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Why Bronchitis Isn’t Always Contagious: The Surprising Truth
Last January, while welcoming an in-bound tour, a hotel concierge in Berlin developed a bad cough after being exposed to travelers battling influenza A. Two days later he had a textbook case of acute bronchitis (fever, hacking cough, tight chest), and was locked away by the hotel’s medical staff because viral bronchitis, which causes an estimated 90 percent of all acute cases (those lasting less than two weeks), is as contagious as colds: little droplets that are dropped when you cough hang in the air or cling to doorknobs and other surfaces until the next unsuspecting host innocently fingers the surface, then swipes at his nose.
But three months later, a 62-year-old taxi driver from the same city turned up at the clinic with the same weird cough, and nobody close to him became sick. Decades of cigarette smoke had inflamed his bronchial tubes, not microbes. Chronic “smoker’s bronchitis", and its chemical-irritant cousin found among workers exposed to ammonia or fine dust, involves no pathogen, so there is nothing to pass along.
In the middle is a misapprehended middle ground: bacterial bronchitis. In children it may be induced by Mycoplasma pneumoniae; in adults it may occur in association with chronic obstructive pulmonary disease. Oddly, however, many of those bacterial examples act more like the popped pustule than an infection on the rise — the renegade bacteria are already buried away in airway mucus and rarely leap to new hosts. That’s why guidelines from the European Respiratory Society advise against indiscriminate antibiotic prescription; most patients get better with rest and hydration alone, with medications saved for the minority who actually harbor transmissible bacteria such as Bordetella pertussis (whooping cough).
The take-home message is counterintuitive: hearing a bronchitis cough doesn’t automatically mean you’re at risk. Contagiousness hinges on cause, not sound.
