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After the first whiff of cigarette smoke, the coughing spasm takes her. It doesn’t let go and soon seems to acquire a life of its own. She coughs and coughs as her concerned family stands by, helplessly trying to offer her water. She can barely see them; her eyes are red and watering continuously. After more than five minutes of coughing, her body can’t take it anymore and she faints.

Later at the hospital, after several tests, the doctor confirms his initial diagnosis of acute viral bronchitis. Now, both for the ill person and those around her, it seems impossible to believe that the degree of her misery is not an indicator of the seriousness of her disease. But in this case, it isn’t. You might be feeling absolutely terrible, but the good news is that you’ll be just fine…given enough time.

It won’t kill you but it’ll make you suffer…but what is bronchitis exactly? “The trachea is the large breathing tube extending down from the larynx or voice box. It divides into two bronchi, which in turn keep dividing right down the line into numerous smaller bronchi,” explains Dr. Vajira Tennekoon, a consultant physician and chest specialist; “Bronchitis simply means an inflammation of these bronchi.” Most of the time bronchitis is caused by a viral infection of some sort.

Also, bronchitis may be only one manifestation of a viral infection or flu. Patients with the flu, for instance, may also complain of several other problems such a runny nose, sore throat, muscle and joint pain, diarrhoea and a bad cough. “Acute bronchitis is usually not a serious illness…and in most instances the symptoms last about 5 -7 days, with fever, cough and phlegm after which it settles.”

However, a more recent strain of the viral infection is proving to be a lot harder to shake off. “There is this particular type of acute viral bronchitis that is going around where the cough just persists for weeks on end without any respite,” Dr. Tennekoon says.

“In acute viral bronchitis the cough can last anywhere up to two months, and I have seen patients who have gone on coughing for up to 3 months…even though it is still a pure bronchitis and nothing more serious than that.”

Nevertheless, Dr. Tennekoon reveals that the infection takes a heavy toll. “It just saps your energy and your body is a complete sore because of violent coughing.” In addition, sleep is hard to come by because the coughing keeps you up all night. Due to the inflammation of the breathing tubes, someone with bronchitis is at risk of developing a wheeze. However, Dr. Tennekoon says that it’s a one off thing and that once the bronchitis settles the wheeze will also automatically disappear. However, he cautions that in such cases it might be hard to differentiate between asthma and acute viral bronchitis.

Since it’s a viral infection, antibiotics (which mostly work only on bacteria) cannot be used to treat it. “Of course there are anti-viral drugs that could be used to treat more serious infections such as viral pneumonia,” he explains, adding that since acute viral bronchitis is a relatively harmless, self limiting disease there’s really no justification in using expensive and potent anti-viral treatment for it. There is cause for concern when a patient with a co-existing disease (such as chronic bronchitis) suffers an attack of acute bronchitis. In such cases, the pre-existing illness must be dealt with as well.

In the end, for the person diagnosed with pure bronchitis, it is the simple things that make the difference. “A cough syrup of some kind, lozenges to soothe the throat, and Paracetamol for the fever is probably all you need.” Simultaneously, one must take care to avoid things that trigger the violent coughing spasms such as irritant fumes, smoke, aerosol sprays and cold drinks. Bronchodilator medicines, such as the ones used in the treatment of asthma may give some relief. If you have a high fever, cough and a cold that has persisted for more than two or three days, visiting a doctor becomes a must. “There are a lot of nasty viral infections going around in the city – take for instance dengue fever,” he says, adding that “it is always good advice to go and see a doctor as early as possible. Remember that acute viral bronchitis is infectious, particularly in the first week.”

The last five years have seen a rise in the number of people infected by acute viral bronchitis and Dr. Tennekoon says he sees several new patients with this infection every day. The reasons behind the increase are not known, and Dr. Tennekoon speculates that it is most probably another mutation in the original virus which has resulted in this more virulent form. Mutations such as this are very common, and occur not just over time but across countries as well – the influenza virus being a perfect example. These changes in the virus strain also mean you may catch a variation of the same infection at some other point.

“It is quite important to make the right diagnosis,” says Dr. Tennekoon, adding that great care must be taken to make sure that it is in fact a case of Viral Bronchitis and not something more worrisome, such as Tuberculosis or Asthma. “It is not a serious illness; although it is certainly a very distressing illness, but nobody has ever come to grief through it,” he says reassuringly, adding that the downside is that patients should be prepared to wait weeks and at worst months for it to sort itself out.