Health focus: the winter bronchitis epidemic in France

The usual winter wave of respiratory illnesses has shone a spotlight on acute bronchitis, which up to 10 million people get every year in France, according to the state healthcare website Ameli.

Known as bronchite aiguë in France, it is a short-term inflammation of the bronchi of the lungs, the most common symptom of which is a cough.

It is classed as chronic bronchitis (bronchite chronique) if you have a cough on most days that lasts three months or more, for at least two years. 

People at higher risk include those with respiratory conditions such as asthma, an autoimmune disorder or other illness that causes inflammation, chronic acid reflux, and smokers (or living with someone who smokes).

Causes and symptoms

Acute bronchitis is nearly always caused by a viral infection and will usually clear up in around 10 days even without treatment, but it can take up to three weeks. 

Although it can feel like a cold, bronchitis develops with more coughing, a wheezing or rattling sensation when you breathe in, and discomfort in the chest. 

It can also bring shortness of breath, blocked sinuses, sore throat, fever and extreme tiredness. Symptoms show up about three days after you have caught the virus.

If you have a cough plus a high fever for more than 48 hours, your bronchitis may have developed into pneumonia, particularly common in older patients or those with a weakened immune system.

Treatment

Your GP may prescribe painkillers and linctus for the cough, but as 90% of bronchitis cases are caused by a virus, you will not be prescribed antibiotics because they simply will not help. 

However, 10% of cases are bacterial bronchitis, which do respond to antibiotics. You may also be prescribed an X-ray or blood test to clarify the diagnosis.

Note that cough syrups containing pholcodine were withdrawn in September 2022 as they can cause a severe reaction when combined with other medication, even several weeks later. 

If you have any old medicines, check the ingredients for pholcodine and dispose of them at your local pharmacy.

Prevention

Official advice to prevent bronchitis includes regular hand-washing and sanitation measures to avoid catching the virus, to stop smoking, to avoid polluted and smoky atmospheres and to air out your living space regularly.

The French health service offers a vaccine against severe forms of RSV, the respiratory syncytial virus that is responsible for bronchitis.

Known in French as the vaccin VRS, it is recommended for patients at higher risk, namely aged 75 and over, or 60 to 74 with risk factors such as chronic heart or lung disease, and pregnant women. 

However, for the time being the vaccine is not reimbursed for adults (except pregnant women) due to a lack of agreement on the price between the laboratories and the Comité économique des produits de santé (CEPS).

People with chronic bronchitis are advised to be vaccinated for the flu (la grippe) and pneumonia (pneumocoque). 

* In early October, the national public health agency Santé publique France warned that two regions – Ile-de-France and Normandy – had pre-epidemic levels of bronchiolitis.

In the majority of cases, bronchiolitis is caused by the respiratory syncytial virus (RSV). 

It causes inflammation of the small bronchial tubes and can lead to significant breathing difficulties in infants. While it usually resolves spontaneously, some babies require hospitalisation.

The newborn immunisation campaign against RSV infections began in early September.