Information on Allergic BronchoPulmonary Aspergillosis (ABPA) / SAFS – For Family and Friends

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WHAT IT IS
ABPA (Allergic Bronchopulmonary Aspergillosis) and SAFS (Severe Asthma with Fungal Sensitisation) are allergic reactions to a common fungus, Aspergillus. In some people with asthma, the immune system overreacts to spores in the air, causing inflammation, swelling, and mucus plugs in the lungs.

WHAT IT’S NOT

• Not contagious – you can’t catch it.

• Not poor hygiene – Aspergillus is everywhere in the air.

• Not the patient’s fault – flare-ups happen because of the condition, not something they did or didn’t do.

WHY AREN’T OTHERS AFFECTED?
Most people’s lungs clear these spores easily. In ABPA/SAFS the immune system reacts too strongly – more likely with long-standing asthma, severe allergies, damaged airways (e.g., bronchiectasis), or a genetic tendency. It’s not weakness or lifestyle choices – often just lung history and bad luck.

TYPICAL SYMPTOMS

• Wheezing, cough (sometimes with mucus plugs)

• Breathlessness

• Severe fatigue

• Sometimes coughing up blood

WORST SYMPTOMS

• Mucus plugs – thick, sticky clumps blocking airways, making breathing suddenly harder.

• Intense coughing – can be exhausting, cause chest pain, and disrupt sleep.

TREATMENT

• Anti-inflammatory medicines (often steroids)

• Antifungals to reduce Aspergillus in the airways

• Biologics for severe asthma/allergic inflammation

• Monitoring with blood tests, breathing tests, and scans

THE REALITY
This condition can dominate daily life. On bad days the person may not be able to do much at all. Energy and breathing can change day-to-day (even hour-to-hour). If plans are cancelled, it isn’t a lack of interest – it’s the illness. Flare-ups can also make people feel short-tempered – a natural reaction to frustration, not a lack of care. Many people also live with a constant awareness of environmental risks – weighing up every new place or activity for dust, damp, or spores. This can feel exhausting and may lead them to avoid situations that others wouldn’t think twice about.

LOOKING AHEAD

• With good control – Many people manage their symptoms well, reduce flare-ups, and keep active with the right treatment and avoidance of triggers.

• Risks – Without good control, repeated flare-ups can slowly damage the lungs and lead to bronchiectasis.

• Change over time – Some improve and need less treatment; others have ongoing ups and downs. Early action on flare-ups makes a big difference.

ENVIRONMENTAL TRIGGERS & PROTECTION
Some people with ABPA or SAFS have to avoid dust, mould, strong smells, smoke, and damp places – these can trigger flare-ups. Activities like gardening, compost turning, or DIY can be risky because they release fungal spores into the air. Wearing a well-fitting mask (e.g., FFP2/FFP3) can help reduce exposure – it’s about staying well, not being antisocial.

HOW FRIENDS AND FAMILY CAN BEST HELP

• Be flexible with plans – energy and breathing can change suddenly; last-minute cancellations aren’t personal.

• Help avoid triggers – choose low-dust, low-mould venues and activities.

• Support treatment routines – lifts to appointments, collecting prescriptions, or reminders if welcome.

• Listen without judgement – let them share symptoms and frustrations.

• Encourage safe activities – suggest hobbies and outings with low environmental risk.

• Show affection and reassurance – a hug, a kind message, or checking in can mean a lot.

MORE INFORMATION & SUPPORT
National Aspergillosis Centre (UK): https://mft.nhs.uk/wythenshawe/services/infectious-diseases/national-aspergillosis-centre/
Patient information & community: https://aspergillosis.org