Sinusitis/Upper Respiratory Infections

Reviewed by: HU Medical Review Board | Last reviewed: September 2021

Viral respiratory infections are the most common cause of wheezing and asthma attacks, especially in children. Infections can cause asthma symptoms to develop or worsen.

Preventing infections is nearly impossible. But there are ways to reduce your risk of infection. Talk to your doctor about what to do if you or your loved one gets sick. Your asthma action plan should include changes to your asthma medicines. It should also include how to treat symptoms and when to get emergency help.

Which infections can trigger asthma?

Respiratory syncytial virus (RSV) and rhinovirus (RV) are the most common respiratory infections that trigger asthma. These are common viruses that infect 80 to 90 percent of all children by age 2.1,2,4

Many other types of viruses also trigger asthma, including:1,2,4

  • Coronaviruses, such as the common cold and COVID-19
  • Influenza, such as the flu
  • Human metapneumovirus (hMPV)
  • Other viruses, such as enteroviruses, boca viruses, parainfluenza, and adenoviruses

Why do these infections trigger asthma?

Studies have shown a strong link between viral infections and asthma. Infections can lead to new or worse symptoms of asthma. For example, a mild cold can cause wheezing and chest tightness for people with asthma. Wheezing from viral infections can make children more likely to develop asthma later in life.1,2

We do not know exactly how viral infections trigger asthma. Asthma develops when genetic and environmental risk factors occur at critical times during childhood. Viral infections contribute to this by increasing airway inflammation. In some people, this causes asthma symptoms to develop or worsen. Certain genetic and environmental factors increase the risk of virus-induced asthma.2,3

Viral infections seem to have the most impact on infants. This is because their immune system and lungs are not fully developed. Viral infections during this time may have long-lasting effects on the immune system and lung function.2

How can I prevent respiratory infections?

Preventing respiratory infections can reduce the risk of asthma attacks. It can also reduce the risk of infection complications, such as pneumonia. Ways to protect yourself from respiratory infections include:5,6

  • Frequently wash your hands with soap and water for 20 seconds
  • Avoid touching your eyes, nose, and mouth
  • Get your yearly flu shot
  • Get the COVID-19 shot
  • Ask your doctor about the pneumococcal shot if you are older than 65
  • Avoid contact with people who are sick
  • Keep inhalers and other breathing equipment clean
  • Do not share inhalers or other breathing equipment

What should I do if I have symptoms of an infection?

Some symptoms of viral-induced asthma include:5,6

  • Wheezing and coughing
  • Chest tightness
  • Shortness of breath
  • Fever and chills
  • Fatigue
  • Runny or congested nose
  • Headache
  • Sneezing

Follow your asthma action plan if you notice any symptoms. This should include any changes to your asthma medicines if you are sick. Keeping your asthma under control can reduce your risk of asthma attacks, complications, and hospital stays.5,6

Your asthma action plan should also include tips on how to treat viral-induced asthma symptoms, such as:5,6

  • Drinking plenty of fluids
  • Resting
  • Avoiding secondhand smoke
  • Monitoring your airflow
  • Staying home from school or work

Get emergency help right away if you show signs of a severe asthma attack, including:5,6

  • Difficulty walking or talking because of shortness of breath
  • Difficulty breathing
  • Bluish gray or pale color change of mucus membranes, fingertips, or nail beds (cyanosis)
  • Fast breathing with chest retractions
  • Ribs or stomach moving in and out deeply and rapidly
  • Flaring of nostrils
  • Rescue medicine does not feel like its working
  • Needing to use rescue medicine more than your doctor recommends
  • Exhaustion
  • Abnormal behavior or altered consciousness

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