CPAP, humidifiers and aspergillosis: safe use and cleaning
If you use CPAP for sleep apnoea and have aspergillosis, asthma, bronchiectasis or another lung condition, it is natural to wonder whether the machine could make symptoms worse. CPAP itself does not usually interfere with recovery from aspergillosis. Good sleep and treatment of sleep apnoea can support overall health. The important things are comfort, correct settings and keeping the mask, tubing and humidifier clean.
This page is general information. Continue using CPAP as prescribed unless your sleep or respiratory team advises otherwise.
What does CPAP do?
CPAP stands for continuous positive airway pressure. It delivers a gentle flow of air through a mask to keep the upper airway open during sleep. It treats obstructive sleep apnoea; it is not a treatment for Aspergillus infection or allergic fungal disease.
When CPAP is working well, people may sleep more soundly and feel less tired during the day. If the mask leaks, the air feels too dry, or nasal symptoms are troublesome, it may disrupt sleep and make cough or throat irritation feel worse.
Can CPAP spread Aspergillus?
There is no good evidence that correctly used CPAP causes aspergillosis or routinely worsens it. Like any equipment that carries air and water, a poorly maintained mask, tube or humidifier chamber can collect environmental organisms over time. This is why regular cleaning and drying matter—particularly for people with chronic lung disease.
Do not assume that a cough or a chest flare is caused by CPAP. It may be due to asthma, bronchiectasis, a viral or bacterial infection, reflux, nasal disease or Aspergillus-related inflammation. Discuss persistent changes with your usual clinical team.
Using a humidifier safely
A heated humidifier can reduce dry mouth, dry nose, congestion and throat irritation. It may be particularly helpful if CPAP air feels uncomfortable. Use the water and cleaning method recommended by your machine manufacturer or sleep service; many advise distilled water for the humidifier chamber.
- Empty any remaining water from the chamber each morning.
- Allow the chamber to dry fully before refilling.
- Use fresh water each night rather than topping up old water.
- Clean the chamber regularly with warm water and mild detergent, following the manufacturer’s instructions.
- Do not use a room humidifier, tap water or homemade disinfectants in the CPAP chamber unless your sleep service or manufacturer specifically advises this.
A simple cleaning routine
Always follow the instructions for your own device, as materials and replacement schedules vary. A practical routine is:
| Part | Routine care |
|---|---|
| Humidifier chamber | Empty and air-dry daily; wash regularly as advised. |
| Mask cushion | Wipe or wash regularly to remove skin oils and residue, helping the seal as well as hygiene. |
| Tubing | Wash and rinse regularly, then hang or lay it so that it can dry completely. |
| Machine filter | Check, clean or replace it on the schedule given by your manufacturer or sleep service. |
Avoid unapproved ozone or ultraviolet “CPAP cleaning” machines. They may damage equipment and can irritate the airways if residues remain. Ordinary washing, rinsing and thorough air-drying are usually all that is needed.
When CPAP seems to make symptoms worse
CPAP can contribute to dryness, nasal irritation, mouth breathing, congestion or cough when the humidity is too low, the mask leaks, or the pressure and mask type need adjustment. This is a comfort and fitting issue—not proof of infection.
Contact your sleep service if you notice:
- persistent dry mouth, sore throat or blocked nose
- new mask leaks, pressure marks or a poor seal
- water collecting in the tubing (“rainout”)
- visible mould, persistent odour, cracked tubing or a damaged chamber
- a recurring cough that seems closely linked with CPAP use.
They may be able to adjust humidity or temperature, check the pressure setting, arrange a different mask or replace worn parts. Do not alter prescribed pressure settings yourself unless your service has shown you how and advised that it is appropriate.
When to seek medical advice
Contact your respiratory team or GP if you have a sustained increase in cough, sputum, wheeze or breathlessness; fever, chest pain, or blood-stained sputum. These need assessment as respiratory symptoms, rather than simply cleaning the CPAP equipment and waiting.
Seek urgent help for severe breathlessness, difficulty speaking in full sentences, blue or grey lips/skin, confusion, chest pain, or more than small streaks of blood in sputum.
The main message
CPAP is usually safe to continue for people with aspergillosis. Keep the equipment clean and dry, use the humidifier as instructed, and ask the sleep service to help with leaks, dryness or congestion. A new chest symptom should be assessed on its own merits rather than blamed on CPAP.
Related information
Last reviewed: September 2026
NTM lung disease and aspergillosis: why they can overlap
Audience: People living with chronic pulmonary aspergillosis (CPA), ABPA, bronchiectasis, previous tuberculosis (TB) or another long-term lung condition.
Nontuberculous mycobacteria (NTM) are bacteria found naturally in soil and water. They can occasionally cause a chronic lung infection, particularly when the airways have already been damaged. NTM lung disease can occur alongside aspergillosis, but a positive sputum sample does not automatically mean that someone has active disease or needs treatment.
This article explains the overlap, the tests specialists use, and what treatment may involve. It is general information and does not replace advice from your respiratory, infection or NTM team.
What are NTM?
NTM are relatives of the bacterium that causes TB, but they are different. They are widespread in the environment, including soil, dust and water systems. Most people breathe them in from time to time without becoming ill.
The term non-tuberculous is important: NTM lung disease is not TB. It is generally not passed from person to person in everyday contact. You cannot usually catch it from hugging, sharing a room or being near someone who coughs.
| Species/group | What it means |
|---|---|
| Mycobacterium avium complex (MAC) | The most commonly recognised group causing NTM lung disease. |
| Mycobacterium abscessus | A rapidly growing NTM that can be particularly difficult to treat and needs specialist assessment. |
| Mycobacterium kansasii | Can cause lung disease that may look similar to TB on a scan. |
Why can NTM and aspergillosis occur together?
Both NTM and Aspergillus take advantage of lungs that are already vulnerable. Bronchiectasis, cavities left by TB or previous infection, COPD, cystic fibrosis and other structural lung damage can make it harder to clear mucus. Mucus then becomes a place where microbes can persist.
Some treatments can also influence risk. Long or repeated courses of oral corticosteroids can suppress parts of the immune response. This never means that steroids should be stopped suddenly or avoided when needed: it means that people with known or suspected NTM need a carefully balanced, specialist plan.
Symptoms can be very similar
NTM lung disease and aspergillosis can both cause:
- persistent or worsening cough
- more sputum, sometimes thicker or discoloured
- tiredness, reduced appetite or weight loss
- breathlessness or reduced exercise tolerance
- fever or night sweats
- chest discomfort or coughing up blood.
These symptoms can also be caused by asthma, ABPA, a bacterial chest infection, bronchiectasis or another condition. That is why it is unhelpful to assume that every increase in cough or mucus is due to one organism.
A culture result is not the whole diagnosis
NTM can appear in sputum without causing progressive lung disease. Before recommending treatment, a specialist normally considers three things together:
- Symptoms: is there a pattern that could be due to NTM?
- Imaging: does a CT scan show changes compatible with NTM, such as nodules, bronchiectasis or cavities?
- Microbiology: are NTM found repeatedly in good-quality sputum samples, or in a bronchoscopy sample where appropriate?
This careful approach prevents people being exposed to long, demanding antibiotic treatment when it is unlikely to help. It also means that monitoring without immediate treatment can sometimes be the right, active decision.
When ABPA and NTM occur together
ABPA is an allergic inflammatory reaction to Aspergillus, most often in people with asthma and sometimes bronchiectasis. It can cause wheeze, cough, fatigue and thick mucus or mucus plugs. Oral steroids are one standard treatment for an ABPA flare, but they can be a concern in someone with active or previous NTM.
The answer is not automatically to leave ABPA untreated, or to stop all steroid treatment. The priority is a joint plan between the teams looking after ABPA/asthma and NTM. This should set out the intended steroid dose and duration, what counts as a response, how sputum and symptoms will be monitored, and what alternatives might be appropriate.
For selected people with repeated ABPA flares or troublesome steroid side effects, the team may discuss an antifungal medicine or a biologic treatment for severe asthma/ABPA. These choices must be individualised. Antifungal azoles can interact with several medicines, including medicines that may form part of an NTM regimen, so a specialist pharmacist should check the complete list.
What does NTM treatment involve?
Not everyone with NTM needs antibiotics. When treatment is recommended, it is usually long-term and tailored to the species, antibiotic-susceptibility results, scan changes, symptoms and the person’s ability to tolerate treatment. MAC treatment often includes a macrolide antibiotic, ethambutol and rifampicin/rifabutin. M. abscessus treatment is different and often more complex, sometimes including intravenous antibiotics during part of the course.
Treatment commonly continues for many months after cultures become negative. Teams monitor carefully for side effects, which may include nausea, liver problems, hearing changes, visual changes, kidney effects and heart-rhythm changes, depending on the medicines used.
Do not stop antibiotics early or make medication changes without speaking to the NTM team. Stopping or changing a regimen can affect future treatment options.
Airway clearance is part of treatment
Whatever the cause of mucus, regular airway clearance can be important. A respiratory physiotherapist can tailor techniques such as the active cycle of breathing, huffing, postural drainage or a PEP/OPEP device. Some people are prescribed nebulised saline or a mucolytic medicine. The safest and most effective approach depends on the individual, particularly if they have asthma, very sensitive airways or a history of coughing blood.
Read more: Mucus clearance techniques and Bronchiectasis and aspergillosis.
Practical steps
- Give sputum samples when requested, including when symptoms change.
- Use sterile or appropriately prepared water for nebulisers exactly as instructed by your clinical team.
- Keep up your agreed airway-clearance routine and physical activity where possible.
- Tell every prescriber and pharmacist about all antibiotics, antifungals, inhalers, steroids, supplements and over-the-counter medicines.
- Ask your specialist team for personalised advice about reducing exposure to NTM. Avoiding hot tubs is commonly advised; there is no need to stop ordinary life or become fearful of all water and soil.
When to contact your team
Contact your respiratory, NTM or GP team promptly for a sustained worsening in cough, sputum, wheeze or breathlessness; fever, night sweats, unplanned weight loss, marked fatigue, chest pain or blood-stained sputum. Your team may want bacterial, fungal and mycobacterial sputum samples before antibiotics are changed.
Seek urgent help for severe breathlessness, difficulty speaking in full sentences, confusion, blue or grey lips/skin, chest pain, a reliever inhaler that is not helping, or more than small streaks of blood in sputum.
Questions for an appointment
- Do my symptoms and CT scan suggest active NTM disease, or could another condition explain them?
- Do I need repeat bacterial, fungal and mycobacterial sputum cultures?
- What is the plan for monitoring if we are not starting NTM treatment now?
- How will ABPA treatment and NTM monitoring be coordinated?
- Which medicines need interaction checks, ECGs, drug-level monitoring or blood tests?
- Would respiratory physiotherapy or a biologic/steroid-sparing approach be suitable for me?
The main message
NTM lung disease is important to recognise in people with aspergillosis and damaged airways, but it is not diagnosed from one symptom or one sputum result alone. With the right tests, coordinated specialist care and a plan that includes airway clearance, both conditions can be managed safely.
Further information
Last reviewed: September 2026
A Long Journey to an ABPA Diagnosis
A Long Journey to an ABPA Diagnosis: An Anonymous Patient Story
An anonymous personal experience
This account has been adapted from an original patient story, with edits for privacy, clarity and current patient-information standards. Everyone’s symptoms, investigations and treatment are different. It is shared for connection and understanding, not as medical advice.
My respiratory problems began in childhood. I was treated for asthma, but my health became much worse and I spent several months in hospital. At that time, clinicians could not explain what was causing the illness.
For many years afterwards, I continued to experience breathing problems. It was not until adulthood that I was diagnosed with aspergillosis—now recognised as allergic bronchopulmonary aspergillosis (ABPA).
Reaching a diagnosis after such a long time was significant. It gave me a clearer understanding of my symptoms and allowed my treatment and follow-up to be reviewed with respiratory specialists.
Finding ways to stay active
Living with ABPA has required ongoing self-management and attention to my lungs. Airway-clearance techniques have been an important part of my routine for many years, and I have found that regular exercise helps me maintain my strength and wellbeing.
My experience is not a guide to treatment—people with ABPA need different approaches depending on their symptoms and circumstances. But I have learned that finding practical routines that work for me, alongside advice from my clinical team, has helped me stay as active as possible.
Looking back, my story is one of persistence through a long and uncertain journey, and of adapting to live well with a long-term respiratory condition.
The Microbiome and Aspergillosis: What Does It Mean?
Originally published: 13 August 2020 | Last reviewed: 18 September 2026 | Next review: September 2028
The word microbiome is used more and more in healthcare. It can sound as though it explains everything—from gut symptoms and immunity to asthma, infection and mood. The reality is more interesting, but also more uncertain.
Research is showing that the communities of microbes living in and on our bodies can influence inflammation and immune responses. This may be relevant to aspergillosis. However, microbiome research has not shown that aspergillosis is caused by an “unhealthy microbiome”, or that diets, probiotics or supplements can replace established treatment.
What is the microbiome?
The microbiome is the community of microscopic organisms that live in and on the body. It includes bacteria, fungi and viruses. Large numbers live in the gut, but microbes are also found in the mouth, nose, skin and airways.
For many years, doctors assumed that healthy lungs were sterile. We now know that the airways can contain small amounts of microbial material, although the lungs are very different from the gut: they have far fewer organisms and are constantly being cleared by coughing, mucus movement and immune defences.
What does this have to do with aspergillosis?
We breathe in fungal spores every day. Most people do not develop aspergillosis because their airways and immune system deal with these exposures effectively. In some people, however, the balance between the fungus, the lungs and the immune response changes.
This balance can be affected by many things, including underlying lung disease, damaged airways, mucus clearance, immune-suppressing treatment, severe asthma, previous infections and the medicines needed to treat them. The microbiome may be one part of this wider picture.
For example, researchers are studying whether changes in the bacteria and fungi found in the gut or airways can influence inflammation, allergy and susceptibility to infection. This may help us understand conditions such as ABPA, bronchiectasis and invasive aspergillosis more clearly in future.
Colonisation, infection and inflammation
It is useful to separate three ideas that can become confused:
- Colonisation means that a microbe is present but is not necessarily causing disease or requiring treatment.
- Infection means that a microbe is causing damage or illness and needs clinical assessment and, often, treatment.
- Inflammation is the body’s immune response. It can be helpful, but it can also cause symptoms and damage when it is too strong or prolonged.
A sputum result showing a bacterium or fungus does not, on its own, tell clinicians which of these is happening. They consider the result alongside your symptoms, scans, lung function, blood tests and changes over time.
Does diet affect the microbiome?
Diet influences the microbes in the gut, and a varied, balanced diet with plenty of plant foods and fibre is generally good for overall health. This is sensible advice for most people, including those living with aspergillosis.
But it is important not to overstate what this means. There is currently no special “aspergillosis microbiome diet”, and there is no good evidence that changing your diet can clear Aspergillus from the lungs, prevent an ABPA flare-up, or replace antifungal treatment.
If poor appetite, weight loss, diarrhoea, reflux or medication side effects are affecting what you can eat, speak to your clinical team or ask whether a referral to a dietitian would help.
What about antibiotics, antifungals and probiotics?
Antibiotics can alter the bacteria in the gut and airways, but they are sometimes essential for treating a bacterial infection or exacerbation. Antifungal medicines are also important treatments for many forms of aspergillosis. Do not stop, delay or change prescribed medication because of concerns about the microbiome without discussing it with your clinical team.
Probiotics and supplements are often marketed as ways to “repair” the microbiome. The evidence is mixed, products vary widely, and they are not proven treatments for aspergillosis. They may not be suitable for everyone—particularly people who are severely unwell or immunocompromised—so check with a clinician or pharmacist before starting one.
What can you do now?
You do not need to try to perfect your microbiome. The most useful approach is to support your general health while continuing the treatment plan agreed with your clinicians.
- Eat as varied and balanced a diet as you can manage.
- Keep hydrated and seek help if medication affects appetite or digestion.
- Use antibiotics and antifungals exactly as prescribed.
- Continue inhalers, airway-clearance techniques and other respiratory treatments.
- Discuss persistent changes in cough, sputum, breathlessness, bowel symptoms or weight with your healthcare team.
- Be cautious about claims that a supplement, test or restrictive diet can “reset” the microbiome or cure a chronic condition.
What might research bring in future?
Microbiome research may eventually help clinicians understand why people respond differently to infections and treatments, identify patterns linked with inflammation, or develop more personalised care. For now, much of the research is early-stage and does not yet change routine treatment for aspergillosis.
It is a promising area of science—but it is not a reason to blame yourself, your diet or your body for having aspergillosis.
Further information
- What is aspergillosis?
- Aspergillus and Pseudomonas: why co-infections matter
- Airway-clearance techniques
- 2024 ISHAM guidelines for ABPA
‘I’M STILL STANDING – (ME ‘N ELTON!)'
Breathing Easier After an ABPA Diagnosis: An Anonymous Patient Story
An anonymous personal experience
This account has been adapted from original patient stories, with edits for privacy, clarity and current patient-information standards. Everyone’s symptoms, investigations and treatment are different. It is shared for connection and understanding, not as medical advice.
For many years, I experienced repeated periods of severe respiratory illness. I had flu-like symptoms, an ongoing cough, night sweats and exhaustion. At times I coughed up thick brown mucus plugs, although I did not understand what they might mean. I had previously been treated for asthma and chest infections, but I did not feel that the treatments fully explained or resolved what was happening.
When things became much worse
During one particularly severe episode, I developed persistent pain in one side of my chest, worsening breathlessness and a cough that would not settle. I became so exhausted that everyday tasks felt difficult. After treatment did not help, I was referred for further investigations.
An initial scan showed an abnormal area in my lung. I was told that more tests were needed to understand what it was. Waiting for answers was frightening. I had to take in the possibility that it might be something serious, while trying to manage symptoms that were already having a huge effect on my life.
I was fortunate to have support from people close to me. Their company, practical help and encouragement made a very difficult period more manageable.
A different explanation
As investigations continued, my respiratory team asked questions about my symptoms and possible exposure to moulds. The pattern of illness, scans and blood tests led to a diagnosis of allergic bronchopulmonary aspergillosis (ABPA). A fungal ball was also affecting part of my lung.
Although the diagnosis was daunting, it also brought relief. At last, there was an explanation for years of symptoms and a plan for treatment and monitoring.
Everyone’s route to diagnosis is different. My experience does not mean that asthma is the wrong diagnosis for other people. But it has made me feel that it is important to speak to a clinician if symptoms are changing, worsening or not responding as expected.
Starting treatment
Treatment had a major positive effect on my breathing. I began to sleep better, cough less and breathe without the same pain and wheeze. Follow-up scans later showed that the fungal ball had cleared, leaving only limited scarring.
That improvement was a huge relief. After living with symptoms for so long, I had not realised how much I had adapted to feeling unwell until I began to feel better.
Recovery was not simple
Improved breathing did not mean an immediate return to my previous life. Persistent fatigue and weakness remained difficult. Some days I could be active; on others, my energy could change quickly and I had to slow down, rest or change my plans.
I learned to balance gentle activity with pacing myself. I made practical changes to reduce the demands of everyday life and discussed persistent symptoms with my clinical team. Living with a long-term respiratory condition has meant accepting that recovery is not always straightforward, even when treatment is working.
Living with uncertainty
As my health improved, follow-up became less frequent. I was pleased that treatment had helped, but I also found it unsettling to feel less closely connected to the specialist team that had supported me through a frightening time.
Over time, I have learned that managing ABPA involves a balance: recognising meaningful changes in symptoms, following the monitoring plan agreed with my clinical team, and getting on with life as fully as possible between appointments.
Looking forward
My experience has left me grateful for the clinician who arranged further investigation, for the respiratory team who reached a diagnosis, and for the people who supported me when I was unwell.
My breathing is now much better than it was during that illness. I still have to pace myself and live with some uncertainty, but I also have a diagnosis, a plan and a renewed appreciation of the ordinary things that feeling able to breathe more easily can make possible.
Can I have ABPA without asthma?
Originally published: 29 May 2020 | Last reviewed: 18 September 2026 | Next review: September 2028
Yes—although ABPA is most often diagnosed in people with asthma, it can occasionally be diagnosed in someone who has not previously been told that they have asthma.
Allergic bronchopulmonary aspergillosis (ABPA) is an allergic-type immune reaction to Aspergillus, usually Aspergillus fumigatus, in the airways. It is most commonly associated with asthma and cystic fibrosis, but clinicians may also consider it in people with bronchiectasis, COPD, or a pattern of symptoms and test results strongly suggestive of ABPA.
Why is ABPA usually linked with asthma?
ABPA develops when the immune system reacts strongly to Aspergillus in the airways. Asthma creates an airway environment in which this reaction is more likely to occur, which is why most people with ABPA have asthma or asthma-like symptoms such as wheeze, chest tightness and variable breathlessness.
However, asthma is not always recognised before ABPA is investigated. Some people have had mild or intermittent symptoms, have been given a different diagnosis, or have airway disease dominated by bronchiectasis rather than obvious asthma.
Can ABPA be diagnosed without asthma?
Yes, but it is uncommon. Current international guidance allows clinicians to diagnose ABPA in someone without a recognised pre-existing condition when their overall clinical picture is compatible with the disease.
This is important because a diagnosis should not be ruled out solely because a person does not have an asthma label. At the same time, ABPA is a specialist diagnosis: an elevated allergy test or a positive sputum culture alone does not prove that someone has it.
When might clinicians consider ABPA?
Your clinical team may investigate for ABPA when there is a combination of symptoms, imaging changes and allergy-test results that point towards it. Features can include:
- recurrent episodes of cough, wheeze, breathlessness or chest tightness;
- thick mucus, sometimes with brownish plugs;
- coughing up blood;
- repeated chest infections or areas of inflammation seen on a chest X-ray or CT scan;
- bronchiectasis, particularly when the larger central airways are affected;
- evidence of sensitisation or allergy to Aspergillus; and
- raised total IgE and, in many cases, raised eosinophils.
Several other conditions can cause similar symptoms or test results. Your doctors will interpret the findings together, including your medical history, scans, lung-function tests and blood results.
How is ABPA diagnosed?
There is no single test that confirms ABPA. Diagnosis is based on a combination of findings. Blood tests can look for allergy to Aspergillus, total IgE and eosinophils. A CT scan can show changes such as bronchiectasis or mucus plugging. Sputum samples and lung-function tests may also help build the overall picture.
The 2024 international ISHAM guidelines lowered the total-IgE threshold used within the diagnostic criteria and recognised that a compatible clinical presentation can support diagnosis even where a usual predisposing condition is absent. These criteria are intended to guide specialist assessment; they are not a checklist for self-diagnosis.
What did earlier research find?
A 2019 retrospective study from a specialist centre reviewed 530 people with ABPA. Around 7% had no asthma diagnosis. In that group, bronchiectasis was more common, while lung function was generally better and ABPA flare-ups were less frequent than in participants who also had asthma.
This was an important study because it showed that ABPA without recognised asthma does occur. However, it was conducted at one specialist centre and cannot tell us exactly how common this presentation is in the wider population.
What should you do if you are concerned?
If you have bronchiectasis, recurrent respiratory symptoms or abnormal Aspergillus blood tests and are wondering whether ABPA could be relevant, discuss this with your GP, respiratory clinician or specialist team. Do not change inhalers, steroids or antifungal treatment without clinical advice.
For a broader introduction, visit our ABPA hub.
Further reading
Gwynedd’s Journey to an Aspergillosis Diagnosis
A personal experience
This is Gwynedd’s account of her own diagnosis and treatment journey. Every person’s symptoms, investigations and treatment are different. It is shared for connection and understanding, not as medical advice.
Aspergillosis is a rare and debilitating fungal infection that is caused by aspergillus mould. This mould is found in many places, including soil, rotting leaves, compost, dust, and damp buildings. There are several variants of the disease, mostly affecting the lungs, and diagnosis is difficult because symptoms are like those of other lung conditions.
Gwynedd Mitchell is 62. She has two adult children and lives with her husband in Wales. Gwynedd is no stranger to health problems; she has extensive allergies, has suffered breathing difficulties from six weeks old, and as a child, she was diagnosed with asthma and suffered frequent attacks. But in 2012, she was left shell shocked when she was diagnosed with three aspergillosis variants, allergic bronchopulmonary aspergillosis (ABPA), chronic pulmonary aspergillosis (CPA) and three aspergillomas (a ball of mould in the lungs).
This is her experience of the aspergillosis diagnostic journey.
Why reducing close contact can help prevent respiratory infections.
Originally published: 6 April 2020 | Last reviewed: 18 September 2026 | Next review: September 2028
Respiratory infections can be particularly disruptive for people with aspergillosis, asthma, bronchiectasis or other long-term lung conditions. A cold, flu, COVID-19 or another viral infection can worsen cough, breathlessness, fatigue and mucus production, and may sometimes trigger an exacerbation.
There are no longer routine social-distancing rules in the UK. However, making a few temporary, practical changes when infection levels are high or when someone close to you is unwell can still help reduce your chance of catching a respiratory virus.
Why does close contact matter?
Many respiratory viruses spread when an infected person breathes, talks, coughs or sneezes. The chance of transmission is usually higher when people are:
- in close contact for a long time;
- indoors, especially in poorly ventilated spaces;
- in crowded settings; or
- near someone who is unwell, even if their symptoms seem mild.
People can sometimes pass on a virus before they realise they are ill. This is why sensible precautions can be helpful during winter, during a local outbreak, or when people in your household have respiratory symptoms.
Small changes can make a difference
This does not need to mean avoiding other people or putting your life on hold. It is about choosing proportionate steps that fit your circumstances. You might consider:
- meeting outdoors, or choosing a well-ventilated place, when practical;
- choosing quieter times for shops, appointments or public transport;
- postponing close social contact with someone who has a new cough, fever, sore throat, streaming nose or feels unwell;
- opening windows or improving ventilation when people are visiting;
- wearing a well-fitting face covering in crowded indoor places if this helps you feel safer;
- keeping up to date with vaccinations you are offered, including flu and COVID-19 vaccines where eligible; and
- washing hands after close contact with someone who is unwell and before eating or preparing food.
When might you take extra care?
You may choose to be more cautious if you are recovering from an exacerbation or hospital admission, have recently started treatment that affects your immune system, are taking high-dose steroids, or know that respiratory infections usually have a major effect on your lungs.
It can also be sensible to take extra care before an important event, such as surgery, a clinic review, travel or a family occasion. Your own experience matters: many people with aspergillosis become very good at recognising the situations in which they are most likely to pick up an infection.
If you develop respiratory symptoms
Follow the advice in your personal asthma, bronchiectasis or respiratory care plan if you have one. Rest, keep hydrated and use your usual prescribed treatments. If your symptoms are more severe than usual, are getting worse, or you are worried, contact your GP, respiratory team or NHS 111.
Continue your usual prescribed respiratory medicines unless your clinician advises otherwise. Follow your personal asthma, bronchiectasis or respiratory care plan, and seek advice early if your symptoms are worsening, different from usual, or not improving as expected.
Seek urgent help for severe breathlessness, chest pain, blue or grey lips, confusion, coughing up a large amount of blood, or if you feel seriously unwell.
Protecting yourself without becoming isolated
Reducing infection risk should not mean losing the people and activities that matter to you. Social connection, exercise, fresh air and enjoyable routines are all important for wellbeing. The aim is to make informed, temporary adjustments when risk is higher—not to live in permanent isolation.
If worries about infection are stopping you from doing things you value, discuss this with your healthcare team. They can help you find a balance that feels safer and more manageable.
Further information
- NHS: how to avoid catching and spreading germs
- NHS vaccinations
- Seasonal changes and aspergillosis
- Vaccination and aspergillosis
Steph Smith
In Memory of Steph Smith
This page remembers Steph Smith and honours the awareness and fundraising work undertaken by her family and partner following her death from invasive aspergillosis in 2009.
Portrait of Steph Smith by her mother, Liz Smith.
Steph Smith was a much-loved daughter, partner, friend and aspiring primary school teacher. In 2009, at the age of 21, she died from invasive aspergillosis following a rapid and devastating illness.
Steph had been completing the final placement of her primary teaching degree when she became unwell. At first, her symptoms were thought to be linked to her asthma. Her breathing then deteriorated quickly and she was admitted to hospital, where she was diagnosed with invasive aspergillosis.
Invasive aspergillosis is a serious fungal infection that can develop rapidly in some people. Steph’s family shared her story to raise awareness of the condition, the importance of recognising severe and worsening symptoms, and the need for better diagnosis and treatment.
Remembering Steph
Steph had worked hard for four years towards her degree in Primary Education. She was looking forward to a career for which she was well suited: caring, thoughtful, energetic and gifted with children.
She had a lifelong love of dance and was an accomplished Highland and ballet dancer. She had been involved with Girlguiding, school music and local community activities, and was remembered by those who knew her for her warmth, generosity and unmistakable smile.
Her asthma had never prevented her from living an active, full life. Her family remember a vibrant young woman for whom “no” was never part of her vocabulary, and who had so much still to look forward to.
A degree awarded in Steph’s honour
On 7 July 2009, Steph’s family attended a private graduation ceremony at the University of Aberdeen. They were presented with her degree, a Bachelor of Education (Aegrotat) in Primary Teaching, awarded in her honour.
Awareness and fundraising
Following Steph’s death, her family and partner raised more than £10,000 to support research into earlier diagnosis and more effective treatment for aspergillosis. Their efforts were an extraordinary tribute to Steph and to the hope that other families might be spared a similar loss.
We remain grateful to Steph’s family for allowing her story to be shared. Steph’s life, and the love and determination of those closest to her, continue to be remembered.
Looking After Your Mental Wellbeing with Aspergillosis
Originally published: 18 May 2020 | Last reviewed: 18 September 2026 | Next review: September 2028
Living with aspergillosis can affect more than your lungs. Symptoms may be unpredictable, treatment can be demanding, and it can be hard to plan around fatigue, appointments, infections or flare-ups. It is understandable to feel anxious, low, frustrated, isolated or worn down at times.
Looking after your mental wellbeing is not a luxury or an optional extra. It can make it easier to cope with symptoms, make treatment decisions and stay connected to the things that matter to you.
There is no “right” way to feel
A diagnosis of aspergillosis, or a change in your health, can bring many different reactions. You may feel relieved to have an explanation for your symptoms, but also worried about the future. You may grieve for activities or independence you have lost. Some days you may feel positive and capable; on others, even small tasks may feel difficult.
These reactions do not mean that you are failing to cope. Chronic illness asks a great deal of people, and feelings can change over time.
Focus on what you can influence
Aspergillosis often involves uncertainty. You cannot control every symptom, test result or appointment outcome, but it can help to identify the small things you can influence today.
- Take medicines and treatments as agreed with your clinical team.
- Keep a short note of symptoms, questions or changes you want to discuss at an appointment.
- Plan a manageable activity that gives your day some structure or enjoyment.
- Build in rest before you become exhausted, rather than treating rest as something you have to earn.
- Choose one reliable source of health information instead of repeatedly searching online.
Stay connected in ways that work for you
Illness can make it easier to withdraw from other people, especially if you are tired, breathless or worried about infection. But connection can be protective. A short phone call, message, online meeting or a gentle outing with someone you trust can make a real difference.
You do not have to explain every detail of aspergillosis. It can be enough to say: “I am having a difficult health day and would appreciate some company,” or “I cannot manage a long visit, but I would like to keep in touch.”
The Aspergillosis Support and Community page includes information about our online meetings and other ways to connect with people who understand some of the challenges of living with aspergillosis.
Be kind to your body and your energy
Your physical and mental wellbeing are closely linked. Gentle, regular routines can help, but they should be adapted to your health and energy—not based on what you think you “should” be able to do.
- Keep as regular a sleep routine as possible.
- Eat and drink regularly, particularly when symptoms or medication affect appetite.
- Include movement that is safe and realistic for you, such as a short walk, stretches, breathing exercises or a programme recommended by your physiotherapist.
- Make time for something absorbing or enjoyable: music, reading, gardening, crafts, a favourite programme or talking with someone you like.
- Notice whether alcohol, smoking, poor sleep or relentless activity are making your mood or symptoms harder to manage.
Make room for difficult thoughts
Trying to push away every worry can sometimes make it more persistent. It may help to name what is happening: “I am feeling frightened about my symptoms today,” or “I am worried because I do not yet have an answer.”
Talking to someone you trust can reduce the pressure. Some people find it helpful to write worries down, practise relaxation or mindfulness, or set aside a short, specific time to think through a concern rather than allowing it to take over the whole day.
If health news or social media leaves you more anxious, consider limiting it to a set time each day and using trustworthy sources. You do not need to follow every new story to be well informed.
Ask for support early
Please speak to your GP, respiratory team or another healthcare professional if low mood, anxiety, panic, poor sleep or loss of interest in everyday life is lasting, worsening or affecting how you manage. Support can include practical advice, talking therapies, medication where appropriate, or referral to local services.
The NHS Every Mind Matters website has practical tools and advice for managing stress, anxiety, sleep and low mood.
Urgent mental-health support
If you or someone else is in immediate danger, call 999 or go to A&E. For urgent mental-health support in England, call 111 or use NHS 111 online and select the mental-health option. You do not have to manage a crisis alone.
Further information
- Mental health and anxiety
- Aspergillosis support and community
- NHS Every Mind Matters
- NHS mental health information and support