenty of rest
• Getting more fluids
• Cool mist humidifier in your child’s room
• Acetaminophen for fever and discomfort
• Medicine for cough Some children may be treated in the hospital if they are
having severe breathing problems.
While in the hospital, treatment may include:
• Antibiotics by IV (intravenous) or by mouth (oral) for bacterial infection
• IV fluids if your child is unable to drink well
• Oxygen therapy
• Frequent suctioning of your child’s nose and mouth to help get rid of thick mucus
• Breathing treatments, as ordered by your child’s healthcare provider.
Treatment of Obstructive lung disease: Obstructive lung disease are mainly known
by Lung cancer and Asthma.

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Treatment of Lung cancer:
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.
Treatment of Asthma:
Treatment usually involves learning to recognize your triggers, taking steps to avoid triggers and
tracking your breathing to make sure your medications are keeping symptoms under control. In case
of an asthma flare-up, you may need to use a quick-relief inhaler.
Medication: Preventive, long-term control medications reduce the swelling (inflammation) in your
airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen
airways that are limiting breathing. In some cases, allergy medications are necessary.
Long-term asthma control medications, generally taken daily, are the cornerstone of asthma
treatment. These medications keep asthma under control on a day-to-day basis and make it less likely
you'll have an asthma attack. Types of long-term control medications include:

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• Inhaled corticosteroids: These medications include fluticasone propionate (Flovent HFA, Flovent
Diskus , Xhance), budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort), ciclesonide
(Alvesco), beclomethasone (Qvar Redihaler), mometasone (Asmanex HFA, Asmanex Twisthaler)
and fluticasone furoate (Arnuity Ellipta). You may need to use these medications for several days to
weeks before they reach their maximum benefit. Unlike oral corticosteroids, inhaled corticosteroids
have a relatively low risk of serious side effects.
• Leukotriene modifiers: These oral medications — including montelukast (Singular), zafirlukast
(Accolate) and zileuton (Zyflo) — help relieve asthma symptoms. Montelukast has been linked to
psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal
thinking. Seek medical advice right away if you experience any of these reactions.
• Combination inhalers: These medications — such as fluticasone-salmeterol (Advair HFA,
Airduo Digihaler, others), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera)
and fluticasone furoate-vilanterol (Breo Ellipta) — contain a long-acting beta agonist along with a
corticosteroid.
• Theophylline. Theophylline (Theo-24, Elixophyllin, Theochron) is a daily pill that helps keep the
airways open by relaxing the muscles around the airways. It's not used as often as other asthma
medications and requires regular blood tests.
Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during
an asthma attack. They may also be used before exercise if your doctor recommends it. Types of
quick-relief medications include:
• Short-acting beta agonists: These inhaled, quick-relief bronchodilators act within minutes to
rapidly ease symptoms during an asthma attack. They include albuterol (Pro Air HFA, Ventolin
HFA, others) and levalbuterol (Xopenex, Xopenex HFA). Short-acting beta agonists can be taken
using a portable, hand-held inhaler or a nebulizer, a machine that converts asthma medications to a
fine mist. They're inhaled through a face mask or mouthpiece.
• Anticholinergic agents: Like other bronchodilators, ipratropium (Atrovent HFA) and tiotropium
(Spiriva, Spiriva Respimat) act quickly to immediately relax your airways, making it easier to
breathe. They're mostly used for emphysema and chronic bronchitis, but can be used to treat asthma.
• Oral and intravenous corticosteroids: These medications — which include prednisone
(Prednisone Intensol, Rayos) and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol) —
relieve airway inflammation caused by severe asthma. They can cause serious side effects when used
long term, so these drugs are used only on a short-term basis to treat severe asthma symptoms.
If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But you
shouldn't need to use your quick-relief inhaler very often if your long-term control medications are
working properly. Keep a record of how many puffs you use each week. If you need to use your
quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need
to adjust your longterm control medication.

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Allergy medications may help if your asthma is triggered or worsened by allergies. These include:
• Allergy shots (immunotherapy): Over time, allergy shots gradually reduce your immune system
reaction to specific allergens. You generally receive shots once a week for a few months, then once
a month for a period of three to five years.
• Biologics: These medications — which include omalizumab (Xolair), mepolizumab (Nucala),
dupilumab (Dupixent), reslizumab (Cinqair) and benralizumab (Fasenra) — are specifically for
people who have severe asthma.
Treatment of COPD:
COPD (chronic obstructive pulmonary disease) is the name for a group of lung conditions that cause
breathing difficulties. It includes:
Emphysema – damage to the air sacs in the lungs’.
Chronic bronchitis – long-term inflammation of the airways.
Treatment of emphysema:
Emphysema and COPD can't be cured, but treatments can help relieve symptoms and slow the
progression of the disease.
Medications
Depending upon the severity of your symptoms, your doctor might suggest:
• Bronchodilators: These drugs can help relieve coughing, shortness of breath and breathing
problems by relaxing constricted airways.
• Inhaled steroids: Corticosteroid drugs inhaled as aerosol sprays reduce inflammation and may
help relieve shortness of breath.
• Antibiotics: If you have a bacterial infection, like acute bronchitis or pneumonia, antibiotics are
appropriate.
Therapy
• Pulmonary rehabilitation: A pulmonary rehabilitation program can teach you breathing exercises
and techniques that may help reduce your breathlessness and improve your ability to exercise.
• Nutrition therapy: You'll also receive advice about proper nutrition. In the early stages of
emphysema, many people need to lose weight, while people with late-stage emphysema often need
to gain weight.

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• Supplemental oxygen: If you have severe emphysema with low blood oxygen levels, using
oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen
24 hours a day. It's usually administered via narrow tubing that fits into your nostrils.
Surgery
Depending on the severity of your emphysema, your doctor may suggest one or more different types
of surgery, including:
• Lung volume reduction surgery: In this procedure, surgeons remove small wedges of damaged
lung tissue. Removing the diseased tissue helps the remaining lung tissue expand and work more
efficiently and helps improve breathing.
• Lung transplant: Lung transplantation is an option if you have severe lung damage and other
options have failed.
Treatment of Chronic Bronchitis:
The goal of therapy for chronic bronchitis is to relieve symptoms, prevent complications and slow
the progression of the disease. Quitting smoking is also essential for patients with chronic bronchitis,
since continuing to use tobacco will only further damage the lungs. Treatment may include:
• Bronchodilator Medications: Inhaled as aerosol sprays or taken orally, bronchodilator
medications may help to relieve symptoms of chronic bronchitis by relaxing and opening the air
passages in the lungs.
• Steroids: Inhaled as an aerosol spray, steroids can help relieve symptoms of chronic bronchitis.
Over time, however, inhaled steroids can cause side effects, such as weakened bones, high blood
pressure, diabetes and cataracts. It is important to discuss these side effects with your doctor before
using steroids.
• Antibiotics: Antibiotics may be used to help fight respiratory infections common in people with
chronic bronchitis.
• Vaccines: Patients with chronic bronchitis should receive a flu shot annually and pneumonia shot
every five to seven years to prevent infections.
• Oxygen Therapy: As a patient's disease progresses, they may find it increasingly difficult to
breathe on their own and may require supplemental oxygen. Oxygen comes in various forms and
may be delivered with different devices, including those you can use at home.
• Surgery: Lung volume reduction surgery, during which small wedges of damaged lung tissue are
removed, may be recommended for some patients with chronic bronchitis.

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• Pulmonary Rehabilitation: An important part of chronic bronchitis treatment is pulmonary
rehabilitation, which includes education, nutrition counselling, learning special breathing
techniques, help with quitting smoking and starting an exercise regimen. Because people with
chronic bronchitis are often physically limited, they may avoid any kind of physical activity.
However, regular physical activity can actually improve a patient's health and wellbeing.
Prevention of ARI
• Breastfeeding infants exclusively (no other foods or drink, not even water) for the first six months
breast milk has excellent nutritional value and it contains the mother antibodies which help to protect
the infant from infection.
• Avoiding irritation of the respiratory tract by indoor air pollution such as smoke from cooking fires
avoid the use of dried cow dung as fuel for indoor fires.
• Immunization of all children with the routine expended programme on immunization.
• Feeding children with adequate amount of varied and nutritious food to keep their immune system
strong.
• Control the spread of respiratory bacteria by educating parents to avoid contact as much as possible
between their children and patients who have ARI's.
• People with ARI's should cough or sneeze away from others hold a cloth to the nose and mouth to
catch ta airborne droplets when coughing or sneezing.
• Immunization also increase control by reducing the reservoir of infection in the community and
increasing the level of herd immunity.
• ARI control programme is the part of RCH programme.
• Health promotion activities.
• Getting the MMR and pertusis vaccine will substantially lower risk of getting a risk of respiratory
infection.
• Practice good hygiene : - Wash hands frequently - Always sneeze into the arm of shirt or in a
tissue. - Avoid touching face especially eyes and mouth to prevent introducing germ into system.

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Conclusion:
Pathogens commonly associated with severe disease include Streptococcus pneumoniae,
Haemophilus influenzae, Bordetella pertussis, and measles and respiratory syncytial viruses.
Because most deaths from AR1 are thought to be caused by S. pneumoniae and H. influenzae
pneumonia. As the infections of respiratory system mainly in respiratory tract can causes a number
of complications which may cause death, we should be aware about this. We should avoid smoking
and make sure we include plenty of vitamins in our diet, such as vitamin C, which helps boost our
immune system. Vitamin C is maintained in immune cells, and a deficiency has been linked to higher
susceptibility to infection. While research is unclear if Vitamin C can prevent an acute respiratory
infection, there is evidence that it can shorten the length of time and or severity of some infections.

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References
I. https://www.ncbi.nlm.nih.gov/pubmed/16028157
II. https://academic.oup.com/cid/article/41/4/490/338609
III. https://www.medicinenet.com/sinusitis/article.htm
IV. https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/symptoms-and-
diagnosis#:~:text=The%20signs%20and%20symptoms%20of,Shortness%20of%20breath
V. https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/asthma-symptoms-
causes-risk-factors/symptoms
VI. https://www.nhs.uk/conditions/lung-cancer/symptoms/
VII. https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-
diagnosis#:~:text=Symptoms%20of%20active%20TB%20include,Fever
VIII. https://www.healthline.com/health/pharyngitis
IX. https://www.mayoclinic.org/diseases-conditions/epiglottitis/symptoms-causes/syc-
20372227
X. https://www.mayoclinic.org/diseases-conditions/bronchitis/symptoms-causes/syc-
20355566
XI. https://medlineplus.gov/emphysema.html
XII. https://www.mayoclinic.org/diseases-conditions/laryngitis/symptoms-causes/syc-
20374262
XIII. www.healthline.com/health/acute-respiratory-disease
XIV. https://www.who.int/.../case-management-infection-prevention-and-control