GAtherton

⭐ Recent Aspergillosis Research & Guideline Updates (Week 47)

Several important new papers on aspergillosis, diagnosis, and antifungal therapy were published this week. These include updated UK guidance, new antifungal drug targets, and insights into diagnosing invasive disease in ICU settings.

1. British Society for Medical Mycology (BSMM) Best Practice Guidance

First author: Dr Rebecca Gorton
Institution: British Society for Medical Mycology (UK)
Published: Nov 2025
Focus: Diagnosis + antifungal stewardship + clinical scenarios

Summary

This newly updated best-practice article explains how clinicians should:

  • combine CT scans, IgG/IgE, PCR, and galactomannan

  • choose antifungals appropriately

  • avoid misdiagnosis

  • apply practical recommendations to real-world cases

It is one of the most up-to-date UK-relevant guidance documents.

Why this matters for patients

Better diagnosis → faster correct treatment → fewer unnecessary antifungals.

2. Diagnostic Algorithms for Invasive Aspergillosis in ICU Patients

First author: Dr Anne-Sophie Hartmann
Institution: University Hospital Freiburg, Germany
Published: Jun 2025
Focus: ICU diagnosis & emerging risk groups

Summary

This study shows that invasive aspergillosis is increasingly found in ICU patients, including those who do not have classic risk factors.
It tests new diagnostic “pathways” combining imaging and multiple laboratory markers.

Why this matters for patients

Improves early recognition of life-threatening fungal infections in critical illness.

3. Advances in Antifungal Drug Discovery (FK1 and new targets)

First author: Dr Jonathan Miles
Institution: University of Cambridge, UK
Published: Aug 2025
Focus: New drug targets & antifungal discovery

Summary

This review outlines progress in antifungal development, including:

  • Fungal Kinase 1 (FK1) as a new therapeutic target

  • new chemical classes

  • failings of older antifungals

  • the need for next-generation medicines

Why this matters for patients

Future antifungals may be more effective, safer, and active against resistant Aspergillus.

4. British Thoracic Society (BTS) Clinical Statement on Aspergillus Lung Disease

Lead author (Chair): Dr Elizabeth Sapey
Institution: University of Birmingham / British Thoracic Society
Published: May 2025
Focus: Chronic Aspergillus disease (CPA, ABPA, SAFS, Aspergillus bronchitis)

Summary

This statement sets out national guidance to improve diagnosis and management of chronic Aspergillus-related lung disease.
It supports earlier testing, consistent management, and clearer referral pathways.

Why this matters for patients

  • Better recognition of CPA and ABPA

  • Fairer access to specialist care

  • More consistent treatment across the UK

5. New Antifungal Drug Classes in Development (Rezafungin, Ibrexafungerp, Olorofim)

First author: Prof David Denning
Institution: University of Manchester / NAC
Published: Sep 2025
Focus: Emerging antifungal drugs

Summary

This review discusses the latest antifungal medicines in the pipeline:

  • Rezafungin – long-acting IV drug

  • Ibrexafungerp – new oral class

  • Olorofim – strong activity against resistant Aspergillus

It explains mechanisms of action, clinical trial progress, and potential future roles.

Why this matters for patients

New drugs are on the way to treat resistant and difficult Aspergillus infections.

📘 Summary Table (with authors & institutions)

Title/Topic Date First Author Institution Key Focus
BSMM Best Practice Nov 2025 Dr Rebecca Gorton British Society for Medical Mycology (UK) Diagnosis & stewardship
ICU Diagnostic Algorithms Jun 2025 Dr Anne-Sophie Hartmann University Hospital Freiburg, Germany ICU diagnosis
New Antifungal Drug Targets (FK1) Aug 2025 Dr Jonathan Miles University of Cambridge Drug discovery
BTS Clinical Statement May 2025 Dr Elizabeth Sapey University of Birmingham / BTS Chronic Aspergillus disease
New Antifungal Classes (Rezafungin/Olorofim) Sep 2025 Prof David Denning University of Manchester / NAC New drug development

💬 Overall Takeaway for Patients

Recent publications show strong progress:

  • Diagnosis is improving, especially in ICU and chronic disease clinics.

  • New antifungals are progressing, including drugs designed specifically to address resistance.

  • UK-specific guidance is strengthening, helping ensure more consistent, high-quality treatment for ABPA, CPA, SAFS, and Aspergillus bronchitis.

This is a period of rapid advancement in aspergillosis care, and the findings highlighted here directly support better outcomes for patients.

by GAtherton

ECFG 2025: Key Aspergillus and Antifungal Insights for Patients and Clinicians

The European Conference on Fungal Genetics (ECFG 2025) gathered the leading fungal biology teams from across the world. Although primarily a genetics meeting, several abstracts offered direct clinical relevance for people living with aspergillosis or those working in the field.

The research covered here focuses on:

  • Aspergillus fumigatus

  • mechanisms of disease

  • resistance to antifungals

  • emerging antifungal treatments

  • environmental drivers of disease

  • insights relevant to CPA, ABPA, SAFS, bronchiectasis and invasive aspergillosis

Summary of Key Themes

1. Aspergillus genetic diversity is much greater than assumed

Pangenome work showed A. fumigatus strains possess different virulence genes and resistance traits. This may explain differences in how patients respond to infection and medication.

2. Environmental azole resistance continues to rise

Multiple abstracts confirmed that resistant strips often originate outdoors, shaped by climate, fungicides, soil chemistry, and climate change.

3. Promising new antifungals are advancing

Manogepix shows excellent activity against resistant strains, while several early-stage compounds (such as G-quadruplex ligands) represent brand-new modes of action.

4. Insights into virulence, persistence and treatment failure

Studies on hyphal fusion, echinocandin tolerance, and hypoxia adaptation shed light on chronic and resistant infections.

5. Improved tools accelerate antifungal discovery

CRISPR and genus-wide sequencing speed up the search for new drug targets and better diagnostics.

ECFG 2025 — Table of All Aspergillus / Aspergillosis / Antifungal-Relevant Abstracts

ID Title Lead Author / Presenter Institution Category Why It Matters
WS1.19 Reference pangenomes for A. fumigatus Marion Perrier Friedrich Schiller University, Jena Genomics / Evolution Reveals hidden genetic diversity linked to virulence and resistance.
WS1.20 Antifungal modes of action of G-quadruplex ligands Isabelle Storer University of East Anglia New antifungal mechanisms Suggests a brand-new antifungal class targeting fungal DNA structures.
WP1.2 NL1 as anti-virulence compound Jorge Amich ISCIII, Spain Virulence / Therapeutics May reduce disease severity without relying on killing the fungus.
WP1.6 Ace2 and RAM pathway regulation Devi N. J. Bale — Pathogenesis Controls tissue invasion, morphology and possibly drug sensitivity.
WP1.8 Hyphal fusion and multi-drug resistant heterokaryons Michael Bottery University of Manchester Resistance mechanisms Shows resistance traits may spread between strains via fusion.
WP1.10 Manogepix activity against A. fumigatus Sean Brazil Trinity College Dublin New antifungals Strong activity including against resistant strains and biofilms.
WP1.14 ZfpA and echinocandin tolerance Dante Calise University of Wisconsin Echinocandin tolerance Explains how fungi sometimes survive caspofungin and related drugs.
WP1.16 Genetic background of azole-resistant A. fumigatus Saioa Cendón-Sánchez University of the Basque Country Environmental resistance Confirms resistant genotypes circulate between the environment and patients.
WP1.18 Genus-wide sequencing of Aspergillus Ronald P. de Vries Westerdijk Institute Evolution / Pathogenicity Identifies traits making some species pathogenic to humans.
WP1.22 Climate, soil & fungicide impacts on Aspergillus Thomas Easter University of Manchester Environmental epidemiology Links climate change and fungicides to rising azole resistance.
WP1.32 Multiplex CRISPR to accelerate antifungal research Fabio Gsaller — Research tools Speeds identification of resistance pathways and drug targets.
WP1.42 Hypoxia-driven adaptations in A. fumigatus Olaf Kniemeyer — Pathogenesis Explains persistence of A. fumigatus in low-oxygen lung cavities (CPA).

Detailed Clinical Relevance of the Findings

1. Rising environmental resistance

Azole-resistant A. fumigatus continues to emerge in agricultural and urban settings. Resistant spores are carried in air and soil, meaning people inhale them in daily life. This is especially relevant to those with CPA, ABPA, bronchiectasis and immunosuppression, who are more vulnerable.

Why it matters:
Resistant strains are a growing cause of treatment failure.

2. New antifungal treatments are progressing

Manogepix shows potent activity against resistant Aspergillus and biofilms, key in difficult-to-treat CPA and invasive aspergillosis.

G-quadruplex ligands and NL1 represent early steps toward new antifungal classes, extremely important after two decades of limited drug options.

3. Virulence and survival mechanisms explain persistent disease

Hypoxia adaptation (low-oxygen survival) helps explain why Aspergillus persists in lung cavities.
Hyphal fusion may allow rapid spread of resistance traits.
Echinocandin tolerance mechanisms (ZfpA) reveal why some invasive cases fail to respond.

Why it matters:
These insights help clinicians anticipate treatment difficulties and inform research for new therapies.

4. Better genomic tools support faster discovery

Multiplex CRISPR and pangenomic databases allow scientists to uncover gene functions much faster. This shortens the path to new antifungal development and improves understanding of how resistance evolves.

Conclusion

ECFG 2025 provides important clues about why Aspergillus disease is so persistent, why azole resistance is increasing, and how new antifungal drugs may overcome today’s challenges. It also reinforces that environmental drivers — including fungicide use and climate factors — are a major part of the problem.

For patients, clinicians, and researchers, these findings highlight a rapidly evolving landscape in aspergillosis research, with promising signs of future treatment improvements.

by GAtherton

TIMM 2025 – Aspergillosis-Relevant Highlights for Non-Specialist Professionals

BRIEFING: Key Aspergillosis Themes from TIMM 2025

(For non-specialist professionals and patient advocates)

The 2025 TIMM abstracts show continuing concern around rising azole resistance, emerging Aspergillus species, and ongoing diagnostic challenges in chronic and invasive disease. A growing number of studies highlight the importance of environmental surveillance, molecular diagnostics, and recognising less typical at-risk groups such as people with viral pneumonias, COPD, and those receiving new biologics or immunomodulators.

Clinical messages for non-specialists:

1. Environmental and agricultural azole use remains a major resistance driver

Multiple studies (Latin America, Spain, Belgium) confirm that agricultural triazoles continue to select for resistant Aspergillus fumigatus. Resistant strains do reach hospital environments, including ICUs and haematology wards.

Implication:
Healthcare teams must remain alert to azole treatment failure, consider susceptibility testing, and recognise that resistance is no longer rare.

2. Cryptic and emerging Aspergillus species are increasingly recognised

Traditional diagnostics often miss less common species such as A. turcosus, A. hiratsukae, and A. pseudodeflectus.
MALDI-TOF may misidentify these species; molecular sequencing gives clearer answers.

Implication:
If disease progresses unexpectedly or does not respond to standard therapy, consider the possibility of an unusual Aspergillus species.

3. New risk groups for invasive aspergillosis

Studies from Europe highlight increasing cases of IA in:

  • Severe viral pneumonia (RSV, influenza, COVID-19)

  • Patients receiving modern biologics (tocilizumab, oblituzumab)

  • Children with haematological cancers

  • Lung transplant recipients (with late-onset IA)

  • COPD patients or those without classical immunosuppression

Implication:
Non-specialists should be aware that IA is no longer confined to neutropenia or transplant; clinicians should maintain suspicion in severely unwell respiratory patients.

4. Diagnostic testing improves when multiple methods are combined

Several abstracts show:

  • Combining galactomannan + PCR on BAL substantially improves detection.

  • Western blot + IgE/IgG pairing improves ABPA and CPA diagnosis.

  • ICAP alone has a very high false-positive rate.

Implication:
Do not rely on a single test. ABPA and CPA particularly require combined clinical + radiological + serological evidence.

5. Aspergillus biofilms remain important and difficult to treat

Biofilm studies show that:

  • Mature Aspergillus biofilms are highly drug-tolerant.

  • Co-habiting bacteria (e.g., Stenotrophomonas maltophilia) enhance biofilm stability.

  • Biofilms may explain chronic, relapsing airways disease patterns in CPA/ABPA/bronchiectasis patients.

Implication:
Patients with chronic or relapsing symptoms may have biofilm-driven inflammation and reduced antifungal penetration.

6. Mortality in invasive disease remains high

Reports from transplant units and paediatric oncology centres show:

  • 58% mortality in paediatric invasive aspergillosis.

  • 6% IA-related mortality in lung transplant cohort (with many later indirect deaths).

  • Early diagnosis and correct drug choice remain critical.

Implication:
Prompt recognition and appropriate antifungal selection (including combination therapy when needed) remain essential.

TABLE OF ALL RELEVANT ASPERGILLUS / ASPERGILLOSIS / ANTIFUNGAL ABSTRACTS

(From full-document review; includes resistance, diagnostics, epidemiology, biofilms, and case reports)

ID Title / Topic Type
Latin America Environment Study Environmental azole resistance across 12 countries; 2152 A. fumigatus isolates Environmental / Resistance
P026 A. fumigatus in Belgian hospitals: triazole resistance surveillance Environmental / Clinical resistance
27-Year Spain Study (Ashraph et al.) 118 azole-resistant strains; multiple fungicide resistance mechanisms Environmental / Genomics / Resistance
P317 Invasive sinus aspergillosis by A. hiratsukae in transplant recipient Case report / Cryptic species
CPA Case – A. pseudodeflectus Chronic necrotising CPA from rare Usti-section Aspergillus CPA / Case
P389 Metagenomics confirming mixed Aspergillus infection (A. niger + A. terreus) Diagnostics / Mixed infection
A. turcosus fatal IA case Cryptic fumigati species causing fatal invasive infection Case report / Cryptic species
P213 Difficult CPA diagnosis in COPD CPA / Clinical
P224 Recurrent maxillary sinus aspergilloma with bone destruction Sinus aspergillosis
P267 Epidemiology of Aspergillus-related lung disease (IPA, CPA, ABPA) in Marseille Epidemiology
P252 Species distribution in 418 filamentous fungal infections – Aspergillus dominant Epidemiology
Lung transplant cohort (1100 pts) IPA incidence, risk factors, treatment outcomes IPA / Transplant
Paediatric oncology IA cohort 43 cases; high mortality Paediatric IA
P352 RSV-associated invasive pulmonary aspergillosis Viral-associated IPA
Asp-WB + ICAP combination study Improved diagnosis of ABPA/CPA; ICAP alone widely false positive Diagnostics
Molecular vs GM vs culture study PCR on BAL highly accurate for Aspergillus detection Diagnostics
P154 Lateral flow assay (LFA) for Aspergillus in sputum/serum Diagnostics
Mixed biofilm GAG study Bacterial–fungal synergy increases biofilm resilience Biofilms / Pathogenesis
P090 Aspergillus biofilm extracellular matrix across strains and mixed species Biofilms
TB–fungal co-infection (Aspergillus rare but present) 7 Aspergillus co-infections among TB cohort Epidemiology

TABLE OF ALL RELEVANT ASPERGILLUS / ASPERGILLOSIS / ANTIFUNGAL ABSTRACTS WITH SUMMARIES

ENVIRONMENTAL & RESISTANCE STUDIES

1. Latin America Environmental Study

Topic: Air sampling in 12 countries: azole-resistant A. fumigatus widely present.
Summary: Large-scale citizen-science sampling found resistant Aspergillus spores across cities, rural sites, and farms. Confirms that humans inhale resistant strains from the environment, not just healthcare settings.

2. P026 — A. fumigatus in Belgian Hospitals

Topic: Hospital environmental surveillance for triazole resistance.
Summary: Resistant strains were found inside clinical areas, indicating they can enter hospitals via outdoor air. Important for infection control planning and for selecting appropriate antifungal therapy.

3. 27-Year Spanish Resistance Evolution Study (Ashraph et al.)

Topic: 118 azole-resistant isolates characterised over nearly three decades.
Summary: Shows a clear link between agricultural fungicide exposure and clinical resistance. Some strains developed multi-fungicide resistance, not just medical azoles.

CLINICAL CASES & CRYPTIC SPECIES

4. P317 — A. hiratsukae Sinusitis in Transplant Patient

Topic: Rare Aspergillus species causing invasive sinus disease.
Summary: Standard tests misidentified the fungus. Molecular sequencing confirmed a rare species. Highlights the need for advanced diagnostics when patients fail to improve.

5. CPA Case — A. pseudodeflectus

Topic: Chronic pulmonary aspergillosis caused by an unusual species.
Summary: Routine ID methods mislabelled the organism. Demonstrates cryptic species can cause CPA and may have different antifungal patterns.

6. Mixed A. niger + A. terreus Wound Infection (Metagenomics)

Topic: Mixed Aspergillus infection detected only by sequencing.
Summary: Traditional culture missed the second species. Mixed infections may explain poor responses to treatment.

7. A. turcosus Fatal IA Case

Topic: Rare fumigati section species.
Summary: Standard MALDI-TOF misidentified the species. High mortality emphasises why correct species identification matters for appropriate antifungal choice.

8. P213 — CPA Misdiagnosed as COPD

Topic: Chronic necrotising CPA mimicking COPD exacerbations.
Summary: Symptoms and imaging resembled COPD flare-ups. Only biopsy and molecular tests confirmed CPA. Highlights need for fungal testing in patients with atypical COPD.

9. P224 — Recurrent Maxillary Sinus Aspergilloma

Topic: Aspergillus sinus infection with bone involvement.
Summary: Shows how aspergilloma can recur if fungal debris remains or anatomy predisposes to blockage. ENT review and sometimes surgery are essential.

EPIDEMIOLOGY & COHORT STUDIES

10. P267 — Aspergillus Lung Disease in Marseille

Topic: Mix of ABPA, CPA and IPA.
Summary: Many ABPA cases were untreated or misclassified. Underlines widespread under-diagnosis and need for education of clinicians.

11. P252 — Species Distribution in 418 Fungal Infections

Topic: Large clinical review of filamentous fungi.
Summary: Aspergillus was the most common mould isolated, with A. fumigatus dominating. Confirms its continuing role as the most clinically significant mould.

12. Lung Transplant Cohort (1100 patients)

Topic: IA incidence, timing, species distribution and outcomes.
Summary: Early IA occurred from colonisation or environmental exposure; late IA linked to rejection and immunosuppression. Mortality remains high.

13. Paediatric Oncology IA Cohort

Topic: 43 children with invasive aspergillosis.
Summary: Mortality 58%. Mostly in acute leukemias. Underscores need for rapid testing and early therapy in children.

14. P352 — RSV-Associated Invasive Aspergillosis

Topic: Expanding “viral-associated pulmonary aspergillosis” beyond influenza and COVID-19.
Summary: RSV can also predispose immune-competent patients to IA. Important emerging risk category.

DIAGNOSTICS

15. Asp-Western Blot + IgE/IgG Combination Study

Topic: Diagnostic accuracy for ABPA/CPA.
Summary: Combining tests improves accuracy. ICAP alone is unreliable, with high false positives.

16. Molecular vs GM vs Culture Study (Italy)

Topic: Diagnostic accuracy of PCR on BAL.
Summary: PCR in BAL fluid was the most sensitive method. Combining PCR + galactomannan gave the best results.

17. P154 — Lateral Flow Assay (LFA)

Topic: Rapid point-of-care test for Aspergillus antigen.
Summary: Good performance in pre-treated sputum and serum. Promising as a rapid triage tool.

BIOFILM & PATHOGENESIS

18. Mixed Biofilm Study — A. fumigatus + S. maltophilia

Topic: How fungi and bacteria form stabilised mixed biofilms.
Summary: The Aspergillus biofilm sugar GAG enhances bacterial adhesion. Explains why some patients have stubborn, relapsing infections.

19. P090 — Biofilm Extracellular Matrix Study

Topic: Differences in matrix structure across Aspergillus strains.
Summary: Certain strains form thicker, more drug-resistant biofilms. May explain different patient responses to the same antifungal treatment.

TB CO-INFECTION (Aspergillus-related)

20. TB + Fungal Co-infection Study

Topic: TB patients screened for fungal disease.
Summary: Aspergillus infections were rare but present. Highlights need to consider CPA in chronic post-TB lung damage.

by GAtherton

Why Join the Aspergillosis Patient Advisory Group (PAG)?

Supported by the European Lung Foundation (ELF), NAC CARES, and the European Respiratory Society (ERS).

Living with aspergillosis — CPA, ABPA, SAFS, Aspergillus bronchitis or sinus disease — can be overwhelming. Many people feel isolated, struggle to find clear information, or feel unsure how to influence the care they receive.
That is exactly why the Aspergillosis Patient Advisory Group (PAG) exists.

The PAG is supported by the European Lung Foundation (ELF) — based in Sheffield — and by NAC CARES, the patient engagement and support team at the UK National Aspergillosis Centre (NAC) in Manchester. Together, ELF, NAC CARES and the PAG work closely with the European Respiratory Society (ERS) to make sure the patient voice shapes research, education, and clinical practice across Europe and the UK.

What ELF Does

ELF brings together patients, carers, researchers and professionals from across Europe including the UK. It:

  • Provides clear, trustworthy patient information

  • Organises and hosts patient advisory groups

  • Ensures patient voices are included in ERS guidelines and research

  • Supports patient–professional workshops, surveys and consultations

  • Helps patients shape respiratory policy and awareness campaigns

Because ELF is UK-based, participation is easy for UK patients.

What NAC CARES Does

NAC CARES is the patient-facing team at the National Aspergillosis Centre in Manchester.
They:

  • Support UK patients to join the PAG

  • Help connect lived experience from UK clinics to the wider European PAG

  • Share updates, resources, and educational material

  • Bring PAG priorities back into NAC’s clinical and research work

  • Ensure UK patients feel included, represented and supported within ELF and ERS structures

NAC CARES acts as a bridge between UK clinical expertise and European patient involvement.

What the Aspergillosis PAG Does

The PAG ensures that people living with aspergillosis have a direct say in:

  • Research design

  • European Respiratory Society guidelines

  • New diagnostic and treatment pathways

  • Patient-friendly information materials

  • Awareness projects and health campaigns

  • Surveys that drive change in policy and clinical practice

Your lived experience is treated as meaningful expertise.

Why Join the PAG? Why Spend Your Energy?

Many people with aspergillosis have limited energy.
Here is why members say it is worth it:

1. You receive clear, reliable information

Updates on research, antifungals, biologics, trials and guidelines — written for patients, not scientists.

2. Your voice shapes real decisions

ERS guideline committees and research teams listen.
Your input changes how care is delivered.

3. You feel less alone

Aspergillosis is rare.
The PAG connects you with people across Europe and the UK who truly understand.

4. You choose how involved you want to be

You can simply receive updates — or you can complete the occasional survey, join a focus group, or help shape a guideline.
No pressure, no obligation.

5. It improves care for everyone — including you

Your experience helps highlight what really matters:

  • Delayed diagnosis

  • Side-effects

  • Treatment access

  • Fatigue and breathlessness

  • Impact on quality of life

This evidence influences clinicians, researchers and policymakers.

6. It is free, inclusive and easy to join

No travel.
No cost.
All online.
Europe includes the UK, and ELF is based in Sheffield.

Who Can Join?

Anyone affected by aspergillosis:

  • Patients with CPA, ABPA, SAFS, Aspergillus bronchitis or sinus disease

  • People with fungal allergy in asthma or bronchiectasis

  • Family members and carers

No medical background needed.

How to Join

You can join in a few minutes:

👉 https://europeanlung.org/en/patient-advisory-groups/
Choose “Aspergillosis”.

You’ll then receive updates and invitations to take part — always at your own pace.

In One Line:

The PAG gives you good information, a real voice in shaping aspergillosis care, and a supportive community — with full backing from ELF, ERS and NAC CARES.

by GAtherton

FINDING COMFORT & PURPOSE ON LOW-ENERGY DAYS

A Gentle, Resource-Rich Handbook for Aspergillosis, Asthma, Bronchiectasis & COPD Patients

Many people living with aspergillosis (ABPA/CPA), asthma, bronchiectasis and COPD experience unpredictable energy levels, breathlessness, coughing, pain, flare-ups, treatment effects and fatigue.
On these days, large tasks feel impossible — but gentle activities can still offer comfort, focus, pleasure and calm.

This handbook brings together low-energy, low-breathing-demand hobbies and micro-activities, with recommended resources for every ability and symptom level.

Table of Contents

1. Understanding Fluctuating Energy & Breathlessness

Living with lung disease means your available energy changes daily. You may move between:

  • Good days (stable breathing, clearer head)

  • Medium days (ok but fragile)

  • Bad days (breathless, fatigued, flaring, coughing)

This is normal.

Helpful Resources

  • The Spoon Theory by Christine Miserandino

  • The Energy Envelope approach – ME Association

  • NHS Lothian – “Managing Breathlessness”

  • NAC Facebook Community – patient-to-patient pacing strategies

2. Creative Hobbies (All low-energy & breath-friendly)

Creativity calms the mind without increasing breathlessness. Most activities below can be done sitting or reclining.

🎨 Watercolour Painting

Why it helps: slow movements, calming colours, short bursts (5–10 min), easy to pause.

Beginner Tutorials (YouTube)

  • Sarah Burns Studio – gentle landscapes

  • Steven Cronin – skies & mist

  • Watercolor Misfit – textures, blending

  • Liron Yanconsky – excellent for beginners

Materials

  • 100% cotton paper: Etchr, Saunders Waterford, Arches

  • Paints: Winsor & Newton Cotman, Daniel Smith

  • Brushes: Da Vinci / Escoda size 6–8 round + 1" flat

✏️ Drawing & Colouring

Resources

  • Colouring apps: Lake, Pigment, Happy Color

  • Colouring books: Johanna Basford, Millie Marotta

  • Drawing tutorials: Draw With Shiba, Art for Kids Hub

Materials

  • Staedtler Noris pencils

  • Faber-Castell Polychromos

  • Smooth sketchpad

  • Sakura Micron pens

💻 Digital Art

Apps

  • Procreate / Procreate Pocket

  • Ibis Paint X

  • Sketchbook (free)

Tutorials

  • Bardot Brush (digital watercolour)

  • Stayf Draws

  • Genevieve’s Design Studio

🧵 Crafts (very low breath demand)

Knitting, crochet, loom bands, origami, scrapbooking.

Tutorials

  • Bella Coco Crochet

  • VeryPink Knits

  • Jo Nakashima (origami)

Beginner Kits

  • Hobbycraft

  • Etsy

  • The Works

📝 Writing, Journalling, Story Snippets

Apps

  • Day One

  • Penzu

  • Bear Notes

  • Gratitude App

Prompt Sources

  • Pinterest: “Journal prompts chronic illness”

  • Reddit r/Journaling

3. Music, Singing & Breath-Friendly Voice Work

Music is deeply calming and very compatible with breathlessness.

🎧 Listening to Music

Playlists (Spotify)

  • Peaceful Piano

  • Lo-Fi Beats

  • Deep Focus

  • Calming Acoustic

  • Rain Sounds / Ocean Waves

YouTube Channels

  • Ambient World

  • Nature Healing Society

  • Lofi Girl

🎤 Gentle Singing (VERY breath-friendly)

Guided Sessions

  • Singing for Lung Health – British Lung Foundation

  • Sidcot Singing for Breathing (YouTube)

  • Breath-Supported Vocal Warmups – Carolyn Grace Music

Why it's helpful

  • controls exhale

  • relaxes throat

  • reduces panic around breathlessness

😌 Humming

One of the most effective breathing tools:

  • lengthens exhale

  • improves nasal airflow

  • calms upper airway

  • reduces anxiety

🎶 Breathing With Music

Apps:

  • Calm

  • Breathing Zone

  • Insight Timer: “Breathing With Music” tracks

🎹 Easy Instruments

  • Kalimba

  • Tongue/Handpan drum

  • Small keyboard

  • Tablet piano apps: FlowKey, Simply Piano, Yousician

🫁 Singing for Lung Health Groups

Available through:

  • British Lung Foundation

  • Local NHS respiratory teams

  • Online Zoom groups (search “singing for breathing UK”)

  • NAC Facebook events

4. Gentle Movement (Breath-aware & low strain)

🪑 Chair-Based Stretching

Videos

  • NHS Sitting Exercises

  • BLF Chair Exercises

  • Jenny Wren Chair Yoga

  • HasFit Senior Chair Workouts

🛏️ Bed-Based Mini Yoga

Videos

  • Yoga With Adriene (Gentle series, Bedtime)

  • Gentle Yoga for Chronic Illness

  • Sleepy Slow Stretching

🏥 Pulmonary Rehab Mini Exercises

  • NHS PR worksheets

  • BLF Pulmonary Rehab Home Sessions

  • “Living Well With Breathlessness” (NHS Ayrshire)

🥋 Seated Tai Chi / Qigong

Videos

  • Dr Paul Lam – Tai Chi for Health

  • Qigong With Mimi Kuo-Deemer

  • Tai Chi for Seniors (seated)

5. Quiet Mind–Body Practices

🫁 Breathing Techniques

Resources

  • NHS Breathlessness Support

  • BLF Breathing Control

  • 4-7-8 Breathing (guided)

  • Apps: Breathe2Relax, Breathing Zone, Oak

🧘 Guided Relaxation

Apps

  • Calm

  • Headspace

  • Insight Timer

  • Aura

YouTube

  • Michael Sealey

  • The Honest Guys

  • Guided Sleep Meditation channels

🌿 Sensory Grounding

Tools:

  • lavender/chamomile inhaler stick

  • warm mug

  • textured blanket

  • grounding cards (“5-4-3-2-1”)

**6. Low-Effort Cognitive Hobbies

(DAILY PUZZLES, JIGSAWS & BRAIN GAMES)**

Cognitive activities are perfect for breathless or fatigued days because they require almost no physical energy.

🧩 Daily Puzzle Sites

New York Times Games

  • Wordle

  • Connections

  • Mini Crossword

  • Spelling Bee

  • Letter Boxed

Others

  • Guardian Puzzles

  • Telegraph Puzzles

  • BBC Puzzle Hub

  • Washington Post Crosswords

  • AARP Games (gentle)

📱 Puzzle Apps (by energy level)

Very Low Energy

  • Zen Match

  • Tiles

  • Color Sort

  • Simple digital jigsaws

  • Solitaire

Medium Energy

  • Flow Free

  • Nonograms (easy mode)

  • Wordscapes

  • Easy Sudoku

  • NYT Mini Crossword

High Energy

  • NYT Crossword

  • Good Sudoku

  • Lumosity

  • Elevate

  • Brilliant.org

🧠 Tiny “Brain Snacks” (1–2 minutes)

  • Brainful

  • Left vs Right

  • Peak (1-minute games)

  • Picture matching

  • Memory card apps

🧩 Jigsaws

Digital Jigsaws

  • Ravensburger Puzzle App

  • Microsoft Jigsaw

  • Magic Jigsaw

  • Jigidy

Physical Jigsaws

  • 100–500 pieces (fatigue-friendly)

  • 1000+ pieces for long-term projects

  • Use a puzzle roll mat

⭐ Puzzle Difficulty Ladder

(To match breathing & fatigue level)

Level 1 — very low energy / flare

Matching games, colour sort, easy jigsaws, Wordle

Level 2 — low energy, stable

Word searches, Flow Free, easy Sudoku, Mini Crossword

Level 3 — medium

Connections, Spelling Bee, medium Sudoku, trivia

Level 4 — good day

Cryptic crosswords, hard Sudoku, logic puzzles, Brilliant.org

7. Social Connection (without exhaustion)

Low-Effort Options

  • WhatsApp voice notes

  • NAC Facebook & Telegram groups

  • “Photo-a-day” messages

  • 5-minute video chats

  • Online craft or puzzle groups

Apps

  • Telegram

  • WhatsApp

  • Discord “chill lounge” servers

  • Facebook Messenger Lite

8. Good / Medium / Bad Day Plans

Good Day

  • 1 creative hobby

  • 1 gentle movement

  • some music

  • small social contact

Medium Day

  • 1 light creative or cognitive activity

  • breathing practice

  • sensory grounding

Bad Day

  • full rest

  • breathing support

  • soft music

  • low-sensory comfort

9. When Rest Is the Right Choice

Good rest-day resources

  • Calm Sleep Stories

  • BBC Sounds (audiobooks, drama)

  • Bob Ross – The Joy of Painting

  • Nature documentaries (slow paced)

  • Gentle ASMR channels

  • Ambient rain / ocean playlists

10. Final Thoughts

Your worth is not measured by productivity.
On low-energy days, you deserve calm, comfort, connection and kindness toward yourself.

This handbook gives you choices — not obligations.
Pick whatever feels gentle today, and leave the rest for tomorrow.

by GAtherton

Inhaled Steroids and ABPA: Do They Help or Should They Be Avoided?

Many people living with allergic bronchopulmonary aspergillosis (ABPA) also use inhaled steroid inhalers such as Symbicort, Fostair, Seretide or Clenil. It’s common to feel confused about whether these inhalers help, whether they should be continued, or whether they could cause harm.

This guide explains what inhaled steroids do, what they don’t do, and how they fit into the treatment of ABPA, asthma, and bronchiectasis.

1. Understanding the basics

What are inhaled steroids?

Inhaled corticosteroids (ICS) are medications breathed directly into the lungs to reduce airway inflammation, especially in asthma. Combination inhalers (e.g., Symbicort, Fostair) contain a steroid + a long-acting bronchodilator.

What they don’t do

Inhaled steroids do not treat ABPA itself.
ABPA is caused by an immune over-reaction to Aspergillus in the lungs. This reaction sits too deep in the airways for inhaled steroids to reach, and the inflammation is too strong for inhaled doses to control.

This is why ABPA flares are treated with:

  • Oral steroids, or

  • Biologics, such as mepolizumab, benralizumab, dupilumab or omalizumab.

2. Why inhaled steroids are still useful for many ABPA patients

Although inhaled steroids don’t treat ABPA directly, most people with ABPA also have asthma.
In asthma:

  • the airways are twitchy

  • inflamed

  • narrow easily

  • and respond well to inhaled steroids

If your symptoms include wheeze, chest tightness, breathlessness that varies from day to day, or a good response to your reliever inhaler, there is a strong chance that asthma is part of your condition.

In those cases, inhaled steroids can be very helpful in keeping the asthma component under control.

3. When inhaled steroids may offer little benefit

Some patients with ABPA have:

  • minimal asthma

  • mainly bronchiectasis

  • or are fully controlled on a biologic

In these situations, inhaled steroids might not provide much additional benefit and occasionally can increase the risk of airway infections, especially in people with significant bronchiectasis.

This is why doctors sometimes sound vague: the answer genuinely depends on your individual mix of ABPA, asthma, and bronchiectasis.

4. How biologics change the picture

Biologics used for ABPA and asthma (e.g., benralizumab, mepolizumab, dupilumab) reduce airway inflammation far more effectively than inhaled steroids. Once a patient is stable on a biologic, many specialists will slowly reduce the inhaled steroid dose if asthma symptoms remain well-controlled.

This does not happen quickly — it is done gradually and only if your breathing tests and symptoms stay stable.

5. Why there is no simple “yes” or “no” answer

Doctors often hesitate to give a straight answer because inhaled steroids can be:

  • Essential for asthma

  • Optional for mild asthma

  • Less useful if ABPA is the main issue

  • Potentially overused in some bronchiectasis patients

  • Safely reduced in people doing well on biologics

Your treatment has to sit in the right place on that spectrum.

6. Questions that can help you get a clear answer from your own team

Many patients say they receive vague responses. These direct questions can help:

✔ “Am I using this inhaler for my asthma, or for my ABPA?”

(If it’s for ABPA, that usually signals a misunderstanding.)

✔ “Do you think my asthma is active, and is the dose of inhaled steroid still appropriate?”

This invites your clinician to be specific.

✔ “If I stay stable on my biologic, could we review the inhaled steroid dose in the future?”

This aligns with typical specialist practice.

7. The bottom line

  • Inhaled steroids do not treat ABPA itself.

  • They are helpful if you also have asthma — which many ABPA patients do.

  • They may be less useful if asthma is mild or absent, especially in pure bronchiectasis.

  • When patients stabilise on biologics, inhaled steroid doses are often reviewed and sometimes reduced.

  • The best approach is individual: the right treatment mix varies from patient to patient.

If you’re unsure what role your inhaler is playing, it’s absolutely reasonable to ask your specialist to explain exactly why you’re on it and whether the dose is still right for you.

by GAtherton

ABPA or Bronchiectasis? A Detailed Guide to Understanding Flare-Ups

Many people with allergic bronchopulmonary aspergillosis (ABPA) also live with bronchiectasis, and the symptoms can overlap so much that it’s difficult to know what’s flaring. This guide explains what is happening inside the lungs, the typical signs of each condition, and how to judge when to seek help.

1. What exactly happens during an ABPA flare?

ABPA is an allergic immune reaction to Aspergillus in the airways.
The fungus is usually present in tiny amounts, but the immune system over-reacts to it.

During a flare:

  • The immune system releases large amounts of inflammatory chemicals (especially IgE and eosinophils).

  • Airways become swollen, narrow and sticky.

  • Thick, glue-like mucus forms and can block off airway sections.

Typical symptoms of an ABPA flare

  • Increased wheeze, chest tightness or asthma-like symptoms

  • Shortness of breath, sometimes sudden

  • Very thick, sticky, tenacious sputum

  • Mucus plugs — sometimes shaped like soft tubes or “casts” of an airway

  • Drop in peak flow or lung function

  • IgE levels rising (but this may lag behind symptoms by days or weeks)

Colour of mucus in ABPA

  • Often golden-brown

  • Can be brown or even dark brown if old mucus is clearing

  • May contain small black dots (fungal elements) but this can also appear in bronchiectasis

2. What happens during a bronchiectasis flare?

Bronchiectasis is a structural lung condition. The airways are wider and more damaged, meaning mucus gets trapped more easily.

During a flare:

  • The airway lining becomes irritated or infected.

  • Mucus production increases.

  • Trapped mucus becomes a breeding ground for bacteria.

  • Breathing may be heavier simply because of mucus load.

Typical symptoms of a bronchiectasis flare

  • Increase in sputum volume

  • Change in sputum colour (yellow, green, brown)

  • Worsening cough

  • Feeling more tired, feverish, or run down

  • Chest tightness from mucus but not usually dramatic wheeze

  • No immediate change in IgE levels

Bronchiectasis and brown sputum

  • Brown sputum is common when old blood, dried mucus or debris is being cleared.

  • After a lung bleed, blood changes colour as it ages:

    • Fresh = bright red

    • 24–48 hours = dark red

    • After a few days = brown, tar-like, sticky

This often appears suddenly after you think everything has settled.

3. Comparing the two conditions side-by-side

Feature ABPA Flare Bronchiectasis Flare
Main cause Immune/allergic reaction to Aspergillus Infection, inflammation, mucus trapping
Breathing Sudden ↑ wheeze + breathlessness Heavy/chesty breathing, fatigue
Mucus amount Normal amount but very thick or plug-like More mucus than usual
Mucus colour Golden-brown, brown, plug-like Yellow, green, brown
Mucus plugs Common Possible but less typical
IgE Often rises (but may lag) Stable
Peak flow Drops significantly Mild change or no change
General wellbeing Often feel “inflamed” without infection symptoms More infection-like tiredness/malaise

4. Understanding brown sputum properly

Brown sputum doesn’t always mean ABPA.

It can be:

  • Old blood breaking loose

  • Dried mucus from bronchiectasis

  • A mixture of dried secretions and oxidised blood proteins

  • Debris from a recently cleared airway infection

This is why a single brown plug — especially after a bleed — is rarely a sign of ABPA on its own.

5. When you should ask for help

Contact your specialist if you notice any of these:

  • Several days of brown plugs or repeated mucus casts

  • Dramatically increased wheeze

  • Peak flow drop >20% from your baseline

  • Fever, chills, or sudden tiredness

  • Breathlessness that feels “different” from normal

  • A major change in your usual bronchiectasis pattern

  • New chest pain

Seek urgent help if:

  • You cough up fresh bright red blood

  • You feel suddenly very breathless

  • You cough up a large amount of blood-stained sputum

  • You have signs of severe infection (rigors, high fever, confusion)

6. And what about IgE?

IgE is helpful, but has limitations:

  • It rises slowly — sometimes days or weeks after symptoms appear.

  • It can stay stable at your “baseline” even when mild inflammation is happening.

  • A stable IgE level is reassuring, but it does not rule out a flare.

Think of IgE as a trend, not an immediate alarm light.

7. The real-world takeaway

  • Bronchiectasis = more mucus, infected/inflamed feeling, colour change.

  • ABPA = allergic response, wheeze, plugs, sudden breathing changes.

  • Brown sputum alone is not enough to diagnose either way.

  • After a bleed, brown sputum is expected for days as the airway clears.

Learning your own pattern takes time. Even experienced patients still contact their team if something feels wrong — and that’s always the safest approach.

by GAtherton

🌿 Why We All Need to Advocate for Ourselves as the NHS Faces Change and Pressure

A patient-friendly guide to staying safe and getting the care you need

The NHS is going through one of the most challenging periods in its history. Services are under pressure, staff are stretched, and backlogs remain high across nearly every speciality. None of this is the fault of patients or staff — it’s the reality of a system trying to do too much with too little.

In times like this, one thing becomes more important than ever:

⭐ Advocating for your own health.

Advocacy simply means speaking up when you need help, asking questions, and making sure your concerns are heard. It’s not about complaining or demanding; it’s about ensuring you get the support, information, and care you deserve.

Here’s why it matters — and how to do it safely and confidently.

🔍 1. Some things no longer happen automatically

With so many clinics running over capacity, routine tasks can be delayed or missed:

  • Follow-up appointments don’t always get booked

  • Test results aren’t always communicated quickly

  • Reviews may slip off the system

  • New medications sometimes aren’t monitored as closely as they should be

This isn’t because your team doesn’t care.
It’s because the system is stretched.

Advocating for yourself helps fill the gaps.

💬 2. Asking questions keeps you safer

If something is unclear — a result, a new medication, a change in symptoms, or a delay — asking for clarification is not only reasonable, it’s sensible.

Good questions to ask:

  • “When should my next review be?”

  • “Who do I contact if I have a problem?”

  • “What symptoms should I watch for?”

  • “Is there a plan for monitoring?”

Healthcare teams want patients to feel informed.
They would rather you ask than worry in silence.

📞 3. The NHS wants patients to raise concerns early

Early contact helps prevent:

  • deteriorations

  • emergency admissions

  • medication complications

  • worsening long-term conditions

Services rely on patients saying, “Something isn’t right.”
It’s an essential part of safe care, not an inconvenience.

🧭 4. The NHS is changing — and patients play a role in shaping care

Integrated Care Systems (ICS), value-based care, and new digital pathways are all evolving.
These changes aim to make care:

  • more personalised

  • more consistent

  • more focused on real outcomes

But during transitions, there are bumps in the road.

Patient feedback — including when something hasn’t worked — helps services identify where improvements are needed.

You are part of shaping that improvement.

❤️ 5. You deserve to be heard

Many patients worry about “bothering” the NHS.
But advocating for yourself is:

  • responsible

  • appropriate

  • encouraged

  • part of keeping long-term conditions well-managed

You are not asking for anything unreasonable.
You are simply making sure your health is looked after.

🌼 6. How to advocate confidently

Here are gentle, effective ways to speak up:

Be clear
“I haven’t had a review since starting this treatment — can we arrange one?”

Be specific
“I’m unsure who to contact if I worsen. Could you give me the correct number?”

Be persistent if needed
“It’s been a few weeks since I asked — could you update me on the appointment?”

Keep records
Dates, names, symptoms, and messages help everything run more smoothly.

Ask for your named clinician or team
Every patient is entitled to know who oversees their care.

🌟 7. You are not alone — and it’s OK to ask for help

Advocacy doesn’t mean you carry the burden alone.
Groups like NAC, patient communities, and charities can help you:

  • understand the system

  • find the right contacts

  • prepare questions

  • know what to expect

  • get support if you’re struggling to be heard

Empowering yourself helps others too — the more patients speak up, the more the system adapts.

💚 In summary

The NHS is still full of dedicated people who care deeply about their patients.
But the reality of high demand and limited capacity means:

We all have to be a little more active in asking for what we need.

Advocating for your own health is:

  • responsible

  • protective

  • empowering

  • part of modern healthcare

It ensures you get the right care at the right time — and it helps the NHS deliver safer, more responsive services.

by GAtherton

🌲 Why Rough-Cut Wood Arrives Mouldy — and How to Reduce the Risk (Important for Aspergillosis Patients)

For anyone living with aspergillosis, ABPA, bronchiectasis or asthma, mould exposure can trigger symptoms or flares. Recently, several patients have reported that rough-cut timber is arriving mouldy from DIY suppliers, sawmills, or timber merchants.

Here’s why this happens — and what suppliers should be doing to prevent it.

⭐ Why rough-cut wood gets mouldy (especially in the UK)

Mould grows on timber whenever three conditions are present:

  1. Moisture

  2. Poor airflow

  3. Warm or humid air

Rough-cut timber is especially vulnerable because:

  • its uneven surface holds moisture,

  • it is often stacked tightly,

  • it may not be dried properly,

  • and UK weather (rain + high humidity) encourages mould.

Many suppliers wrap wood in plastic, which traps condensation during transport. This can create a humid “greenhouse” around the timber — perfect for mould growth in only 24–48 hours.

⭐ What UK suppliers should be doing (even for low-cost timber)

These are standard industry practices in UK timber yards and sawmills. None of them require wood to be kiln-dried (which is more expensive).

✔ 1. Air-dry properly (“sticker stacking”)

Boards must be stacked with spacers (“stickers”) between them so air can circulate.
No airflow = mould.

✔ 2. Store under cover, not outside in the rain

A simple open-sided shelter is enough.
Rain-soaked timber nearly always grows mould in transit.

✔ 3. Use breathable wrapping — NOT plastic sheeting

Plastic traps moisture.
Breathable paper wrap or perforated cover prevents condensation build-up.

✔ 4. Apply anti-fungal dip (borate)

Most UK sawmills use anti-mould dips to prevent blue-stain and mould during storage.
This costs pennies per board.

✔ 5. Moisture-test before delivery

A good supplier will check wood is below 20–22% moisture before dispatch.
Wet wood + UK weather = guaranteed mould.

⭐ Kiln drying is not essential

Kiln-dried timber is more expensive because it uses energy, equipment, and time to force-dry the wood.

But you do not need kiln-dried timber to avoid mould.

You simply need a supplier who:

  • stores the timber properly,

  • allows airflow,

  • avoids plastic,

  • and checks moisture before delivery.

If rough-cut wood is arriving mouldy, it usually means these steps were not followed.

⭐ What you can do to protect yourself (aspergillosis patients)

If you receive wood that:

  • smells musty,

  • has surface mould,

  • or shows green/black spots,

…it is best not to bring it indoors until cleaned.

✔ Immediately unwrap outdoors

Plastic wrapping traps mould spores.

✔ Keep well away from ventilation intakes, windows, or living areas

This avoids airborne spores entering the home.

✔ If mould is visible — return it

You have the right to reject mouldy timber.

✔ If keeping it, clean outdoors with PPE

Use:

  • gloves

  • FFP3 mask

  • borax solution (borax + hot water)
    to remove early surface mould.

Never sand mould indoors — sanding releases spores.

⭐ Simple Diagram: Correct Way to Store Wood to Prevent Mould

Correct storage includes:

  • boards stacked with spacers between them (“sticker stacked”),

  • raised on bearers above the ground,

  • stored under a roof with airflow on all sides,

  • NEVER wrapped in sealed plastic,

  • ends exposed to allow moisture to escape.

This method is cheap, simple, and prevents mould without needing expensive kiln drying.

⭐ Summary for Aspergillosis Patients

Rough-cut wood should not arrive mouldy.
Mould growth usually means it was:

  • stacked badly,

  • stored wet,

  • wrapped in plastic,

  • or shipped before drying.

For people with aspergillosis, ABPA, bronchiectasis or severe asthma, mould spores can trigger symptoms — so it’s completely reasonable to:

  • refuse mouldy timber,

  • request proper handling,

  • or ask the supplier to follow UK best practice.

by GAtherton

⚠️ Flu Season Warning: UK Flu Cases Are Now Surging — Dominated by a Drifted H3N2 Strain

The UK flu season has begun much earlier and much faster than usual, and cases are now surging across the country. The UK Health Security Agency (UKHSA) confirms that the dominant strain this year is a drifted influenza A(H3N2) variant (sub-clade K). This strain now accounts for the vast majority of flu cases in people tested.

🔥 Why this flu season is different

  • Almost all flu cases are influenza A, and around 84% of typed cases are H3N2.
    This pattern is consistent across community, GP and hospital surveillance.

  • The H3N2 strain circulating is genetically drifted, meaning it has evolved away somewhat from the reference vaccine strain.
    UKHSA has publicly confirmed this drift.

  • This increases the risk of infection spreading rapidly — which is exactly what is happening now.

🛡️ Does the flu vaccine still work?

Yes — despite the drift, UKHSA reports that the 2025–26 flu vaccine still provides important protection, including:

  • ~70–75% effectiveness in children

  • ~30–40% effectiveness in adults

This means vaccination dramatically reduces severity, even if it does not fully prevent infection.

⚠️ Why this matters for people with lung conditions

If you have:

  • ABPA (Allergic Bronchopulmonary Aspergillosis)

  • Bronchiectasis

  • Asthma

  • Chronic lung disease
    …you are at higher risk of:

  • pneumonia

  • severe chest infections

  • hospitalisation

  • long recovery times

H3N2 seasons are historically worse for adults and people with underlying respiratory disease.

🔺 What you should do now

1. Get vaccinated immediately

If you haven’t had your flu jab yet, do not wait.
The season is already surging and accelerating earlier than usual.

2. Be extremely cautious in high-risk environments

  • Schools

  • Public transport

  • Healthcare settings

  • Large indoor gatherings

  • Poorly ventilated rooms

3. Use winter protection behaviours

  • Ventilate indoor spaces

  • Consider wearing a mask in crowded indoor areas

  • Wash hands frequently

  • Avoid contact with people who are unwell

4. If you become ill — act fast

For anyone with ABPA, bronchiectasis or asthma:

  • A sudden fever

  • A sharp rise in cough

  • Change in sputum

  • Chest tightness

  • Breathing changes

…should be treated as early warning signs.
Contact your GP or respiratory team quickly, as secondary pneumonia is more likely in H3N2 seasons.

Summary

Flu is now surging across the UK, driven by a drifted H3N2 strain, and people with underlying lung disease should take this season particularly seriously.
Vaccination remains strongly protective, but additional precautions are vital during this rapid upswing in cases.

by GAtherton