Introduction

Bronchitis is one of the most common respiratory disorders that affect millions of people globally, involving inflammation and irritation of the breathing tubes responsible for carrying air into your lungs. Persistent coughing with mucus production and breathing difficulties are the core features of bronchitis that are capable of interfering with life's daily routine and leaving you feeling genuinely exhausted.^1,2

Nevertheless, is bronchitis contagious? It's necessary to know whether it is contagious or not, especially in cold and flu season when the threat of respiratory infections goes up.

In this article, we look at different types of bronchitis, the causes, and ways to protect yourself and others from the disease.

What are the types of bronchitis?

Bronchitis can be contagious, but its severity relies mainly on the type of bronchitis. There are two types of bronchitis, as follows:^3,4

Acute bronchitis

It may be brief (acute) and begin abruptly, usually brought on by a viral infection. It typically resolves on its own within a few weeks. Most patients with acute bronchitis don't require medical attention.⁴

Acute bronchitis is often contagious, depending on its cause, particularly if it's due to a virus. It is estimated to affect around 44 out of every 1,000 adults each year, mostly during autumn or winter.³

Chronic bronchitis

Chronic bronchitis symptoms develop slowly. If you have a mucus-producing cough most days for three months a year and the pattern continues for at least two years, you might have chronic bronchitis.⁴

Chronic bronchitis is linked to chronic obstructive pulmonary disease (COPD). So, ask your healthcare professional if you need a COPD test.⁴

Chronic bronchitis is not contagious. It typically results from long-term irritation of the airways, such as from smoking or environmental pollutants.

What are the causes of bronchitis?

Causes of acute bronchitis

There are various causes of acute bronchitis. Viral and bacterial infections can easily spread from person to person.⁵

Viral Infections

• Adenovirus, rhinovirus, and influenza virus that are responsible for the common cold or flu are the most frequent causes of acute bronchitis⁵ 
• Transmission: Spread through respiratory droplets and cause inflammation and irritation in the bronchial tree
• Seasonal patterns: More common in winter months as a result of more indoor activities and close contacts

Bacterial infections

• Acute bronchitis from bacterial infections is less common. Only about 10% of the acute bronchitis cases are from bacterial infections⁵
• Mycoplasma pneumoniae, Bordetella pertussis, and Chlamydia pneumoniae are the common infective bacteria

Environmental irritants

Smoke, polluted air, and dust can trigger acute bronchitis.⁵ 

• Smoke, including tobacco smoke and smoke from fires
• Polluted air contaminated with dust, chemicals or other pollutants
• Dust from various sources, including house dust and construction

Allergens

Allergens, such as pollen, mould, and animal dander, can result in bronchitis.⁵ 

• Pollen: Allergic reaction to pollen may result in bronchitis
• Mould: Mould spores could definitely cause respiratory irritation
• Animal dander: The hair and dander of some pets will trigger bronchitis

Seasonal variations

• Winter: Influenza viruses A and B are more prevalent during the winter season
• Spring and autumn: These are peak seasons of rhinovirus infections, wherein they are most commonly involved in seasonal allergies
• Summer: During this time, when outdoor activities increase, the incidence of enteroviruses also rises

Vaccine history

Although the risk for flu is diminished with influenza vaccination, one is still at risk due to other viruses, such as rhinovirus.⁵

Close contact situations

Crowded indoor environments, including schools, work areas, and public gatherings, can fully exposea person to respiratory viruses.⁵

Identifying these reasons enablesthe implementation of effective preventive and control measures, particularly regarding respiratory viruses that are evolving due to changing environmental conditions.⁵

Causes of chronic bronchitis

On the other hand, chronic bronchitis is not considered contagious. This form of bronchitis is usually the result of long-term irritation of the airways, such as:⁶

Cigarette smoke

It is the main cause of chronic bronchitis, including active smoking as well as passive (second-hand) smoke.

Environmental irritants

Exposure to pollutants, toxic chemical fumes, and industrial emissions can result in chronic bronchitis owing to the airway irritation caused.

Infections

• Repeated attacks of viral infection, including influenza types A and B viruses
• Bacterial infections, including Staphylococcus, Streptococcus, and Mycoplasma pneumoniae

Pre-existing respiratory disorders

• Asthma, the inflammation of airways in the lungs, is commonly associated with chronic bronchitis
• Cystic fibrosis, a genetic disorder of the lungs
• Bronchiectasis is a condition whereby sections of the airways are permanently enlarged

Chronic gastro-oesophageal reflux

Acid reflux into the airways, commonly seen in chronic gastro-oesophageal reflux disease (GERD), will irritate them and can develop into chronic bronchitis.⁶

Chronic bronchitis is part of a broader group of lung diseases known as chronic obstructive pulmonary disease (COPD) and does not spread from person to person because it is not caused by infectious agents like viruses or bacteria.²

Symptoms of bronchitis

Symptoms of acute bronchitis

Acute bronchitis exhibits various symptoms that differ among individuals, such as:⁵

Cough

• Begins as a dry, irritating cough
• Quickly becomes productive, producing sputum
• Typically lasts for more than five days
• Prolonged or severe coughing can cause chest wall or substernal muscle discomfort

Other common symptoms

• Low-grade fever
• Fatigue
• Body aches

Symptoms of chronic bronchitis

A patient history is essential to assess exposure to inhaled irritants (e.g., chemicals or fumes) or other causes of chronic bronchitis. Chronic bronchitis exhibits various symptoms:⁶

• Chronic cough is the most common symptom that occurs on most days of the month for at least three months over two following years
• Sputum colour changes and they do not necessarily indicate a bacterial infection
• Fever may suggest concurrent infections, such as influenza or pneumonia
• General malaise (low on energy) and discomfort
• Chest or abdominal pain from prolonged coughing
• Wheezing caused by airway inflammation

Types of chronic bronchitis

• Uncomplicated: Cough without airway obstruction
• Chronic asthmatic: Cough with wheezing due to intermittent bronchospasm
• Obstructive: Involves small airway disease, potentially leading to emphysema

Diagnosis

Your healthcare professional will approach multiple steps, including:^5,6

Patient history

The diagnosis usually starts with a thorough patient history. Your doctor will ask about recent illnesses, exposure to irritants, and smoking habits. 

Physical examination

Physical examination includes checking vital signs like:

• Oxygen saturation
• Pulse rate
• Temperature
• Respiratory rate

Examining the chest can reveal wheezing and breathing difficulties as in chronic bronchitis.

Chest x-ray

Usually, the chest X-ray appears normal but may show thickened bronchial walls. This observation helps rule out pneumonia.

Other tests

• Sputum test
• Lung function tests

Treatment of bronchitis

The management of bronchitis depends on the type.

Acute bronchitis

Acute bronchitis is usually a self-limiting situation that often resolves itself. However, treatments are concentrated on relieving symptoms and providing supportive care.⁵

Cough relief

• Non-pharmacological approaches like drinking hot tea, honey, ginger, and throat lozenges could help in soothing the cough⁵
• Pharmacological approaches⁵
  • Antitussive agents (like dextromethorphan sometimes combined with codeine) are widely used on the basis of their effectiveness in other conditions (chronic bronchitis and common cold)
  • Mucolyticscan be used if there is sputum (phlegm); it eases the mucus and helps in expelling it out easily

Controlling other associated symptoms

• Analgesics and antipyretics like paracetamol and ibuprofen  are prescribed by a professional doctor to lower the body temperature and body aches⁵
• If there are bacterial infections or complex bronchitis, doctors may prescribe antibiotics^5,7

Chronic bronchitis

Key objectivesof treatment for chronic bronchitis are:⁶

• Relieve symptoms
• Prevent complications
• Slow the progression of the disease
• Reduce overproduction of mucus
• Control inflammation
• Decrease cough

The treatment for chronic bronchitis includes pharmacological and non-pharmacological approaches.⁶ 

Pharmacological approaches

Bronchodilators 

• Include short- and long-acting β-adrenergic receptor agonists and anticholinergics
• Increase airway size, improve ciliary function, and enhance mucus hydration

Inhaled corticosteroids

Corticosteroids reduce inflammation and mucus production. Short-term use under medical supervision is necessarydue to the risks of osteoporosis, diabetes, and hypertension with long-term use.⁶

Antibiotic therapy

Generally, there is no indication in chronic bronchitis. There might be a place for the addition of macrolide therapy for its anti-inflammatory properties.⁶

Phosphodiesterase-4 Inhibitors

Phosphodiesterase-4 Inhibitors reduce inflammation and promote relaxation of airway muscles.⁶

Non–pharmacological approaches

Smoking cessation

• Most important intervention
• Improves the natural ability of the airways to capture and eject the harmful particles trapped in the mucus (mucociliary dysfunction)
• Reverses the airway remodelling (goblet cell hyperplasia)
• Decreases airway injuryand lowers mucus production

Pulmonary rehabilitation

Pulmonary rehabilitation includes education, lifestyle modification, regular exercise, and avoiding exposure to pollutants.⁶

It is important to seek medical attention for proper management of the condition.

Bronchitis prevention tips

There are some ways to reduce your risk for bronchitis:²

• Get a flu vaccination every year: The flu virus often leads to acute bronchitis. Consult your healthcare professional for specific pneumonia vaccines
• Practice good hand hygiene: Wash hands frequently and use alcohol-based sanitizers 
• Avoid close contact with sick people: Stay away from those with influenza or other viral respiratory illnesses
• Avoid cigarette smoke: It raises the chance of developing chronic bronchitis
• Wear a face mask when required: Wear a mask when exposed to dust or fumes at work, and discuss protective measures with your employer

Summary

Bronchitis is an upper respiratory infection causing inflammation of the airways, coughing, and breathing difficulties. Bronchitis can be contagious, but its severity relies mainly on the type of bronchitis: acute or chronic bronchitis. Acute bronchitis is often contagious, depending on its cause, particularly if it's due to a virus. On the other hand, chronic bronchitis is not considered contagious, as it is usually the result of long-term irritation of the airways.

Treatment depends on the form, with preventive measures including vaccination, hygiene, and mask use. It is advisable to ask for medical advice from a professional and follow their tips.

FAQs

How long does bronchitis last?

It depends on the type, but usually acute bronchitis lasts for two weeks.

Should I stay home when I have bronchitis?

If you are tired and not feeling well, it is highly recommended to have a rest and proper hydration.

Is bronchitis a chest infection?

Yes, it is one of the chest infections.