Chest Pain & Infections

Overview

Chest pain and respiratory infections are common concerns for travelers, as they are frequently exposed to new environments, germs, and conditions that can compromise their respiratory health. Respiratory infections, ranging from the common cold to more severe conditions like tuberculosis (TB), can develop while traveling and vary in severity.

Respiratory infections are a major cause of illness among travelers, second only to diarrheal diseases. While most are mild and treatable with over-the-counter remedies, others, such as TB, can be more serious and require medical intervention.

Symptoms and Causes

Respiratory infections during travel can arise from exposure to new pathogens, crowded environments, or poor sanitation. Common symptoms of respiratory infections include coughing, sore throat, congestion, chest pain, and fever.

Common Respiratory Infections:

1. Colds, Coughs, and Sore Throats:

These are viral infections caused by different pathogens, especially when exposed to new environments.
Symptoms: Runny nose, sore throat, coughing, sneezing, mild chest pain, and fatigue.
Treated with over-the-counter medications.

2. Influenza (Flu):

A viral infection affecting the respiratory tract, especially during travel in flu season.
Symptoms: High fever, body aches, cough, sore throat, and chest pain.
Prevented by the flu vaccine, especially before travel to high-risk regions.

3. Tuberculosis (TB):

A bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs but can spread to other organs.
Symptoms: Persistent cough, fever, night sweats, weight loss, chest pain, and fatigue.
TB can be contracted through inhaling droplets from an infected person's cough or sneeze. It is more common in areas with crowded, unsanitary conditions or poor nutrition.

4. Atypical resp infections (legionella, mycoplasmsa, etc)

A severe form of pneumonia caused by inhaling bacteria found in contaminated water systems or milder forms often with non respiratory features as well.
Symptoms: Fever, chills, cough, muscle aches, and chest pain.

5. Diphtheria and other conditions - traveller’s pneumonia

A bacterial infection affecting the throat and upper respiratory tract, leading to breathing difficulties and chest pain.
Symptoms: Sore throat, fever, swollen glands, and difficulty breathing.

6. Severe Acute Respiratory Syndrome (SARS) and Bird Flu:

These are viral infections that cause serious respiratory distress.
Symptoms: High fever, cough, shortness of breath, and in some cases, severe chest pain.

Diagnosis

Diagnosing respiratory infections, particularly those that cause chest pain, depends on the severity of the symptoms and the suspected cause. Doctors may perform various tests to identify the type of infection:

1. Physical Examination:

A doctor will assess symptoms such as coughing, wheezing, chest pain, and breathing patterns.

2. Chest X-ray:

Used to identify infections like pneumonia or tuberculosis and check for lung inflammation or damage.

3. Sputum Test:

In cases of bacterial infections like tuberculosis, a sample of mucus (sputum) may be tested for the presence of specific pathogens.

4. Blood Tests:

These can help identify infections, including viral and bacterial causes, and check for immune responses.

5. Tuberculosis Blood Test

Used to detect latent or active TB infection by checking for a reaction to injected TB proteins.

6. Rapid diagnostic point of care (POCT) tests pcr, next generation sequencing

Treatments

The treatment for chest pain and respiratory infections varies depending on the underlying cause. While many infections are viral and resolve with rest and over-the-counter medications, others require more intensive treatments.

1. Common Cold and Flu:

Rest and Hydration: Key to recovery from viral respiratory infections.
Over-the-Counter Medications: Decongestants, pain relievers, and cough syrups can relieve symptoms.
Antiviral Drugs: For severe cases of the flu, antiviral medications may be prescribed.

2. Tuberculosis (TB):

Antibiotic Treatment: TB is treated with a prolonged course of antibiotics, usually lasting six to nine months.
Directly Observed Therapy (DOT): Ensures patients take the full course of medication, reducing the risk of antibiotic resistance.
BCG Vaccine: This vaccine offers protection, especially for children, and is recommended for travelers to areas with high TB prevalence.

3. Atypical pneumonias (mycoplasma, legiionella)

Antibiotics: This condition is treated with antibiotics, often requiring hospitalization for severe cases.

4. Diphtheria:

Antibiotics and Antitoxin: Immediate treatment with antibiotics and an antitoxin is necessary to neutralize the bacterial toxins.
Vaccination: Preventive vaccines are available and recommended before travel to areas where diphtheria is prevalent.

5. Prevention of Respiratory Infections:

Vaccinations: Flu, diphtheria, and tuberculosis vaccines are recommended based on destination.
Good Hygiene Practices: Frequent handwashing, wearing masks in crowded places, and avoiding contact with sick individuals can reduce the risk of infection.
Avoiding Exposure to Unpasteurized Milk: For tuberculosis prevention, avoid consuming unpasteurized dairy products in areas where bovine TB is prevalent.

6. Prevention

Vaccination: Stay updated with vaccinations like the flu, diphtheria, and TB vaccines, especially before traveling to high-risk areas.
Avoid Crowded Places: In countries where respiratory infections are common, avoid crowded, poorly ventilated spaces.
Good Hygiene: Regular handwashing and avoiding contact with individuals showing symptoms of respiratory illness can help reduce the risk.
Avoid Unpasteurized Dairy: Consuming unpasteurized milk in areas where bovine TB is present can increase the risk of infection.

By taking preventive measures and being aware of symptoms, travellers can minimise the risk of respiratory infections and manage chest pain effectively during travel.