Respiratory infections: symptoms, how long they last and when to get help

Doctors sort respiratory infections by where they sit in the airway. Upper respiratory infections involve the nose, sinuses and throat, and include the common cold and most sore throats. Lower respiratory infections involve the windpipe, large airways or lungs, and include bronchitis, bronchiolitis and pneumonia.

The NHS says a chest infection is an infection of the lungs or large airways, which often follows colds or flu. The practical difference between upper and lower infections is the level of risk: an upper infection is usually a nuisance, while a lower infection can interfere with breathing and deserves more attention in anyone very young, older, pregnant or with a long-term condition.

Symptoms depend on where the infection is. The NHS lists these for the main types.

It depends on the type. The NHS says a cold should start to improve in about 1 to 2 weeks and that a person is infectious until all symptoms have gone, which can take longer in babies and young children. A chest infection usually gets better on its own in about 7 to 10 days, though the cough and mucus can last up to 3 weeks. Bronchitis usually clears up without treatment in around 3 weeks, and a sore throat normally gets better within a week.

Pneumonia takes longer. The NHS says that, depending on symptoms, most people get better in 2 to 4 weeks. Contact a doctor if you are not improving, and see a GP if you have had a cough for more than 3 weeks.

Most are treated at home. For a chest infection the NHS suggests getting plenty of rest, drinking lots of water to loosen the mucus, raising your head on extra pillows, using painkillers to bring down a high temperature and ease aches, and a hot lemon and honey drink for a sore throat. It cautions against letting children breathe steam from a bowl of hot water because of the risk of scalding, giving aspirin to children under 16, and smoking.

A pharmacist can advise on cough and cold medicines. The NHS says cough medicines are not suitable for children under 6, decongestants should not be used by children under 6, nasal sprays should not be used for more than a week, and honey must not be given to babies under 12 months. It also warns against taking several products containing paracetamol at once. It adds that there is little evidence that vitamin C, echinacea or garlic prevent colds or speed recovery.

Usually not. Antibiotics only treat bacterial infections. The NHS says GPs do not recommend them for colds or flu, and that for a sore throat they are not normally needed because they will not usually relieve symptoms or speed recovery. For a chest infection, treatment depends on the cause: viral bronchitis usually clears up by itself after a few weeks, while a bacterial infection such as pneumonia may need antibiotics.

The NHS says you may need a blood test or a sample of mucus to find the cause. If you are given antibiotics, complete the whole course as advised, even if you start to feel better, and contact your doctor if you do not feel any better after taking them for 2 to 3 days. The NHS advises against cough medicine in pneumonia, because coughing helps the body get rid of the infection.

Viruses cause most respiratory infections. The NHS says colds are spread by germs from coughs and sneezes, which can live on hands and surfaces for 24 hours. For flu, you are more likely to pass it on in the first 5 days after being infected. Pneumonia is usually caused by a bacterial or viral infection and can follow flu, RSV or COVID-19. Bronchiolitis is caused by a viral infection, usually respiratory syncytial virus (RSV), and the NHS says almost all children get RSV at least once before they are 2.

To avoid spreading infection, the NHS advises washing your hands often with warm water and soap, using tissues to trap germs when you cough or sneeze, binning them quickly, and staying at home and avoiding contact with others if you have a high temperature or do not feel well enough to do normal activities.

The NHS says to see a GP if you have a chest infection and you feel very unwell or your symptoms get worse, you cough up blood or blood-stained mucus, you have had a cough for more than 3 weeks, you are pregnant, you are over 65, your immune system is weak, or you have a long-term heart, lung or kidney condition. For a cold it adds a high temperature for more than 3 days, symptoms that do not improve after 10 days, shortness of breath or chest pain.

Call 999 or go to A&E if you are struggling to breathe (choking, gasping and unable to speak), have pale, blue or blotchy skin, lips or tongue, are coughing up blood, suddenly feel confused, or cannot wake your baby or they feel floppy. For flu, the NHS also lists sudden chest pain or severe difficulty breathing.

For babies and young children with bronchiolitis, the NHS lists grunting noises, the tummy sucking under the ribs, pauses in breathing, and blue or grey skin as reasons to call 999. Ask for an urgent GP appointment or call 111 if a baby is feeding much less than usual, has had a dry nappy for 12 hours or more, or has a high temperature. The NHS says you may know if your child seems seriously unwell and should trust your own judgement.

The NHS says pregnant women should see a GP if they have a chest infection, and for flu to ask for an urgent GP appointment or get help from NHS 111 if you are pregnant or have recently given birth. Some cough and cold medicines are not suitable for pregnant women, so check with a pharmacist. The NHS lists the flu vaccine as recommended during pregnancy, and the RSV vaccine from 28 weeks to help protect the baby after birth.

The NHS lists vaccines that help protect against infections that can lead to pneumonia: the pneumococcal vaccine for babies, adults over 65 and people at higher risk, the annual flu vaccine for eligible people, a seasonal COVID-19 vaccine for those at increased risk, and an RSV vaccine for adults aged 75 and over, some adults aged 65 to 74, and during pregnancy from 28 weeks. Eligibility changes, so check current NHS guidance.

Stopping smoking also reduces your chance of pneumonia, and the NHS notes that children who breathe in cigarette smoke are at higher risk of severe bronchiolitis. The flu vaccine does not prevent colds.

Most respiratory infections are managed at home with advice from a pharmacist, and the NHS says a pharmacist can help with colds, sore throats and chest infection symptoms. A GP, NHS 111 or urgent treatment services can assess you if symptoms are severe or you are at higher risk. Some people use a private GP or urgent care service for quicker assessment, but the treatment advice is the same, and the NHS says antibiotics are used only when a bacterial infection is likely.