What is SARS?

It is an atypical severe pneumonia caused by SARS-Cov coronavirus (unknown at the time), a virus capable of surviving about three hours outside the host organism.

Coronaviruses are generally the main cause of mild to moderate respiratory illnesses such as the common cold, but which can worsen into pneumonia and acute respiratory syndromes, sometimes fatal.

Symptoms of SARS

The incubation period of SARS is rather short: between 2 and 7 days.

The first symptoms are very similar to those of influenza:

  • high fever (>38°C)
  • joint and muscle pain
  • dry throat
  • headaches
  • chills
  • cough
  • difficulty breathing.

In some cases, respiratory symptoms occur from the first onset of the disease and may worsen leading to hypoxia and pneumonia.

After about 7 days, the disease progresses with a dry cough that may lead to a poor oxygen supply to the blood and in 10-20% of cases may worsen to the point where supportive therapies such as assisted breathing, oxygen therapy or, in extreme cases, resuscitation are required. The mortality rate is around 9% (source: World Health Organisation).

SARS transmission, diagnosis and treatment

SARS is mainly spread by direct contact with infected patients, through their respiratory secretions (droplets of saliva expelled with coughs or sneezes) or their body fluids.

Diagnosis is made through the observation of symptoms and the results of a series of tests: chest X-ray, blood cell count (thrombocytopenia and leucopenia have been found in many patients), Gram culture and a search for respiratory viruses.

SARS is treated like any severe atypical pneumonia, i.e. mainly with antibiotics for bacterial and antiviral agents.

Oral or intravenous steroids may also be administered in combination with antimicrobials.

Preventive measures against SARS

As SARS is still being researched and therefore there is no vaccine or specific treatment, prevention still remains the only effective weapon to prevent the spread of the disease.

First and foremost, it is important to take some simple hygiene measures:

  • wash your hands often
  • cover your nose and mouth when coughing or sneezing;
  • avoid sharing towels, glasses and cutlery.

Like all infectious diseases, SARS is more easily transmitted in crowded and poorly ventilated places, where the concentration of pathogens can be noticeably high. Wearing a face mask can be a good way to protect yourself and others from the spread of SARS and other respiratory diseases.

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The common cold is caused by a viral infection in the upper airways, sinuses, throat, and nose. Although unpleasant, it is generally not a cause for concern.

In the vast majority of cases, despite feeling ill, with sneezing, sore throat, cough, and runny nose, a cold is a self-limiting infection; this means it gets better on its own without requiring any special treatment.

Most people get better within 1 week although, in some cases, it may last longer.

In this article, the MNT Knowledge Center will look at ways to treat the symptoms of a cold and get some relief.

Antibiotics are prescribed for bacterial infections. Colds are caused by viruses and do not respond to antibiotics. Antibiotics will not help patients get better any faster, neither will they prevent patients from passing it on to other people.

An article published in the BMJ said that fear of complications is not a good enough reason to prescribe antibiotics for the common cold. However, it adds that, “as far as the elderly are concerned, antibiotics do significantly lessen the risk of pneumonia following a chest infection.”

Echinacea, also known as purple coneflower is a native North American wild flower. Indigenous peoples use it as an herbal remedy for a variety of illnesses and conditions. Studies have produced, and continue to produce, conflicting results.

As an example, a 2007 study published in The Lancet Infectious Diseases, found that the herbal remedy reduced the duration of a cold by an average of 1.4 days and lowered a person’s chance of catching a cold by 58 percent.

Conversely, researchers from the University of Wisconsin-Madison School of Medicine reported in Annals of Internal Medicine that Echinacea has no big impact on the common cold, and only reduces the duration of symptoms “by half a day at the most.”

Sweating and runny noses are common when people have a cold; these symptoms can cause dehydration. This loss of fluids needs to be constantly replaced. The best drink is water.

When someone has a cold, they should drink plenty of water. Remember that coffee and caffeinated sodas can cause dehydration – so consider avoiding them.

Experts believe that chicken soup really does help relieve the symptoms of colds. It is believed to inhibit the movement of neutrophils, immune system cells that cause inflammation, and also the movement of mucus.

Chicken soup is also watery and may help with dehydration.

Getting plenty of rest will not only help alleviate some of the symptoms, and make people feel less miserable, it may also reduce the duration of their cold. Rest helps the immune system fight off the viral infection more effectively.

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If there are no tissues, doctors recommend sneezing or coughing into the crook of the elbow to stop germs spreading.

Good hygiene is important to prevent the spread of infection. Stay away from work or school while not feeling well.

Cover the mouth with a tissue when coughing or sneezing, and throw it away into a trash can immediately. Make sure to wash hands thoroughly with warm water and soap.

If there are no tissues and a person coughs or sneezes, doctors recommend doing so into the inner part of the elbow, because that part of the body does not then contaminate surfaces.

Salt water gargle – making a solution consisting of one-quarter teaspoon of salt dissolved in 8 ounces of warm water and gargling it may provide some temporary relief for sore throat symptoms. A saline solution can help draw excess fluid from inflamed tissues in the back of the throat, resulting in less pain. Thick mucus may also become loosened, making it easier to expel.

Nasal saline drops – available from pharmacies, these may help young babies with nasal congestions. Nasal saline drops may be a useful alternative to salt solutions for gargling (getting babies and very young children to gargle is virtually impossible).

The steam may help alleviate symptoms of congestion. For a traditional steam inhalation:

  • Half fill a pan with water and bring it to the boil.
  • Place the pan on a sturdy table; make sure there is a towel or heat-resistant mat under it.
  • Patients can sit with their head over the pan and cover themselves with a towel.
  • Breathe deeply with eyes closed.
  • Make sure none of the steam gets into the eyes.

Do not use steam inhalation with small children – there is a risk of scalding. Small children may benefit from standing close to a hot shower and breathing in the steam.

Previous studies have had mixed results regarding the benefits of zinc for fighting colds. Most positive studies say the zinc should be taken within 24 hours of the onset of symptoms.

Canadian researchers recently found that zinc tends to work better with adults than with children; they added that adverse effects, especially when higher doses are taken, are common. A serious adverse side effect is permanent anosmia, or lack of smell. Before using zinc, it is important to know which preparation and dosage you are taking.

A 2013 Cochrane review examined Vitamin C’s effects on the common cold. The review concluded that there was a reduction in duration of symptoms in people who were already taking at least 200 milligrams a day of vitamin C supplements. Once symptoms had begun, they found no benefit to taking Vitamin C.

Sedating (first generation) antihistamines may alleviate some cold symptoms slightly, such as the watery eyes, runny nose, coughs, and sneezes. Experts are not sure, though, whether the benefits of using antihistamines really outweigh the side effects. Studies have come back with mixed results.

Many specialists say that antihistamines dry up nasal membranes, which slows down mucus flow, undermining the nasal passages’ ability to get rid of germs.

A recent review, published in PLOS, demonstrated that antihistamines may have a short term effect on symptoms, but this occurred only in adults during the first 2 days of treatment. There is not enough evidence in children to determine the efficacy of this treatment. Again, the side effects may outweight the benefits.

Decongestants are medications that shrink the swollen membranes in the nose, allowing for easier breathing. There are oral or nasal decongestants. Unless a doctor says so, nasal decongestants should not be used for more than 5 days – longer usage may actually block up the nose more.

Patients with hypertension should not use decongestants, unless they are under a doctor’s supervision. Many researchers are not sure whether decongestants really work, or whether they are worth recommending because they only work for a very short time. Nasal decongestants should not be used by patients on MAOI (monoamine oxidase inhibitor) antidepressants.

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While cough medicine may help adults, it is not suitable for children in many cases

Over-the-counter cough medicines may be hazardous for children. The FDA says they should not be given to children younger than 2.

Painkillers and antipyretics (drugs to reduce fever) may be helpful. Although a high fever might not be desirable, a slight fever is not such a bad thing – it helps the body fight off infections more rapidly. When body temperature rises, viruses and bacteria find it harder to reproduce. With the exception of very young patients, doctors no longer recommend trying to bring a slight fever down.

However, if patients feel bothered and uncomfortable, an antipyretic is usually fine. Aspirin should only be taken by older adults, not children or young adults.

Acetaminophen or ibuprofen are effective for the treatment of both fever and pain. Check with a doctor or a qualified pharmacist for the correct dosage and schedule for these medications. Overmedication may cause liver injury or failure or kidney injury or failure.

During the cold months, when the central heating dries the air out, an air humidifier will help keep the throat and nasal passages moist.

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The Centers for Disease Control and Prevention (CDC), the national public health agency of the United States, has issued a warning over an increase in the number of enterovirus cases. Enterovirus-D68 is a virus that causes a respiratory illness in children, weakens their muscles, and causes a type of paralysis called Acute Flaccid Myelitis (AFM). While AFM is rare, full recovery from it is even rare. Polio falls in the enterovirus family and both enterovirus-D68 and poliovirus can overwhelm the nervous system and cause weakness in the muscles.

In this article, we would focus on what this virus is, its symptoms, causes, diagnosis, treatment, prevention tips, and enterovirus in India.


Enterovirus, which was first detected in 1962, is one of the non-polio enteroviruses.

According to the CDC, most people who get infected with non-polio enteroviruses “do not get sick, or they only have mild illness, like the common cold". Enterovirus entails a wide range of symptoms such as fever, runny nose, sneezing, cough, skin rash, mouth blisters, and body and muscle aches. In rare cases, enterovirus can cause paralysis.

There are three types of non-polio enteroviruses: enterovirus D68 (EV-D68), enterovirus A71 (EV-A71), and coxsackie virus A6 (CV-A6).

While D68 usually causes respiratory illness, A71 and A6 are better known to cause hand, foot, and mouth disease. Enterovirus are generally active during summer and autumn seasons.


1 Some cases have no symptoms

2 Some have mild: Runny nose, sneezing, cough, body aches, and muscle aches

3 Some cases have severe symptoms: Wheezing (to breathe noisily), and difficulty breathing


Enterovirus-D68, which affects the nervous system, can also cause acute flaccid myelitis (AFM). AFM is very uncommon; it can cause serious neurologic conditions in children due to which muscles and reflexes can become weak.


See a doctor if the kids develop these symptoms:

1 Arm or leg weakness

2 Pain in the neck, back, arms, or legs

3 Difficulty swallowing or slurred speech

4 Difficulty moving the eyes or drooping eyelids

5 Facial droop or weakness


The virus of Enterovirus-D68, which is a respiratory illness, can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or mucus-like secretions from the lungs.

It spreads from a person to person when an infected person “coughs, sneezes, or touches a surface that is then touched by others", according to the CDC.


According to the CDS, enterovirus-D68 can only be diagnosed by doing specific lab tests on specimens from a person’s nose and throat, or blood.


There are no antiviral medications currently available for people who become infected with enterovirus-D68, according to the CDC.


1 Wash your hands often with soap

2 Avoid touching your eyes, nose, and mouth if your hands aren’t washed

3 Avoid close contact with an infected person

4 Cover your coughs and sneezes

5 Disinfect frequently touched surfaces

There have been no official cases of enterovirus-D68 in India.

(With inputs from CDC)

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Enterovirus D68 cases in pediatric hospitals have risen again since the 2014 outbreak. (Image: Adobe Stock; Illustration: Sebastian Stankiewicz/Boston Children's)

By now you’ve seen the news: Several health care providers and hospitals across the United States during August 2022 identified an increase in pediatric hospitalizations due to a virus causing children to develop coughing and breathing problems that are often more severe than the common cold. That virus is Enterovirus D68 (EV-D68) and it’s just one strain of Enteroviruses, which cause colds, fever, headaches, vomiting, and rashes among other symptoms. Most Enterovirus infections are very common and spread quickly primarily among children. EV-D68, however, is an unusual strain.

Not only is it much less common than other Enteroviruses, but it can also cause especially bad respiratory illnesses, including a bad cough and difficulty breathing. In some cases, children and other patients with EV-D68 have needed ICU-level care and the assistance of a mechanical ventilator. EV-D68 can be especially dangerous for children with existing lung problems (like asthma) or who have weaker immune systems (like newborns). In 2014, there was a large outbreak of EV-D68 from mid-August 2014 until January 2015. Almost all of the confirmed cases were children — many of whom had asthma or a history of wheezing. This was the first documented nationwide outbreak of the EV-D68, and now we’re taking a closer look at the current uptick in cases once again.

The Centers for Disease Control and Prevention (CDC) is monitoring the situation closely. Like any other virus, EV-D68 spreads from person to person through bodily fluids — think saliva and nasal mucus — as well as through sneezes, handshakes, changing diapers, and many other kinds of interactions.

Although EV-D68 seems to affect children more than adults, it may be that adults who become infected show much less severe symptoms. There are no vaccines or antiviral therapies for EV-D68 and care is supportive, meaning that all hospitals can do is provide relief for the symptoms. So it’s important that adults who are around children take precautions to minimize the risk of spreading the virus.

Here are some things you can do to help prevent the spread:

  • Wash your hands often with soap and water for 20 seconds.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick, and when you are sick.
  • Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
  • Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
  • Stay home when you are sick.
  • Consider wearing a mask around other people if you have respiratory symptoms.
  • Contact a healthcare provider immediately if you or your child has trouble breathing or has a sudden onset of limb weakness.
  • Ensure you or your child are following an up-to-date asthma action plan if you or your child have asthma.
  • Stay up-to-date with all recommended vaccines.

For more information about EV-D68, visit the CDC at www.cdc.gov/non-polio-enterovirus/about/ev-d68.html#outbreak.

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I wore a mask to protect myself from germs and viruses before it was required by the COVID-19 pandemic. After my diagnosis of idiopathic pulmonary fibrosis (IPF), a debilitating and life-threatening respiratory disease, in April 2016, I now do everything I can to protect my lungs.

Unfortunately, I learned the hard way how serious respiratory viruses can be for those of us with IPF. A year after I was diagnosed, I caught a common respiratory virus and both of my lungs collapsed, landing me on a ventilator. I still suffer from post-traumatic stress from that incident and am deeply fearful of it happening again.

The months leading into winter can be brutal due to respiratory viruses, partly because kids head back to school. Last week, I was excited to see a friend who just had her second baby, but the visit was postponed after her toddler caught a cold just one week into day care.

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Here in Canada, the cold and flu season extends through most of the winter, but September, October, and November are particularly difficult months for my breathing. I usually catch a virus that knocks me down for a few weeks, making work and other responsibilities challenging. However, it’s not just the common cold that poses a threat to my breathing every fall.

The following are some of the things that will be stacked against me in coming months, creating a perfect storm for my breathing:


As the summer fades into fall, I notice my environmental allergies flare up, causing congestion, itchy eyes, and a dry cough. Many places in Canada are still screening people for COVID-19 symptoms before appointments or visits to certain locations, so I’m sure I’ll be doing a lot of explaining this fall that my symptoms are not related to COVID-19, but rather due to my lung disease or allergies.

Fluctuating temperatures

September and October typically have warm days and cool nights. While this is ideal for sleeping, the temperature fluctuation isn’t good for my breathing because it causes increased breathlessness and discomfort in my chest. Temperature changes also cause a runny nose, which makes me cough or clear my throat more than I otherwise would.

Cold and flu season  

I always get my flu shot, and if you’re immunocompromised and living with IPF, you should talk to your doctor about doing the same. While I do whatever I can to protect myself, I often end up with a cold or the flu. However, I believe the flu vaccine helps me avoid more serious symptoms.

Change in medications

It may seem odd that my medications change with the seasons, but it’s true. My pulmonologist typically increases the dose of my prescribed antihistamine in the fall to help reduce allergy-related symptoms. The increased dosage and the more frequent use of inhalers in the fall can make me feel fairly lousy.

What season is particularly difficult for your IPF symptoms? I’d love to hear your thoughts in the comments below. 

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.

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Elementary school teacher and her students wearing protective face mask in the classroom. Image credit: iStock


Andrew Ault
Andrew Ault

Since the Centers for Disease Control and Prevention acknowledged SARS-CoV-2 was airborne in spring 2020, University of Michigan aerosol scientists Andrew Ault and Kerri Pratt have advised public school systems on how to mitigate the transmission of COVID-19 in the classroom.

That’s partly because social distancing isn’t enough of a mitigation strategy. Have you ever smelled food burning in a kitchen or cigarette smoke in restaurants before indoor smoking was banned? Distance doesn’t automatically mean particles in the air aren’t reaching you, say the researchers.

Kerri Pratt
Kerri Pratt

Now, as students return to school, Ault and Pratt, both associate professors in the U-M Department of Chemistry, give tips about how teachers can keep their classrooms safer for themselves and their students. The key, they say? Masks, open windows, and HEPA filters, including a do-it-yourself air filter made out of furnace filters taped around a box fan.

Can you describe how airborne transmission of COVID works?

Airborne transmission means that a virus is spread by aerosols, which are tiny particles we exhale into the air when we are breathing and talking. The louder we are talking or harder we are breathing, the more aerosols we emit. When someone has COVID, those aerosols contain virus (SARS-CoV-2), which can infect others that breathe the aerosols in. These aerosols are so small (100 times smaller than the diameter of a human hair) that they can stay in the air for hours.

What are some ways people can visualize airborne transmission via aerosols?

You can think of aerosol transmission like cigarette smoke, which is similar in size to exhaled aerosol. Smoke travels across rooms and builds up in poorly ventilated spaces. When restaurants and bars previously allowed smoking, it didn’t matter if you were one table away or across the restaurant, everyone was breathing in the smoke.

How do aerosols move throughout enclosed spaces, such as classrooms?

Classrooms are just like any other indoor space. If infected kids or adults are in the room, they will exhale aerosols with the coronavirus in them, and these aerosols will hang in the air, like smoke. The best things to do to prevent others from breathing in those virus aerosols are to wear masks and improve ventilation through filtration and opening windows.

What are some affordable ways teachers and school administrators can keep classrooms more safe for students?

There are a number of low-cost steps that schools can take to clean the air and reduce transmission of COVID-19.

  1. All students and adults should wear masks indoors at all times, since respiratory aerosols are released through breathing. Masks reduce the amount of aerosol released to the room by someone infected (including those that are asymptomatic) and also reduce the amount of aerosol breathed in by someone else (reducing the chance of infection). Mask fit is important, with the mask sealing against your face without gaps (i.e., not leaking) for best protection. KF94, KN95 and N95 masks are readily available and provide an even higher level of protection than cloth and surgical masks by removing greater than 90% of aerosols exhaled by others when you breathe in.
  2. Eat outdoors, and in inclement weather, have students eat in individual, well-ventilated classrooms, rather than large cafeterias, to reduce the number of students exposed to an infected individual.
  3. Improve ventilation, which can be as cheap as opening a window. Steps beyond just opening a window are to use fans to bring fresh air in and push dirty air out. Improving ventilation has the added side benefit of improving cognitive function by decreasing carbon dioxide buildup.
  4. Lastly, a cool do-it-yourself option is to make a Corsi-Rosenthal Cube, which is a box fan with 5 MERV-13 furnace filters duct taped together and can be made for less than $100. Research shows that these filters decrease aerosol levels, and they are being used in numerous schools nationwide. There are also commercial HEPA air filtration units available that cost more. There should be at least one HEPA air filter/cube in each classroom and multiple filters/cubes in any larger indoor spaces. Portable HEPA air filters supplement HVAC MERV-13 filters by filtering air immediately around students.

Do not buy ionizers, ozone generators or any products claiming to use ions/chemicals to remove virus particles. We, in the indoor air community, have been trying to raise the alarm about this, but unfortunately many individuals and school districts have wasted a lot of money on products that do not effectively remove virus aerosols, but do introduce other harmful gases. HEPA and MERV-13 level filtration is the best option for aerosol removal, as used in hospitals.

How can teachers or school administrators monitor indoor air quality and know if a room may have high aerosol concentrations?

A carbon dioxide monitor (about $250) will tell you how much exhaled air has built up in a room. With good ventilation, carbon dioxide concentrations indoors and outdoors should be similar (about 420 ppm). If the carbon dioxide levels reach higher than 800 ppm, that means that the room is poorly ventilated and that you are rebreathing the air that someone else has exhaled. This calls for the need for increased ventilation (opening a window to mix in outdoor air) and adding an air filtration unit to remove exhaled aerosol.

How will what we’ve learned about the transmission of COVID through aerosols impact how we handle other diseases such as the flu or the common cold?

What we’ve learned about aerosol transmission of COVID can greatly improve how we handle many other airborne respiratory diseases, like influenza, and improve our health overall. By improving indoor ventilation, we will reduce respiratory disease transmission, reduce exposure to air pollution and allergens like pollen, and improve cognitive function (by reducing exposure to high levels of carbon dioxide). In many countries even before COVID-19, it is customary to wear a mask when sick to prevent infecting others.

We have received public health guidance to social distance—what does this mean in the context of airborne transmission?

Just like standing next to a smoker, there is more exhaled aerosol close to a person, such that social distancing reduces exposure, particularly to droplets. However, aerosols travel across rooms, much farther than 6 feet, and build up in poorly ventilated spaces. Another way to think of it is—if you are in a pool and someone pees in it, you don’t want to stay in the pool, even if you are more than 6 feet away from them. This is why masking and ventilation indoors are so important, in addition to social distancing.

What’s the difference between exhaled droplets and aerosols?

Droplets are emitted during coughing and sneezing and are approximately the diameter of a human hair (100 times larger than aerosols). Droplets stay in the air for only a few seconds while traveling up to 6 feet of distance. Since the early 1900s, most doctors thought that infectious diseases spread primarily via droplets and surface contact. This was in part because droplets and surfaces are easier to measure.

Over the course of this pandemic, we’ve come to realize that this thinking was outdated. Aerosols can stay in the air for hours in poorly ventilated indoor spaces and can infect people across rooms that breathe in the previously exhaled aerosols. There is now overwhelming evidence that aerosols are how COVID-19 is transmitted.

What is the riskiest part of the school day for COVID transmission?

The riskiest part of the school day is anytime students are indoors and unmasked together. For students wearing masks, this risk occurs when eating lunch or snack. When multiple cohorts (classrooms) of students are together in a cafeteria/lunchroom, this increases the number of students exposed to an infected individual, since the aerosols travel across the entire room, far beyond 3-6 feet. Outdoor eating is the best solution, but with inclement weather, the next best solution is for small cohorts to eat in well-ventilated classrooms to reduce the number of students exposed to each other, to prevent outbreaks.

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While pain under the right breast is rarely a cause for concern, it can sometimes indicate an underlying condition. Some possible causes of this pain include injuries, infections, muscle strain, inflammation, and gastrointestinal issues.

A strain or injury are common causes of pain under the right breast, and the pain usually gets better on its own. However, it can also result from conditions affecting the underlying tissues and organs, or the pain may be extending from another area of the body, such as the stomach.

In this article, we explore some potential causes of pain under the right breast, along with their main symptoms and treatments. We also describe when to see a doctor.

Tired or exhausted man lying down after workout holding chest or abdomen in pain
An injury or muscle strain can cause pain under the right breast.

Injuries to the ribs or chest area are common and can be very painful. Depending on where the injury occurs, this pain may manifest under one or both of the breasts.

Possible causes of chest injuries include:

  • knocks or blows to the chest area
  • falls
  • severe coughing

Other symptoms of an injury can include swelling and bruising. More forceful injuries can also result in bruised or fractured ribs.

People recovering from surgery to the breasts or chest area may also experience pain or discomfort under one or both breasts.


A person can usually treat minor chest injuries at home with rest and over-the-counter (OTC) medications, such as acetaminophen and ibuprofen.

Applying ice to the affected area for up to 20 minutes at a time may also help reduce pain and swelling.

See a doctor for pain that results from a serious injury, such as a car accident. People with severe or worsening pain should also speak to a doctor.

It is possible to strain or overstretch the chest muscles, which can result in soreness and pain. Depending on which muscles a person strains, this pain may occur under a single breast.

Chest muscle strains can result, for example, from throwing, heavy lifting, and using heavy tools or equipment.


Muscle strains usually get better with rest. OTC pain relievers and applying ice to the affected area for up 20 minutes at a time may help reduce chest discomfort.

Hormonal fluctuations that occur during the menstrual cycle can cause the breasts to become swollen and tender.

This tenderness usually occurs in the week or so before a person’s period, and it can affect one or both breasts.


Taking OTC pain relievers and drinking plenty of water can help reduce breast tenderness from menstrual hormonal changes. The symptoms usually resolve before a person’s period is over.

Costochondritis is an inflammation of the cartilage in the costochondral joint, which is the area where the ribs meet the sternum, also called the breastbone.

The main symptom of costochondritis is chest pain, which can occur in one or both sides of the chest. This pain can be dull or sharp and may get worse when taking a deep breath or coughing. There may also be tenderness around the breastbone.

Costochondritis does not usually cause severe symptoms, such as shortness of breath, fever, or dizziness.

Doctors do not fully understand what causes costochondritis, but it may result from one or more of these issues:

  • chest injuries
  • intense physical activity
  • strenuous coughing
  • illness, such as a chest infection near the costochondral joint


Costochondritis often gets better on its own, but it may last several weeks.

Some ways to relieve inflammation and pain from costochondritis:

  • avoiding activities that stress or aggravate the chest area
  • applying heat packs to the affected area
  • taking nonsteroidal anti-inflammatory drugs — NSAIDs — such as naproxen or ibuprofen

For pain that gets worse or does not go away, a doctor may recommend steroid injections or physical therapy.

A person who experiences a gallbladder attack should seek treatment.
A person who experiences a gallbladder attack should seek treatment.

The gallbladder is a small organ on the right side of the body that stores bile from the liver. If bile contains too much cholesterol or bilirubin, or if a person’s gallbladder does not empty properly, gallstones can form.

Most gallstones pass without causing problems. However, gallstones that block the flow of bile in the bile ducts can cause pain and inflammation. The episodes of pain resulting from these blockages are called gallbladder attacks or biliary colic.

The pain from a gallbladder attack usually occurs in the upper right abdomen and can last for several hours.

Attacks that last for more than a few hours can lead to complications. For instance:

  • jaundice, which is yellowing of the skin and eyes
  • nausea and vomiting
  • fever


Anyone who has had a gallbladder attack should see a doctor, even if symptoms get better, because more attacks may follow. People who experience complications should receive prompt medical attention.

If gallstones continue to cause problems, doctors usually recommend surgery to remove the gallbladder. The gallbladder is not an essential organ, and removal reduces the risk of it becoming infected and causing further complications.

For people who cannot undergo gallbladder removal, doctors may recommend some of the following nonsurgical treatments:

  • endoscopic retrograde cholangiopancreatography
  • oral dissolution therapy
  • shock wave lithotripsy

A hiatal hernia occurs when part of the stomach slides up through the hiatus, which is an opening in the diaphragm. The diaphragm is a large, thin sheet of muscle that separates the chest cavity from the abdomen.

Hiatal hernias do not always cause noticeable symptoms, but they can increase a person’s risk of gastroesophageal reflux disease (GERD). Some examples of symptoms:

  • chest pain
  • heartburn
  • problems swallowing
  • shortness of breath
  • nausea and vomiting


Treatment is usually necessary if the hiatal hernia is causing problems. For people with symptoms of GERD, treatment options include:

  • lifestyle and dietary changes, such as maintaining a healthy weight and avoiding foods that make symptoms worse
  • medications that reduce stomach acid, such as antacids, H2 receptor blockers, and proton pump inhibitors

If these treatments are unsuccessful, a doctor may recommend surgery to correct the hernia.

Irritable bowel syndrome (IBS) causes gastrointestinal symptoms, such as abdominal pain and changes to a person’s bowel movements. These symptoms tend to vary in type and severity from person to person.

Some symptoms of IBS:

  • bloating and gas
  • constipation or diarrhea
  • a feeling of incomplete evacuation after having a bowel movement
  • stools containing a whitish mucus

IBS can sometimes also cause referred pain, including right-sided chest pain.


Treatment for IBS typically includes some of the following lifestyle and dietary changes:

  • increasing fiber intake
  • exercising regularly
  • reducing and managing stress
  • getting enough sleep
  • following a specific diet, such as the low-FODMAP diet.

FODMAP is an acronym for oligo-, di-, monosaccharides, and polyols, which are groups of carbs that can cause digestive symptoms, including bloating, gas, and pain.

Doctors may also prescribe specific medications to reduce constipation, diarrhea, and abdominal pain.

Mature asian woman holding hand to chest due to heart attack or breathing pain.
Shortness of breath and chest tightness are potential symptoms of pleural disorders.

The pleurae make up a large, thin membrane that is folded over to form two layers. One layer wraps around the lungs, and the other lines the inside of the chest cavity. The space between these two layers is called the pleural space.

Inflammation of the pleura is called pleurisy, and it can cause the two layers to rub against each other. This friction can lead to sharp chest pain when coughing or breathing deeply.

In different pleural disorders, air, gas, fluid, or blood collects in the pleural space, which can also cause sharp chest pain.

Other symptoms of pleural disorders:

  • coughing
  • fever and chills
  • shortness of breath
  • fatigue
  • chest tightness
  • weight loss
  • a bluish tint to the skin


Treatment for a pleural disorder depends on the underlying cause and the severity of a person’s symptoms.

For example, if a bacterial infection is causing the condition, a doctor may prescribe antibiotics. They may also recommend anti-inflammatory medications or pain relievers to help reduce a person’s discomfort.

Some people require a procedure to drain gas or fluids from the pleural space.

Pneumonia is infectious inflammation of the tiny air sacs in the lungs, which causes them to fill up with fluid. It can lead to a range of symptoms, including sharp chest pain that typically gets worse with deep breathing or coughing.

Other symptoms of pneumonia:

  • fever and chills
  • a persistent cough that produces green, yellow, or bloody mucus
  • a loss of appetite
  • fatigue and low energy levels
  • confusion
  • nausea
  • shortness of breath or other breathing difficulties

Early symptoms of pneumonia can be similar to a common cold or the flu and may come on suddenly or gradually worsen over a few days. Symptoms can vary from mild to severe.

The most common cause of pneumonia is a bacterial infection, but pneumonia can also result from viral or fungal infections.


People with symptoms of pneumonia should see a doctor. Seek urgent medical attention if symptoms are severe.

Pneumonia can sometimes lead to life-threatening complications, and some people require hospitalization.

Treatment depends on the type of pneumonia and the severity of symptoms. Doctors may prescribe antibiotics for bacterial pneumonia or antiviral medications for viral pneumonia.

To treat mild pneumonia at home, a doctor may recommend the following:

  • getting plenty of rest
  • drinking lots of fluids
  • taking OTC pain relievers
  • avoiding tobacco smoke and other lung irritants
  • taking oral antibiotic or oral antiviral therapy, as prescribed

See a doctor if the pain under the right breast gets worse, does not go away, or is interfering with daily activities. Also, seek medical attention if the pain accompanies other concerning symptoms.

Some symptoms that require immediate medical attention:

  • severe, sharp, or sudden chest pain
  • chest pain that radiates to other parts of the body, such as the jaw, arms, or shoulders
  • a bluish tint to the lips or skin
  • difficulty breathing
  • coughing up blood
  • confusion, dizziness, or loss of consciousness

Pain under the right breast is rarely a cause for concern and often results from muscles strains or minor injuries.

However, it can indicate a more serious condition, such as an infection, chest inflammation, or a gastrointestinal issue.

If the pain gets worse, does not go away, or occurs with other concerning symptoms, see a doctor. Seek immediate medical attention for severe chest pain or pain that accompanies breathing difficulties.

Read the article in Spanish.

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STATEN ISLAND, N.Y. — The Centers for Disease Control and Prevention (CDC) issued a warning to health providers after an increase in pediatric hospitalizations among children who tested positive for a respiratory virus.

The virus, known as enterovirus D68 (EV-D68), has been found in a higher proportion of children compared to recent years, the agency said in its alert Friday, and officials are bracing for the potential more cases will arise in the coming weeks.

EV-D68 has similarities to rhinoviruses, or the common cold, but has the potential to cause more significant neurological complications like acute flaccid myelitis — a polio-like illness that can lead to paralysis.

Around 10% of people diagnosed with EV-D68 during a 2004 United States outbreak developed acute flaccid myelitis, according to research. There is currently no vaccine or specific treatments to manage the virus, officials said.

The initial similarities, however, could lead to difficulties detecting EV-D68, which, akin to the common cold, typically peaks in the early fall.

While adults could be infected by EV-D68, experts said it is more common among adults with underlying conditions. Children around the age of 3 are among the most affected, but all ages of children and adolescents are at risk, regardless of underlying lung conditions like asthma, said the CDC.

The agency advised pediatricians to be aware of the increase and consider it when symptoms are present. Additionally, laboratory testing should be completed when the cause of respiratory infection in severely ill patients is unclear.

To protect against EV-D68, the CDC recommends frequent hand-washing, similar to prevention methods for other respiratory illnesses. Additionally, health authorities suggest wearing a mask around others if you have respiratory symptoms.

“Avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick, and when you are sick,” said the CDC, adding: “Stay home when you are sick.”

If a child is sick or has sudden breathing issues or limb weakness, call a healthcare provider.

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The Centers for Disease Control and Prevention (CDC) issued an alert to doctors and parents about a rare respiratory disease that is affecting children.

The virus, called Enterovirus D68 (EV-D68), has similar symptoms to influenza or the common cold, health officials said last week.

Other health officials say that while enteroviruses are very common viruses that affect 10 to 15 million Americans per year, EV-D68 is “less common than other types of enterovirus.”

“Healthcare providers and hospitals in several regions of the United States notified the Centers for Disease Control and Prevention (CDC) during August 2022 about increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV) … upon further typing, some specimens have been positive for enterovirus D68 (EV-D68),” said the CDC on its website in a Sept. 9 alert.

The CDC said that parents should contact their child’s doctor if they experiencing difficulty breathing or if their symptoms worsen. They also called on people to contact a healthcare provider if the child has a sudden onset of limb weakness.

Children with asthma might have a higher risk for severe respiratory illness caused by EV-D68, officials said.

“EV-D68 can also cause acute flaccid myelitis, an uncommon but serious neurologic condition which mostly affects children and causes the muscles and reflexes in the body to become weak,” the agency says.

There are no available vaccines or therapies for any enterovirus, the CDC alert said. It is recommended that doctors provide supportive clinical management of enteroviruses and related rhinoviruses, including EV-D68.

Prior outbreaks of EV-D68—first discovered in California in 1962—occurred in 2014, 2016, 2018, and in 2020 to a smaller extent, according to the agency’s alert. Data shows that the median age of children who obtained emergency department or inpatient care in 2018 was 3 years old, the CDC said.

“However, all ages of children and adolescents can be affected,” said the CDC. “Children with a history of asthma or reactive airway disease may be more likely to require medical care, though children without a known history of asthma can also present with severe illness. EV-D68 in adults is less understood but is thought to be more commonly detected in patients with underlying conditions.”

The CDC issued several recommendations regarding the virus, including advising people to wash their hands often; avoid touching the eyes, nose, and mouth; avoid close contact with people who are symptomatic; cover a cough or sneeze; clean and disinfect frequently touched surfaces; and stay home when sick.

Jack Phillips


Jack Phillips is a breaking news reporter at The Epoch Times based in New York.

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Many viruses can cause sniffles and other cold symptoms, including human metapneumovirus (hMPV). When you experience an upper respiratory infection, you may have one caused by human metapneumovirus. For most people, symptoms stick around for a few days and fade without medical treatment. 

However, some people may develop complications from hMPV if the illness begins to affect the lower respiratory system (the airways and lungs).

This article will look at how to cope with human metapneumovirus, precautions you can take while sick to prevent its spread and avoid complications, and warning signs that the illness has become more serious.

vitapix / Getty Images

Coping With Symptoms

In most cases, dealing with hMPV means waiting out the symptoms. You may start to feel a tickle in your throat before you begin to cough and have a runny nose.

Once symptoms set in, they’ll likely fade completely within about a week, whether you use over-the-counter (OTC) cough and cold products or not. Unlike a bacterial infection, viral infections cannot be treated with antibiotics. No existing antivirals are approved to treat hMPV. 

There are a few measures you can take to feel better. If you’re experiencing a painful sore throat and hoarse cough, try using a humidifier to add moisture to the air and prevent dry air from triggering respiratory symptoms. The humid air can also help with congestion.

You may also experience mild body aches, fever, and headache when you have cold-like symptoms. OTC pain relievers and fever reducers like Advil (ibuprofen) or Tylenol (acetaminophen) can help. You can also find products for congestion and cough at the drugstore or other store.

Precautions for Treating Children

If you are treating a child, talk to a healthcare provider before giving them any OTC medication. Medications such as aspirin can cause complications, and cough and cold medications may be ineffective or hazardous.

Be careful not to mix products that contain the same ingredients. Some cold and flu products may also be unsafe to combine because of possible medication interactions. When in doubt, talk to a pharmacist or healthcare provider.

Rarely do people need prescription medication to help with hMPV symptoms. While a healthcare provider won’t prescribe antibiotics for viral illnesses, they may recommend a corticosteroid inhaler if you have asthma.

Human Metapneumovirus Precautions

Before the COVID-19 pandemic, it might have seemed OK to go to work or see family and friends when you were sick with symptoms of the common cold. Today, people are more aware of how viral illnesses can affect others, particularly those who are immunocompromised (have a weakened immune system). 

While not everyone has the means to miss school or work or skip important events, you should take precautions, especially if you know you’ll be in contact with people at high risk for complications.

Human metapneumovirus is spread by respiratory droplets, as well as hand-to-hand contact and contact with infected surfaces.

Ways to help prevent the spread of viruses include:

  • Wash or sanitize your hands frequently.
  • Cover your mouth and nose when coughing or sneezing. Throw used tissue into the trash and sanitize your hands.
  • Try not to touch your nose, eyes, or mouth. Wash or sanitize your hands after touching these areas.
  • Don't share utensils or drinking vessels.
  • Clean items the sick person may have touched (such as toys or door handles).
  • Don't kiss other people.
  • Stay home when sick, if possible.

Warning Signs to Watch For

Most people don’t develop complications with hMPV. But it’s helpful to know the signs of lower respiratory infection so you can promptly seek treatment if you experience them. 

Warning signs can include:

  • Difficulty breathing
  • Rapid breathing
  • High fever and chills
  • Cough that doesn’t go away
  • Cough that produces mucus
  • Fatigue
  • Chest pain
  • Pain when coughing
  • Nausea and vomiting
  • Loss of appetite


Human metapneumovirus usually isn't serious, but it’s still important to take precautions to avoid complications and spreading it to others. Staying home when sick, handwashing, and covering your face when coughing or sneezing can help prevent the spread of human metapneumovirus. 

Keeping tabs on your symptoms can help you spot the signs of lower respiratory illness and get treatment before they worsen.

A Word From Verywell

It’s not always easy to tell when someone might be vulnerable to infection. People with compromised immune systems don’t wear a sign on their foreheads. When in doubt, try to make the extra effort to protect others. 

Even if you’re not sick, you might want to wear a mask when you are out in public, especially if you visit a place with many immunocompromised people, like a skilled nursing center or a hospital. If you begin to feel symptomatic, consider testing yourself for COVID-19 to prevent the spread of the disease. 

By Steph Coelho

Steph Coelho is a freelance health writer, web producer, and editor based in Montreal. She specializes in covering general wellness and chronic illness.

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A cough, also known as tussis, is a voluntary or involuntary act that clears the throat and breathing passage of foreign particles, microbes, irritants, fluids, and mucus; it is a rapid expulsion of air from the lungs.

Coughing can be done deliberately or as part of a reflex. Although coughing can be a sign of a serious illness, more often, it will clear up on its own without the need for medical attention.

In this article, we will cover the possible causes, diagnosis, and treatments for coughs.

There are three phases to a cough:

  1. Inhalation (breathing in).
  2. Increased pressure in the throat and lungs with the vocal cords closed.
  3. An explosive release of air when the vocal cords open, giving a cough its characteristic sound.

If somebody coughs a lot, it can be a sign of a disease. Many coughs are caused by infectious diseases, like the common cold, but there are also non-infectious causes. We look at some potential causes in the next section.

The majority of coughs are caused by viruses and clear up without treatment.

Causes of acute (short-term) cough

In most cases, the infection is in the upper respiratory tract and affects the throat, this is known as a URTI or URI (upper respiratory tract infection). Examples include:

If it is an LRTI (lower respiratory tract infection), the lungs are infected, and/or the airways lower down from the windpipe. Examples include:

An acute cough can also be caused by hay fever.

Causes of chronic (long-term) cough

A chronic cough may be caused by:

  • smoking
  • mucus dripping down the throat from the back of the nose (post nasal drip)
  • GERD (gastro-esophageal reflux disease)
  • asthma
  • some medications (e.g., ACE inhibitors)

Chronic coughs in children are most often caused by asthma, but can also be from conditions like post-nasal drip or GERD.

Less common causes of chronic cough in adults include TB (tuberculosis), fungal infections of the lung, and lung cancer.

If a cough has persisted for 3 weeks without improvement, it is sensible to visit a doctor.

In most cases, there will not be anything serious underlying the cough, but in rare cases, a long-term cough can be a sign of something that needs treating, such as lung cancer or heart failure.

Other reasons to seek medical advice include:

  • The cough is getting worse.
  • There are swelling or lumps present in the neck region.
  • Weight loss.
  • Severe coughing.
  • Difficulty swallowing.
  • Permanent changes in the sound of the voice.
  • Coughing up blood.
  • Difficulty breathing.
  • Chest pain.
  • Fevers that are not getting better.

If a doctor decides that a cough is caused by the common cold or flu, the general advice will be to rest, drink plenty of fluids, and let it run its course. In the majority of cases, such coughs clear up after 1–2 weeks.

A cough caused by a viral infection that persists for more than a couple of weeks will probably require medical attention.

The doctor may order some diagnostic tests, such as a chest X-ray; a sample of phlegm may be sent to a laboratory for analysis to determine what is causing the infection.

The patient may be asked to breathe in and out of a tube attached to a machine; this helps the doctor determine whether the airways have an obstruction (this test is called spirometry), which is common in asthma or emphysema.

If asthma is diagnosed, the patient may be prescribed asthma medication.

Sometimes, a doctor might refer the patient to a lung or ear, nose, and throat (ENT) specialist.

The best way to treat a cough caused by a viral infection is to let the immune system deal with it — generally, such coughs clear up on their own.

If a doctor is treating a cough, they will focus on the cause; for example, if it is due to an ACE inhibitor, it may be discontinued.

Codeine, dextromethorphan, and other cough suppressants are often used by people with coughs.

However, there is not much research into cough medicines and how much they can actually reduce symptoms.

Home remedies

According to the National Health Service (NHS), United Kingdom, a homemade remedy with honey and lemon is as good, if not better than most over-the-counter (OTC) products sold in pharmacies.

Treatments are mostly aimed at making the patient feel a little bit better but generally do not decrease the length of the cough.

Honey — it coats the throat, resulting in less irritation and possibly less coughing. Honey is a demulcent (something that soothes).

Cough medications — some may help associated symptoms, such as fever or a stuffy nose. However, there is no compelling evidence that cough medicines are effective in making the cough go away faster. A variety of cough medicine is available for purchase online.

For small children, it is a good idea to talk to a doctor before giving OTC cough medicine. Some ingredients in cough medicines, such as codeine, can be dangerous for small children. There is no evidence that cough medicines help children, and they can actually be dangerous due to the side effects.

Cough suppressants — these suppress the cough reflex and are generally only prescribed for a dry cough. Examples include pholcodine, dextromethorphan, and antihistamines.

Expectorants — these help bring up mucus and other material from the trachea, bronchi, and lungs. An example is guaifenesin (guaiphenesin), which thins the mucus and also lubricates the irritated respiratory tract, helping to drain the airways. Cough expectorants are available to purchase over-the-counter or online.

In summary, coughs can be annoying and uncomfortable but, for the most part, they will clear up on their own. However, if a cough has continued for some time or got worse, it is still important to speak with a doctor.

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About a month after US Transportation Secretary Pete Buttigieg and his husband adopted their twins, the kids got a cold, which developed into a cough and then trouble breathing. What followed was a "terrifying" health scare, Buttigieg shared in a personal essay, describing the common yet often misdiagnosed sickness known as RSV.

Respiratory syncytial virus, more commonly referred to by the acronym RSV, is a respiratory virus that usually causes cold-like symptoms, according to the Centers for Disease Control and Prevention. Especially common in infants, almost all children get an RSV infection by their second birthday without too much cause for concern. But with more severe cases, RSV can cause infections such as bronchiolitis or pneumonia.

The twins, Penelope Rose and Joseph "Gus" August, were born prematurely and dealt with health issues during their first few weeks of life, putting them at higher risk for a severe case of RSV. The entire family were diagnosed with the virus: "For us it just meant a nasty cold, but for premature infants like them it was a serious threat," Buttigieg writes.

The twins were given oxygen and sent home a few days after receiving care. But Gus continued to struggle. "We started hearing words like 'serious' and then 'critical,' and soon the doctor was recommending we immediately transfer Gus to a full-scale children's hospital in Grand Rapids, about a hundred miles away, and place him on a ventilator," he continues. "Next thing we knew, the doctor had determined that the ventilator couldn't wait — Gus would need to be intubated now and then transferred." Fortunately, his condition improved enough to go home, and earlier this month, the twins celebrated their first birthday.

October is National RSV Awareness Month. Knowing what to look out for can save a life, so keep reading to learn more about how to prevent the virus and how to treat it.

What Is Respiratory Syncytial Virus?

It's a respiratory virus that usually causes cold-like symptoms. In high-risk babies — such as babies born prematurely, children under 2 born with heart or lung disease, infants with weakened immune systems, and children 8-10 weeks old — it can become a much more serious infection. Symptoms of RSV can include wheezing or difficulty breathing, decreased or no appetite, decreased fluid intake, sneezing and coughing, runny nose, and fever, according to the CDC. And severe cases of RSV can cause bronchiolitis or pneumonia.

How Is Respiratory Syncytial Virus Prevented?

Like with the common cold or COVID-19, washing your hands is an essential preventative measure, according to the Mayo Clinic. Avoiding exposure, keeping things clean by disinfecting surfaces, refraining from sharing glasses, and washing toys regularly are also listed as best practices. The Mayo Clinic also encourages parents not to smoke, as "babies who are exposed to tobacco smoke have a higher risk of getting RSV and potentially more-severe symptoms." If you do smoke, it's advised that you do it away from your baby — never in the house or car.

There's also a protective medication available, called palivizumab (Synagis). It's given in the form of a shot and designed for children under 2 who are at high risk of serious complications from RSV. Scientists are still working to develop a vaccine to protect against RSV.

If an infant has symptoms of a cold that aren't improving, take them to the doctor immediately.

How Is Respiratory Syncytial Virus Treated?

Most RSV infections go away on their own in less than two weeks, the CDC says. There's no current treatment plan to fight the infection, but for adults, you can relieve symptoms by drinking fluids to prevent dehydration and taking over-the-counter fever reducers and pain relievers. For children, talk to your healthcare provider first before giving them nonprescription cold medicines, and never give aspirin to children. In more severe cases when there is difficulty breathing, like with Buttigieg's twins, go to the hospital immediately. They may require additional oxygen or incubation.

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Human metapneumovirus (hMPV) is a viral illness that affects the upper respiratory tract. Several viruses can cause common cold symptoms, including hMPV. 

With hMPV, symptoms such as runny and stuffy nose are common. People may experience more serious effects in some cases, but most don't develop serious symptoms.

This article will take a closer look at the symptoms of human metapneumovirus, including frequent and rare symptoms and potential complications. It will also discuss when it might be time to seek medical help. 

Geber86 / Getty Images

Frequent Symptoms 

Most people who contract human metapneumovirus experience mild cold symptoms such as:

  • Runny nose
  • Congestion
  • Sore throat
  • Cough
  • Headache
  • Fever

Infants with human metapneumovirus may also experience weight loss.

Most people with mild symptoms will feel better within a few days and won’t require medical treatment. This virus most often circulates in winter and spring.

Rare Symptoms 

Some people with human metapneumovirus may develop shortness of breath. This is more likely in people with pre-existing respiratory conditions such as asthma (a chronic lung disease with constricted and inflamed airways). People with asthma may also experience flare-ups of their symptoms if they contract hMPV.

Other uncommon symptoms may include:

  • Trouble breathing
  • Wheezing (a high-pitched whistling sound when breathing)
  • Hoarse voice
  • Vomiting

Complications and Sub-Group Indications 

People are more likely to develop complications from a cold caused by human metapneumovirus if they are immunocompromised (have reduced immune system function).

However, hMPV is less likely to cause serious complications compared to other respiratory infections.

In some people, hMPV can develop into:

  • Pneumonia: Lung infection or inflammation of the airways and air sacs (alveoli)
  • Bronchitis: Inflammation of the bronchi, which are the larger air tubes in the lungs
  • Bronchiolitis: Inflammation of the smallest air tubes in the lungs (bronchioles)

What Is Bronchiolitis?

Bronchiolitis is inflammation of the smallest air passages in the lungs, the bronchioles. It is often caused by viral lung infections that primarily affect young children.

Symptoms may include:

  • Trouble breathing
  • Coughing
  • Fever
  • Fatigue
  • Intercostal retractions
  • Widening of nostrils while breathing
  • Fast breathing
  • Bluish tinge to the skin, which signals the need for emergency treatment

Children and Infants

According to the American Lung Association, between 5% to 16% of children who contract human metapneumovirus develop pneumonia, a serious lower respiratory tract complication. Infants are particularly susceptible to this kind of complication.

Infants under 1 year who develop serious complications may have a decreased appetite and display poor feeding. Additionally, children and infants with lung disease or who are born prematurely have a higher risk of developing complications.

One study found lower respiratory tract infection by hMPV was more common in infants and children whose birthing parent had asthma.

Symptoms of Pneumonia

Pneumonia is a potentially serious complication of hMPV that can cause:

  • Mucus-producing cough
  • Shortness of breath
  • Fever 
  • Sweating
  • Fast, shallow breathing
  • Chills
  • Pain in the chest coughing or breathing deeply
  • Nausea
  • Vomiting
  • Appetite loss 
  • Fatigue

Older Adults

People over age 75 are at greater risk of developing severe pneumonia from hMPV. Large outbreaks have been reported in nursing homes and skilled nursing facilities.

Symptoms of Bronchitis

Acute bronchitis (also called a chest cold) can cause symptoms such as:

  • Coughing, with mucus or without
  • Excessive fatigue
  • Body aches
  • Sore throat
  • Sore chest 
  • Headache 

Acute bronchitis develops because of an upper respiratory infection. Symptoms don't usually last longer than a few weeks.

Chronic bronchitis is characterized by long-term lung inflammation and is more serious. People with chronic bronchitis are at higher risk of developing complications due to respiratory infections like human metapneumovirus.

When to See a Healthcare Provider

Trouble breathing or shortness of breath are good indicators of when to seek medical attention. This may be a sign that the illness has developed into pneumonia or another lower respiratory tract infection.


Human metapneumovirus (hMPV) is a virus that causes the symptoms of the common cold. It’s one of many viruses that causes similar upper respiratory symptoms. Common symptoms are coughing, runny nose, and congestion. Some people may also experience shortness of breath. 

People with weakened immune systems, such as older adults and infants, are more likely to develop complications from hMPV. But most people's symptoms go away in a few days without treatment.

A Word From Verywell 

For most people, a cold is self-limiting and doesn’t cause serious symptoms. If you have a stuffy nose, cough, and a mild fever, chances are some rest and fluids will help you cope with discomfort and eventually lead you on the road to recovery.

It’s important to remember, though, that symptoms of COVID-19 can resemble those of the common cold. If you have plans to attend a large gathering or interact with people who may have weakened immune systems, it’s a good idea to take a COVID-19 test to check for a positive result.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Chest Physicians CHEST Foundation. Human metapneumovirus (hMPV).

  2. American Lung Association. Learn About human metapneumovirus (hMPV).

  3. Peña SA, Davis SS, Lu X, et al. Severe respiratory illness associated with human metapneumovirus in nursing home, New Mexico, USA. Emerg Infect Dis. 2019;25(2):383-384.  doi:10.3201/eid2502.181298

  4. Illinois Department of Public Health. Human metapneumovirus.

  5. Mount Sinai. Bronchiolitis.

  6. Libster R, Esteban I, Bianchi A, et al. Role for maternal asthma in severe human metapneumovirus lung disease susceptibility in children. J Infect Dis. 2021;223(12):2072-2079. doi:10.1093/infdis/jiaa019

  7. American Lung Association. Pneumonia symptoms and diagnosis

  8. Centers for Disease Control and Prevention (CDC). Chest cold (Acute bronchitis)

  9. American Lung Association. Chronic bronchitis.

  10. American Lung Association. Human metapneumovirus (hMPV) symptoms and diagnosis

By Steph Coelho

Steph Coelho is a freelance health writer, web producer, and editor based in Montreal. She specializes in covering general wellness and chronic illness.

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If you’ve ever spent a night tossing and turning, you already know how you’ll feel the next day — tired, cranky, and out of sorts. But missing out on the recommended 7 to 9 hours of shut-eye nightly does more than make you feel groggy and grumpy.

The long-term effects of sleep deprivation are real.

It drains your mental abilities and puts your physical health at real risk. Science has linked poor slumber with a number of health problems, from weight gain to a weakened immune system.

Read on to learn the causes of sleep deprivation and exactly how it affects specific body functions and systems.

In a nutshell, sleep deprivation is caused by consistent lack of sleep or reduced quality of sleep. Getting less than 7 hours of sleep on a regular basis can eventually lead to health consequences that affect your entire body. This may also be caused by an underlying sleep disorder.

Your body needs sleep, just as it needs air and food to function at its best. During sleep, your body heals itself and restores its chemical balance. Your brain forges new thought connections and helps memory retention.

Without enough sleep, your brain and body systems won’t function normally. It can also dramatically lower your quality of life.

A review of studies in 2010 found that sleeping too little at night increases the risk of early death.

Noticeable signs of sleep deprivation include:

Stimulants, such as caffeine, aren’t enough to override your body’s profound need for sleep. In fact, these can make sleep deprivation worse by making it harder to fall asleep at night.

This, in turn, may lead to a cycle of nighttime insomnia followed by daytime caffeine consumption to combat the tiredness caused by the lost hours of shut-eye.

Behind the scenes, chronic sleep deprivation can interfere with your body’s internal systems and cause more than just the initial signs and symptoms listed above.

Your central nervous system is the main information highway of your body. Sleep is necessary to keep it functioning properly, but chronic insomnia can disrupt how your body usually sends and processes information.

During sleep, pathways form between nerve cells (neurons) in your brain that help you remember new information you’ve learned. Sleep deprivation leaves your brain exhausted, so it can’t perform its duties as well.

You may also find it more difficult to concentrate or learn new things. The signals your body sends may also be delayed, decreasing your coordination and increasing your risk for accidents.

Sleep deprivation also negatively affects your mental abilities and emotional state. You may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity.

If sleep deprivation continues long enough, you could start having hallucinations — seeing or hearing things that aren’t really there. A lack of sleep can also trigger mania in people who have bipolar mood disorder. Other psychological risks include:

You may also end up experiencing microsleep during the day. During these episodes, you’ll fall asleep for a few to several seconds without realizing it.

Microsleep is out of your control and can be extremely dangerous if you’re driving. It can also make you more prone to injury if you operate heavy machinery at work and have a microsleep episode.

While you sleep, your immune system produces protective, infection-fighting substances like antibodies and cytokines. It uses these substances to combat foreign invaders such as bacteria and viruses.

Certain cytokines also help you to sleep, giving your immune system more efficiency to defend your body against illness.

Sleep deprivation prevents your immune system from building up its forces. If you don’t get enough sleep, your body may not be able to fend off invaders, and it may also take you longer to recover from illness.

Long-term sleep deprivation also increases your risk for chronic conditions, such as diabetes mellitus and heart disease.

The relationship between sleep and the respiratory system goes both ways. A nighttime breathing disorder called obstructive sleep apnea (OSA) can interrupt your sleep and lower sleep quality.

As you wake up throughout the night, this can cause sleep deprivation, which leaves you more vulnerable to respiratory infections like the common cold and flu. Sleep deprivation can also make existing respiratory diseases worse, such as chronic lung illness.

Along with eating too much and not exercising, sleep deprivation is another risk factor for becoming overweight and obese. Sleep affects the levels of two hormones, leptin and ghrelin, which control feelings of hunger and fullness.

Leptin tells your brain that you’ve had enough to eat. Without enough sleep, your brain reduces leptin and raises ghrelin, which is an appetite stimulant. The flux of these hormones could explain nighttime snacking or why someone may overeat later in the night.

A lack of sleep can also make you feel too tired to exercise. Over time, reduced physical activity can make you gain weight because you’re not burning enough calories and not building muscle mass.

Sleep deprivation also causes your body to release less insulin after you eat. Insulin helps to reduce your blood sugar (glucose) level.

Sleep deprivation also lowers the body’s tolerance for glucose and is associated with insulin resistance. These disruptions can lead to diabetes mellitus and obesity.

Sleep affects processes that keep your heart and blood vessels healthy, including those that affect your blood sugar, blood pressure, and inflammation levels. It also plays a vital role in your body’s ability to heal and repair the blood vessels and heart.

People who don’t sleep enough are more likely to get cardiovascular disease. One analysis linked insomnia to an increased risk of heart attack and stroke.

Hormone production is dependent on your sleep. For testosterone production, you need at least 3 hours of uninterrupted sleep, which is about the time of your first R.E.M. episode. Waking up throughout the night could affect hormone production.

This interruption can also affect growth hormone production, especially in children and adolescents. These hormones help the body build muscle mass and repair cells and tissues, in addition to other growth functions.

The pituitary gland releases growth hormone throughout each day, but adequate sleep and exercise also help the release of this hormone.

The most basic form of sleep deprivation treatment is getting an adequate amount of sleep, typically 7 to 9 hours each night.

This is often easier said than done, especially if you’ve been deprived of precious shut-eye for several weeks or longer. After this point, you may need help from your doctor or a sleep specialist who, if needed, can diagnose and treat a possible sleep disorder.

Sleep disorders may make it difficult to get quality sleep at night. They may also increase your risk for the above effects of sleep deprivation on the body.

The following are some of the most common types of sleep disorders:

To diagnose these conditions, your doctor may order a sleep study. This is traditionally conducted at a formal sleep center, but now there are options to measure your sleep quality at home, too.

If you’re diagnosed with a sleep disorder, you may be given medication or a device to keep your airway open at night (in the case of obstructive sleep apnea) to help combat the disorder so you can get a better night’s sleep on a regular basis.

The best way to prevent sleep deprivation is to make sure you get adequate sleep. Follow the recommended guidelines for your age group, which is 7 to 9 hours for most adults ages 18 to 64.

Other ways you can get back on track with a healthy sleep schedule include:

  • limiting daytime naps (or avoiding them altogether)
  • refraining from caffeine past noon or at least a few hours prior to bedtime
  • going to bed at the same time each night
  • waking up at the same time every morning
  • sticking to your bedtime schedule during weekends and holidays
  • spending an hour before bed doing relaxing activities, such as reading, meditating, or taking a bath
  • avoiding heavy meals within a few hours before bedtime
  • refraining from using electronic devices right before bed
  • exercising regularly, but not in the evening hours close to bedtime
  • reducing alcohol intake

If you continue to have problems sleeping at night and are fighting daytime fatigue, talk to your doctor. They can test for underlying health conditions that might be getting in the way of your sleep schedule.

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Whatever your level of activity, staying healthy is crucial. But missing a week or two of training due to an illness can cause a real setback for an endurance athlete. So what are the main illness culprits and how can we prevent them? 

The majority of illnesses that triathletes face are usually from the environment in which they train or race.

A recent review of 30 studies showed endurance athletes were more susceptible to respiratory infections than normal exercising controls. This is because depression in immunity, as seen in ultra-endurance athletes following competition, leads to the increased frequency of colds.

Furthermore, colds are more common in athletes with pre-existing chronic conditions related to an inflamed nasal lining, such as nasal allergies, due to increased ventilation and exposure to sport-specific environmental factors (e.g. pollution, pollen, dust, cold air or chlorination products).

What are URTIs? 

Upper respiratory tract infections (URTIs) are infections of parts of the body involved in breathing, such as the sinuses, throat, airways or lungs. Most URTIs get better without treatment, but sometimes you may need to see a GP.

What are the most common URTIs that affect triathletes?

The environmental illnesses encountered while running or cycling are the same airborne viruses you would encounter in any other area of life. There are, however, some more unusual ones that you can encounter when swimming, both in chlorinated pools and in open-water environments.


Many scientific research studies have outlined the myriad of diseases you can pick up in swimming pools, even with chlorination, that can be a little unnerving.

In 2019, a review listed a number of outbreaks at swimming pools over the last 70 years (1). The most common cause of illness was found to be adenovirus, which can survive for long periods in water, are very common (we’ve probably all had one at least), and can cause gastric, respiratory, eye or urinary symptoms.

Prevention – Keeping your nasal airway healthy reduces the risk of illnesses. Following a swimming session in the pool treated with chlorination products, it’s advisable to rinse your nose with a saline solution.

Gastrointestinal issues

In a 2019 review on illnesses contracted in lakes (2), open-water swimming was unsurprisingly at the top of the list due to total immersion and the risk of ingesting the water.

Although the causes were not discussed, the symptoms were mainly gastrointestinal, and the summer appeared to be higher risk, due to increased faecal indicator bacteria (yuck) than in the winter.

Prevention – A simple counter to this (with no evidence to it) is to have a cola drink after your swim!

  1. A review and update on waterborne viral diseases associated with swimming pools. Bonadonna L, La Rosa G. Int J Environ Res Public Health. 2019, 16(2), 166.
  2. Risk of human illness from recreational exposure to pathogens in freshwater bodies: a systemic review. Adhikary RK, Mahfuj MS et al. Exposure and Health. 2022, 14, 325-343

Infectious rhinitis (common cold) 

A study based on detailed training logs of the Norwegian triathlon national team members, demonstrated the source of virus transmission. Flights, unsurprisingly, were a major risk factor, likely due to crowded planes and dry air.

If sick athletes travel in groups to training camps or competitions, they tend to pass it on to their teammates, as has been evident with the Covid-19 pandemic.

Monotonous hard training was also identified as a risk factor for illnesses. This is likely related to a steady weakening of the immune system.

Prevention – Wearing masks or delay the flight to avoid travelling in a group. Interchange hard days with easy training sessions will also help to reduce the risk.

Treatment – In most cases, a common cold is a self-resolving viral disease, and the treatment is rest, hydration and symptomatic control. However, some medications can help to relieve the symptoms while you’re waiting to recover; these are listed in the table below.

Acute and recurrent tonsillitis

Acute tonsillitis often complicate URTIs. These are common in children and adolescents but can occur in athletes as part of recurrent URTI. One-off acute tonsillitis are not often a problem but recurrent episodes can be a real burden as it will negatively impact training and performance.

Prevention – As per ‘common cold’, above.

Treatment – For acute episodes, rest, take hydration symptomatic relief and antibiotic therapy. For recurrent episodes, especially for those who have suffered more that four episodes a year requiring antibiotic therapy, tonsillectomy may be beneficial.

Seasonal and perennial allergic rhinitis (hayfever)

Allergic rhinitis affects approximately 30% of the general population, so by definition the same percentage of triathletes will be affected.

As triathlon is a seasonal sport, athletes will be more susceptible to exposure to allergens, mainly pollen, during the three disciplines and this may have a negative impact on their performance. It will therefore be necessary to address their symptoms to maximise their performance.

Symptoms can include itchy red eyes, nasal watery discharge and blockage and shortness of breath, especially if you also suffer from seasonal or exercise-induced asthma.

Prevention – Non-sedating antihistamines, antihistamine eye drops, topical nasal steroids with or without topical antihistamines during the season. If symptoms are not controlled by the above medications, a desensitisation programme should be considered.

Treatment – The best treatment for AR is its prevention, as it will take a few days for some of these medications to have a full effect, especially the topical nasal steroids.

Fokkens WJ. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020 Feb 20;58(Suppl S29):1-464. doi: 10.4193/Rhin20.600. PMID: 32077450

Exercise-induced laryngeal obstruction (EILO)

EILO is a condition that has been more recently recognised. It occurs when the athlete starts breathing hard, massively increasing the airflow through the larynx (voicebox).

Normally the muscles in and around the larynx open up the airway maximally to allow as much air through as possible.

However, in EILO some of the tissues are more flexible, or floppy, than normal and increasing airflow causes these tissues to collapse into the airway, narrowing it and causing noisy breathing (stridor) and a restriction in exercise tolerance.

This can happen without any stimulus and these cases are a function of increased airflow due to increased breathing rate, but it can also be triggered if the airway is sensitive to certain airborne particles, such as pollens or chlorinated water.

If this happens regularly then a referral to a specialist may be needed. You’re not on your own though, as there are a number of elite international athletes who have struggled with ‘asthma’ only to find out that they have EILO.

Prevention – Awareness and avoidance of trigger factors.

Treatment – Diagnosis and treatment will require specialist referral. Speech-behavioural therapy, inspiratory muscle training, general relaxation and psychotherapy are all part of upfront treatment strategies. In severe cases, it can be corrected surgically in the form of supraglottoplasty.

Otitis externa

Otitis externa is an infection of the external ear canal. It’s very common in swimmers and it’s due to the water getting in the ear canal and not being properly cleared, mainly due to wax build-up.

The symptoms include ear pain, especially when pressing the tragus (small cartilage protrusion in front of the ear canal), discharge (usually watery) and referred pain to the side of the head and jaw.

Prevention – Appropriate ear protection with both a swim cap and ear plugs.

Treatment – Topical antibiotic with steroid ear drops or spray in mild cases may be sufficient. In severe cases, systemic antibiotics, anti-inflammatories and suction clearance of the wax and debris may be required.

Osteomas or exostosis (swimmer’s or surfer’s ears)

Osteomas and exostosis are chronic swellings of the lining of the ear canal caused by recurrent exposure to cold water.

Prevention – Appropriate protection of the ear canal with a swim cap and ear plugs.

Treatment – Most patients do not require any treatment except in severe cases where surgical removal might be necessary.

Additional author biography:

Dr Nicholas Gibbins, MBBS, BSc (Hons), FRCS(ORL-HNS), MD, is consultant otolaryngologist and voice surgeon at University Hospital Lewisham. He graduated from Guy’s and St Thomas’ Hospitals, London in 1998 and trained in Wessex and London. 

He’s known primarily for his work with professional voice users, including professional singers and actors, and has a specialist interest in EILO in athletes. He’s an expert in the treatment of vocal fold scar and sulcus and is one of the only people in the world to investigate and treat disorders of the throat and voice that are caused by distal biomechanical factors.

With this work he’s built up a wide network of expert allied professionals who can help manage throat and voice issues, including speech therapists, physiotherapists, osteopaths, vocal rehabilitation coaches and psychologists.

He’s on the vocal health working group for the British Association of Performing Arts Medicine and has advised for West End Theatre Companies.

He’s been awarded a number of prizes for his work including the Registrar’s Gold Medal for research in 2011. Other awards include the Van Lawrence Prize and the David Howard Prize. He’s published more than 30 articles and written eight text-book chapters regarding the management of voice disorders and on ENT emergencies. He’s an external examiner for the University of Canterbury Christ Church in the MCh for Otolaryngology. 

Nick has participated in triathlons since his medical school days and he’s a keen long-distance racer. 


Top image credit: Getty Images

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Tightness in the throat can make you feel as if your airway passage is narrowed, with symptoms of difficulty swallowing or breathing. You may feel as if there's a lump in your throat, or that it's swollen or closed off, in ways that are different from a sore throat or common cold.

The causes of throat tightness can vary in their severity. For example, gastroesophageal reflux disease (GERD) is a common and treatable condition affecting the esophagus, the tube that carries food to the stomach. But an allergic reaction that closes off the trachea, the tube that carries oxygen to the lungs, is a life-threatening emergency.

This article explains tightness in the throat, and how it is diagnosed and treated. It will help you to know which structures and muscles may be involved, and why you may need to see a healthcare provider.

Cunaplus_M.Faba / Getty Images

Causes of Throat Tightness

Throat tightness often arises with other symptoms, including a sense of burning in the throat or the frequent need to clear the throat. These symptoms may occur at specific times, like when you have tightness in throat after eating or when you first wake up.

The pattern of symptoms can help you and your healthcare provider to understand the cause.

GERD or Acid Reflux

Gastroesophageal reflux disease (GERD) is extremely common throughout the world, and the incidence is escalating in the United States. Since 2010, it has particularly increased among individuals 30–39 years of age. The prevalence is approximately 18.1% to 27.8% in North America.

GERD causes stomach acid to reflux into the esophagus, sometimes even reaching the back of the throat. Stomach acid is very damaging to the tissue of the esophagus and throat. This creates symptoms such as heartburn, sore throat, coughing, hoarseness, and in some cases, throat tightness.

A narrowing of the esophagus can occur when the tissue is damaged and scar tissue is formed. This can make it difficult to swallow, create a feeling of tightness in the throat, or make it feel like you constantly have a lump in your throat. Food may also become lodged in the esophagus.


An estimated 40 million adults in the United States live with an anxiety disorder, and six million of those have been diagnosed with panic disorder.

Anxiety disorders can result in what is called anxiety or panic attacks. During these episodes, you may feel an overwhelming sense of anxiety and fear, which causes your heart to pound. You also may hyperventilate, with breathing that's rapid and shallow.

These breathing episodes can dry out your throat. They can cause tightness in the throat, along with symptoms of:

  • Dizziness and lightheadedness
  • Air hunger (feeling like you can’t get enough air)
  • Excessive sweating
  • Body chills and trembling

Although it feels like a medical emergency, anxiety and panic attacks typically are not.


Tightness in the throat may be caused by tonsillitis. It is an inflammation of the tonsils (usually the palatine tonsils) and is an extremely common condition, although the exact incidence is unknown.

A second set of tonsils, called the lingual tonsils, is located in the throat below the palatine tonsils. While less common, the lingual tonsils can also become swollen and inflamed.

Some consider the adenoids to be the third set of tonsils, but they are located above the other two sets of tonsils and are unlikely to cause throat tightness.

Tonsillitis can be acute or chronic and has a myriad of underlying causes, including bacterial infections such as strep throat, viral infections such as mononucleosis, and allergies.

Symptoms of tonsillitis include sore throat, red throat, and difficulty swallowing. In rare cases, when the tonsils become very large, you may feel throat tightness or even have difficulty breathing.

Muscle Tension Dysphonia (MTD)

Muscle tension dysphonia (MTD) is a condition where the muscles surrounding the larynx (the voice box) become so tight that they fail to function properly.

Symptoms of MTD include:

  • Hoarseness
  • Voice straining
  • A sore and tender neck
  • Sense of a lump in your throat
  • Needing to clear your throat a lot

Muscle tension dysphonia may be more prevalent than researchers think, since there is evidence it is common in people who have severe asthma.


A goiter is a benign (non-cancerous) enlargement of the thyroid gland. It is more common outside of the United States, in areas where there are iodine-deficient soils and table salt is not enriched with iodine, but it occurs in the United States also.

If the thyroid becomes too large, it can compress the trachea and/or esophagus and create problems with breathing and swallowing, as well as throat tightness.

Allergic Reaction

Anaphylaxis is a life-threatening allergic reaction that can cause a dangerous swelling in your throat, closing off your airway and preventing you from swallowing and breathing properly.

It usually occurs as a result of allergies to insect bites and stings, certain foods and medications, or latex. While allergies to these substances are very common, anaphylaxis is not.

Throat Tightness and Anaphylaxis

Anaphylaxis is a medical emergency. You should call 911 and use epinephrine (if you carry it) as soon as signs and symptoms appear. These include severe itching, redness, swelling of the tongue or difficulty talking, swelling of the lips, tightness in the throat or chest, or difficulty breathing or swallowing.

When to See a Healthcare Provider

Tightness in the throat tightness doesn't always impair your ability to breathe or swallow. You should still see a healthcare provider even though it's not a medical emergency. For example, in rare cases, untreated strep throat can lead to kidney and heart problems.

If you carry epinephrine and go into anaphylaxis, you should still call 911 or go to the emergency room even after giving yourself epinephrine, as further treatment is usually necessary. It is possible to go back into anaphylaxis even hours after your initial symptoms have subsided.

With the exception of an identified panic or anxiety attack, any throat tightness that impairs your ability to breathe or swallow is a medical emergency. You should call 911 or go to your nearest emergency room.

Diagnosing Throat Tightness

With throat tightness, an accurate medical diagnosis will be based on your symptoms and personal medical history. Your healthcare provider will want to know how and when you experience symptoms, such as throat tightness with exercise or during stressful episodes of anxiety.

A physical examination and one or more of the following tests may be used to diagnose the disorders that can cause tightness in the throat:

Some conditions, including anxiety disorders and MTD, do not have specific or definitive diagnostic tests. They are diagnosed by carefully considering your symptoms and medical history, and then ruling out other similar conditions that could be causing your symptoms.

Throat Tightness and Treatment

Tightness in the throat is treated on the basis of its cause. Some treatments are comparatively simple and rely on medication and lifestyle changes. Others may involve surgery.

GERD or Acid Reflux

While antacids such as Tums (calcium carbonate) may be adequate for treating occasional heartburn, they probably won’t cut it if your symptoms are severe enough that you’re experiencing tightness in the throat.

Medications such as Pepcid (famotidine), an H2 blocker, or proton-pump inhibitors like Prilosec (omeprazole) are better at reducing acid and facilitating the healing of damaged esophageal tissue.

Even though many of these medications are available over-the-counter, it is recommended that you consult a healthcare provider before taking them.

Severe cases of GERD may warrant treatment with surgery. The esophagus can be dilated via endoscopy to improve swallowing, or other procedures such as fundoplication may be needed.


Treatment for anxiety disorders may include talking to a therapist, joining a support group, or cognitive behavioral therapy (CBT). Treatment also may rely on medication, including:

Adequate treatment can help to reduce the frequency of panic attacks.

If you know you are having a panic attack, there are steps you can take. They include:

  • Sitting down so that you don’t pass out and injure yourself
  • Finding a comfortable area where you will be safe and not hit your head if you faint
  • Having another person with you in the rare event that you do need medical attention
  • Focusing on slow, deep breaths. If you cannot slow your breathing down, you can try breathing through pursed lips or into a paper bag to treat hyperventilation.

Don’t breathe into a paper bag if it increases your anxiety, however. You may feel that you are unable to breathe or that you are having a heart attack, but this is not actually the case. Most panic attacks last between five and 20 minutes.


While the treatment for tonsillitis may vary depending on the cause (antibiotics for strep throat, for example), the actual swelling in the tonsils can be treated with steroid medications in some cases.

For chronic tonsillitis, a complete tonsillectomy may be necessary.

Muscle Tension Dysphonia

Voice therapy is the most common treatment for MTD. In some cases, botox injections are used to stop muscle spasms.


The treatment for thyroid goiter varies depending on the root cause. For example, if the cause is iodine deficiency, then iodine supplements may help. In other cases, you may need thyroid hormone supplements. When the goiter cannot be reduced with medications, surgery may be necessary.

Allergic Reaction

The most important treatment for a serious allergic reaction is epinephrine. If you don’t carry epinephrine with you, you must call 911 or get to a hospital right away to get this crucial medication.

In addition to epinephrine, you may also be treated with oxygen, IV fluids, antihistamines, and steroid medications, but these are all secondary to the prompt administration of epinephrine. Never delay emergency medical care if you suspect you are having a severe allergic reaction.

Home Remedies

There are a few simple things you can do at home to help relieve throat tightness. If you have acid reflux, for example, taking an over-the-counter antacid may provide some immediate relief.

You should also keep your head elevated rather than lying down flat to sleep at night so that stomach acid is less likely to travel up the esophagus. Pay attention to what foods trigger your symptoms so you can avoid them in the future.

Swollen tonsils can respond to cold food and fluids, or you can put an ice pack on your neck. It may also be helpful to sleep with a cool mist humidifier next to your bed at night.


Not all causes of throat tightness are easily prevented, but there are things you can do to lower your risk. Use the following tips to prevent throat tightness:

  • If you have been diagnosed with one of the conditions above known to cause throat tightness, make sure you work with a qualified healthcare professional to develop a good treatment regimen and then stick to it.
  • If you have allergies and risk anaphylaxis, talk to your healthcare provider about carrying epinephrine.
  • Wash your hands and stay away from people who are sick to prevent throat infections. Get plenty of sleep and exercise to bolster your immune response.
  • Pay attention to potential triggers such as allergies or foods that bring on your symptoms so that you can avoid them.
  • If you have anxiety, note potential triggers as well as things that alleviate your symptoms. Practice deep breathing techniques. Consider support groups.
  • If you have acid reflux, avoid lying down flat and instead keep your head elevated. Avoid overeating and instead opt for smaller, more frequent meals.
  • Protect your voice by not overusing or straining it.

A Word From Verywell

Tightness in the throat may not have a serious underlying medical cause, but it's still important to see a healthcare provider for a diagnosis. Once you've identified the cause, you'll learn more about treatment options for the condition.

Frequently Asked Questions

  • What causes a throat muscle spasm?

    Throat muscle spasms can be caused by muscle tension dysphonia (MTD), a condition that occurs when muscles around the larynx tighten too much. Cricopharyngeal spasm, caused by a muscle in the throat contracting too much, also is a possible cause.

  • Why does my throat feel strained when talking?

    Muscle tension dysphonia (MTD) can cause strained throat or voice straining. Other symptoms include hoarseness, a sore and tender neck, the sensation of a lump in the throat, and feeling the need to clear the throat often.

  • Can you have tightness in the throat with COVID-19?

    It's possible, but if it's COVID-19 you'll also have more common COVID symptoms like fever and a dry cough. The hoarseness and difficulty swallowing linked to throat tightness are more likely to have another cause, such as tonsillitis.

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How long is a cold contagious is a common question. The short answer: A cold is most contagious during the first four days. However, some viral strains can continue to spread for up to a month.

Each year, millions of cases of the common cold occur in the United States. According to the Centers for Disease Control and Prevention (CDC), hundreds of different cold viruses spread easily from person to person.

The common cold is an almost inevitable part of life and can be difficult to avoid. Understanding the risk of transmission and taking proper precautions can help stem the spread of colds.

This article explains how colds are spread and when they are the most contagious. It also discusses ways to lower your odds of catching a cold and how to prevent spreading a cold to a loved one.

Verywell / Ellen Lindner

How Are Colds Contagious?

Cold viruses are spread through airborne droplets, person-to-person contact, and contact with contaminated surfaces.

When a person is sick with a respiratory virus, coughing and sneezing propel droplets into the air. The virus-loaded droplets land on surfaces or enter someone else's upper respiratory tract.

Cold viruses can live on surfaces for several hours, making it possible to become infected if you touch a contaminated surface and then your nose. This is referred to as fomite transmission.

Most colds are caused by strains in the rhinovirus and coronavirus families. Adenovirus, metapneumovirus, parainfluenza, and respiratory syncytial virus (RSV) are other viruses that cause upper respiratory symptoms.


Colds are spread through airborne droplets. The virus can also be passed through person-to-person contact or contact with contaminated surfaces.

How Long Are You Contagious?

The incubation period for a cold virus is 24 to 72 hours. This is how long it takes for symptoms to appear after you become infected. For the common cold, symptoms start to develop one to three days after exposure to the virus.

Colds are most contagious one to four days after symptoms develop. Common cold symptoms include:

  • Congestion
  • Coughing
  • Headache
  • Runny nose
  • Sore throat

Not everyone gets all these symptoms, and the severity can vary.

Most colds last for about a week, but it's possible to spread the virus after that. Cold viruses can persist in the body for up to four weeks.

While the risk of airborne or fomite transmission decreases rapidly over time, infecting others may still be possible even if you no longer have symptoms.


The incubation period of cold viruses is between 24 and 72 hours. Colds tend to be most contagious one to four days after symptoms appear but can continue to be contagious well after symptoms resolve.

Prevention Tips

If you get a cold, the best way to avoid spreading the virus is to isolate yourself. When around others, it helps to wear a face mask to catch respiratory droplets if you cough or sneeze. People who live with you can do the same.

Be sure to cover your mouth when coughing or sneezing. It is best to cough or sneeze into the crook of your arm; in this way, you can avoid contaminating your hand. You can cough or sneeze into a tissue but will need to wash your hands afterward (or use an alcohol-based hand sanitizer).

You and others in your household should frequently wash your hands and regularly clean surfaces. Try your best to avoid touching your face (like scratching or rubbing your nose).

It's especially important to take these precautions when you are in contact with people who are at an increased risk of complications. These include:

While a cold may not necessarily be worse in these individuals, your symptoms may turn out to be something more dangerous, like the flu or COVID-19. To be safe around high-risk people, continue to use precautions for a week after cold symptoms abate.


You can prevent the spread of colds by isolating yourself, wearing a face mask, covering your mouth when coughing or sneezing, washing your hands frequently, and cleaning surfaces.

What To Do If You Are Exposed

While there are no vaccines to prevent colds or surefire ways to avoid cold symptoms, there are things you can do that may reduce the severity or duration of a cold. These include:

  • Getting plenty of rest
  • Increasing fluid intake to prevent dehydration
  • Sipping warm tea, warm soup, or warm apple juice to loosen congestion
  • Using a cool-mist vaporizer or humidifier
  • Gargling with salt water to relieve a sore throat
  • Using over-the-counter saline nasal drops or sprays to treat a stuffy nose


Colds are spread by airborne droplets, person-to-person contact, and touching contaminated surfaces. Colds are most contagious one to four days after cold symptoms appear but may be contagious even longer.

If you get a cold, you can prevent the spread of the virus by isolating yourself, wearing a face mask, covering your mouth when coughing or sneezing, washing your hands frequently, and regularly cleaning surfaces.

Treating a cold properly, including getting plenty of rest, may reduce its duration or severity.

A Word From Verywell

No one enjoys catching a cold, but by taking a few standard precautions, you may be able to avoid spreading the virus to others. Out of courtesy to others, taking time off from work or school is best if you have cold symptoms.

The same applies if you are scheduled to go to an event or location where there will be a lot of people, such as a concert or a movie theater. Even if you're not entirely sure you are sick, you should avoid going out as you may inadvertently be the cause of a super-spreader event.

Frequently Asked Questions

  • Is there a vaccine for the common cold?

    No. Colds can be caused by hundreds of different viruses. This makes it virtually impossible to develop a single vaccine or preventive medication.

    While a cold can feel miserable, it typically resolves in a week to 10 days without complications. As such, isn't a serious health threat that would benefit from a vaccine like COVID-19.

  • Can you catch a cold from kissing?

    Yes, kissing a person with a cold can transmit a virus. You can catch a cold virus from any close contact with a sick person.

    Colds are most contagious during the first four days of cold symptoms. However, cold viruses can persist in the body for up to a month.

  • How long is a toddler cold contagious?

    Toddler colds can be caused by different viruses. One of the more contagious strains is respiratory syncytial virus (RSV). According to the Centers for Disease Control and Prevention, RSV is typically contagious for three to eight days. However, in some cases, children may still be contagious with RSV for up to four weeks.

  • Can a cold pass back and forth between people?

    Possibly, but it's not likely. Cold viruses spread easily from person to person. Most of the time, once you catch a specific virus, your body produces antibodies to ward off another invasion from the same virus.

    There are hundreds of different viruses that cause the common cold. What may seem like the same cold circulating through a household, workplace, or school is more likely a different viral strain.

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Elderberry is dark purple fruit from the elderberry shrub. It's a rich source of antioxidants known as anthocyanins.

Some claims about elderberry's benefits have more scientific backing than others. These include:

  • Treating the common cold and the flu (influenza)
  • Pain relief
  • Disease prevention

Traditional uses with less evidence behind them are for:

In addition to the fruit itself, you can get elderberry through commercial supplements in the form of gummies, lozenges, syrups, teas, and more.

In this article, you'll learn about the evidence behind elderberry's benefits and how to take it plus the possible side effects, drug interactions, and other potential dangers you should be aware of before using this fruit medicinally.

Verywell / JR Bee

Health Benefits

The European elder (black elderberry, Sambucus nigra) is the species most often used in supplements. Other elder species also produce anthocyanin-rich berries, as well.

Many of elderberry's health benefits are linked to anthocyanins. Some research suggests they may:

  • Clear your body of free radicals (unstable molecules that damage cells and may cause disease)
  • Have antiviral properties that prevent or reduce the severity of some common infections
  • Have anti-inflammatory benefits due to changing your body's immune response

Colds and Flu

Elderberry juice syrup has been used for centuries as a home remedy for viral illnesses like the cold and flu. Some researchers have concluded that this syrup shortens the duration of some illnesses and makes them less severe.

Some preliminary evidence from small studies appears promising.

  • In a 2019 study on elderberry for cold and flu, it appeared to greatly reduce upper airway symptoms.
  • A 2012 study suggested elderberry could help prevent influenza by stimulating an immune response.
  • A 2016 study on airline passengers suggested using elderberry extract for 10 days before and five days after a flight led to milder symptoms and 50% fewer sick days from the cold.

In the air travel study, while it appeared to lower the duration and severity of the illness, it didn't appear to prevent it. Both the elderberry group and placebo group had about the same infection rate.

Pain Relief

Anthocyanins are known to reduce inflammation. Those in elderberry do so by blocking nitric oxide production in your immune system.

Nitric oxide tells the immune system to cause inflammation, which is part of its response to illness or injury. Elderberry seems to slow down the inflammatory response, which may lower swelling and the pain it can cause.

Topical elderberry tinctures and salves have long been used in folk medicine to treat:

Few studies have investigated elderberry's anti-inflammatory or pain-relieving benefits in humans. Evidence should be considered preliminary.

Disease Prevention

Some alternative healthcare providers say elderberry's antioxidant effects can reduce your risk of cancer and heart disease.

While it's true that antioxidant-rich diets may offer such benefits, no studies have been done that directly link elderberry consumption to better disease outcomes.

Nutritional Data

One cup of elderberries provides:

  • 106 calories
  • 1 gram of protein
  • 27 grams of carbohydrate
  • 10 grams of fiber

When it comes to the recommended daily allowance of vitamins and minerals, a cup of elderberries contains:

  • Vitamin C - 58% 29% of the RDA
  • Vitamin B6 - 20%
  • Iron - 13%
  • Potassium - 9%

Possible Side Effects

Ripe, cooked elderberry fruit is considered safe to eat in moderation. As with several other fruits, eating a lot can cause:

  • Diarrhea
  • Stomach ache
  • Abdominal cramping


Elderberries should always be cooked before they're consumed. Certain parts of the plant contain a poison called known as cyanogenic glycoside—cyanide. It's in the:

  • Leaves
  • Roots
  • Bark
  • Stems
  • Unripe, raw berries

Unripe elderberries can release cyanide into your body and make you sick. Even ripe berries contain trace amounts, so elderberries must be cooked before you eat them.

Poisoning Symptoms

Poisoning from elderberries is rarely life-threatening. But it may cause:

Get medical attention if you develop these symptoms after consuming elderberry.

Who Shouldn't Take It

Elderberries may not be safe for some groups of people. No safety information is available about elderberry use:

  • In children
  • During pregnancy
  • While breastfeeding

Don't consume elderberries if:

  • You have an autoimmune disease
  • You've had an organ transplant
  • You're taking medication for diabetes

Drug Interactions

Elderberry products may interact with drugs that suppress the immune system and make them work less efficiently. Examples of these drugs are:

Forms and Dosages

Elderberries have long been cultivated for food and to make natural medicines. Products are available in many forms, including:

  • Syrups
  • Teas
  • Capsules
  • Gummies
  • Tonics
  • Tinctures
  • Topical ointments

The ripe berry is tart and typically sweetened (like cranberries).

For Cold and Flu Symptoms

Treatment should start no later than 48 hours after the first cold or flu symptoms appear. As a general rule, you shouldn't take more than what the manufacturer recommends on the label.

Many commercial syrup manufacturers recommend taking 1 tablespoon (15 milliliters) of elderberry syrup four times a day to treat cold or flu symptoms. Elderberry lozenges (175 milligrams) can be taken twice daily.

Keep in mind that elderberry should never be used as a substitute for conventional medical care. Self-treating a condition and delaying standard medical treatment may have serious consequences.

What to Look For

Elderberry-based medications are classified as dietary supplements by the U.S. Food and Drug Administration (FDA). Under this classification, they're not meant to be sold or marketed as a treatment for any medical condition.

Because supplements aren't required to undergo rigorous research or testing, they can vary significantly in quality. To ensure quality and safety, only buy supplements that are certified by an independent certifying body, such as:

  • U.S. Pharmacopeia (USP)
  • NSF International
  • ConsumerLab

This certification doesn't mean the product is effective, only that it's not contaminated and actually contains what the label says it does.

Safety Warning

If you eat fresh berries, be sure you buy them from a reputable source. It's never safe to eat unknown berries in nature, as they may have dangerous effects. If you have eaten an unknown berry and develop concerning symptoms, get immediate medical attention.


Elderberry is a fruit that's long been used in traditional medicine and appears to have some medicinal benefits. These include treating the cold and flu, relieving pain, and possibly helping prevent disease due to their antioxidant activities.

You can take elderberry supplements in several forms, including gummies, syrups, teas, and capsules. Don't eat unripened berries in any form, as they can make you sick. Ripe berries should always be cooked before consumption.

Frequently Asked Questions

  • What is elderberry most commonly used for?

    Elderberry is most commonly used as a cough syrup. Research suggests elderberry juice syrup may help treat upper respiratory symptoms of colds and flu.

  • Is it safe to take elderberry every day?

    Commercially made elderberry supplements shouldn't contain cyanide, so they're considered safe for daily use. Only take the amount recommended on the label.

    Use homemade elderberry syrup—sometimes marketed as artisan, handcrafted, or small-batch—with caution as it may contain small amounts of cyanide.  

  • How should I store fresh elderberries?

    Elderberries will keep longer if they're stored in the refrigerator.

  • How do you make elderberry syrup?

    1. Combine 2 cups of dried elderberries with 4 cups of cold distilled water in a heavy saucepan.
    2. Bring it to a boil, reduce heat, and cook uncovered for 30 to 40 minutes. Stir regularly.
    3. Remove from heat and steep for 1 hour. Strain mixture into a large measuring cup covered with cheesecloth, reserving liquid and discarding the used berries.
    4. Allow syrup to cool, then stir in 1 cup of honey. Pour mixture into a sterilized container.
    5. Seal and store in the refrigerator for up to three months.

    You can buy dried berries online and in health food stores.

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Researchers have developed a novel wrist-worn device that marks itself as a good candidate for detecting the symptoms of COVID-19 before they can actually occur. Although the technique is not new, researchers have utilized almost the same mechanism to detect the symptoms of influenza and the common cold as reported in research published last year. However, this new device has been specifically designed by incorporating an algorithm to detect the symptoms of COVID-19 a couple of days before they occur. It should be noted that the research work for this detecting device began in 2020 when COVID-19 was spreading like a wildfire.

The wristwatch, known as the “Ava Bracelet,” has been given to 1,000 young participants who participated in this continued research work. It is made to be worn at night and can detect “heart rate, breathing rate, skin temperature, heart rate variability, and blood flow” every 10 seconds. As the study completed its one-year, there was a lab-confirmed case of COVID-19 from the 11% population. Moreover, half of those COVID-positive patients wore the device at a much higher frequency, which ultimately assisted researchers in setting up an algorithm through the data gathered from these participants that can detect the infection as soon as it progresses into the body, even before the presence of any physical symptoms.

The researchers said, “Wearable sensor technology is an easy-to-use, low-cost method for enabling individuals to track their health and well-being during a pandemic. Our research shows how these devices, partnered with artificial intelligence, can push the boundaries of personalized medicine and detect illnesses prior to SO [symptom onset], potentially reducing virus transmission in communities. “

Coupled with this, the algorithm that was being designed after gathering data from the population under consideration was then trained on 70% of the COVID-positive group. The algorithm was then applied to 30% of the remaining population, and guess what? Through the algorithm, around 68% of infected patients were caught by this wearable device even two days before their symptoms started to appear.

According to David Conen, who is the author of this study, “That an existing medical device is able to be used in a different meaning [shows] that wearables have a promising future. This is not related only to COVID; in future diseases, it could also lead to preventative treatments and prevent significant complications. ” Apart from this, the team is now expanding their research and it was reported that they are implementing the procedure on about 20,000 people, the results of which are expected in the last quarter of this year.

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MUMS have shared videos of their seriously unwell babies in order to help other parents spot the vital signs of illness.

Children always seem to have some bug of another, with many having surged following the Covid-19 pandemic.

Mums shared videos of their little ones in order to raise awareness of breathing issues


Mums shared videos of their little ones in order to raise awareness of breathing issuesCredit: CPR Kids
The experts said that you should look out for their breathing as they could display red flags which need urgent medication attention


The experts said that you should look out for their breathing as they could display red flags which need urgent medication attentionCredit: CPR Kids

This is because it's the first years many little ones have had without any restrictions.

While most people know what to do when it comes to signs and symptoms of the common cold, there are other illnesses that you may not have come across.

Posting to CPR Kids, first aiders said parents should also be on the lookout for respiratory distress.

Paediatric nurse and managing director of the company, Sarah Hunstead said clips like the ones shared by mums help to empower everyone, by showing what respiratory distress can look like.

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The first clip, is one of a young boy who is experiencing a tracheal tug.

Sarah explained that this is when you can see visible sucking in a the neck.

"This is another 'red flag' of respiratory distress and requires urgent medical attention," she said.

The other clip was of a little girl who was also breathing heavily, sucking in her chest.

She reassured followers that both of the children were now doing well, but added that with so much sickness around 'it is so important that everyone knows how to spot when a little one needs you to take action'.

The NHS says that there are many reasons your child might be breathing faster or have an altered breathing pattern.

Guidance states that this could be because they are acutely unwell with a virus or many other reasons.

They added that you don't need to know why - but that acting fast is crucial.

What to do if your child's breathing has changed

Medics state that if your child has one or more then you should seek help.

  • noisy breathing - breath that sounds like grunting
  • nasal flaring - nostrils widening when breathing
  • mood change - sleepier, difficult to wake, fussier
  • accessory muscle use - shoulders elevating when breathing
  • head bobbing- bobbing forwards
  • change in body position - altering posture to breath better
  • retractions around the collarbones, in-between the ribs or if the tummy pulls beneath the rib cage.
  • pale or bluish skin
  • clammy skin.

If any of these happen then try and stay calm and reassure your child.

Make sure they are in a comfortable position in order to ease breathlessness.

If they have a reliever inhaler, give them this and is they have a chest physiotherapy programme –complete this.

If after a couple of minutes they continue to show these signs then contact 999 immediately.

In the event of an emergency and if your child is unresponsive - always call 999.

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