What is laryngitis and what are its causes?

Laryngitis can have a very quick onset, but usually develops as a result of a viral infection of the upper respiratory tract. Although the disease is quite common, its course can be very severe, sometimes critical. Laryngitis is especially dangerous for young children, as they are at a risk of sudden suffocation due to swelling in their small airways.

“Laryngitis is an inflammation of the larynx, which is the cartilage-reinforced tube that connects your bronchi and lungs to allow oxygen to flow through. It is protected by a flap that prevents food and fluids from entering the lower respiratory tract when swallowing. In its vicinity are vocal cords, which are responsible for the voice and other sounds. The larynx is therefore important for the formation of the voice, for breathing, coughing, and swallowing - and these functions can be weakened in its inflammation or laryngitis, "describes Dr. Barbara Taušová, paediatrician at Canadian Medical.

Most often laryngitis is triggered by viral (parainfluenza, influenza, respiratory syncytial virus, and others), which cause inflammation of the larynx and bronchi. Inflammation can also be exacerbated by a secondary colonization of bacteria that are commonly present in the respiratory tract (Haemophilus influenzae, streptococci, staphylococci).

Types of laryngitis

• Acute laryngitis – can start out in a completely healthy individual and has a very quick onset, but also improves after roughly 2 weeks. It is most often caused by an airborne virus, but allergies or intense vocal cord exertion (for example loud or exerted screaming, etc.) may also be to blame.

• Chronic laryngitis – it is often related to a disorder of the nervous system, but it can also be caused by nodules on the vocal cords caused by a prolonged viral infection, injury, frequent inhalation of smoke or chemical fumes. The result is irreversible damage to surrounding tissue, polyps, and tumours.

Symptoms of laryngitis

While in adults the disease isn’t usually very serious, and plenty of fluids and rest usually do the trick, in children the course of the disease can be quite severe. For those that suffer from it often, it can come on suddenly at night and is only preceded by an inconspicuous hoarseness or a mucous cough.  

A typical symptom of laryngitis is dry irritating cough. Furthermore, hoarseness, a sore throat or difficulty swallowing are also common. It may also be accompanied by general weakness, 39 ° C + fever, chest pain and difficulty speaking and can lead to a complete loss of voice. A summary of the typical symptoms of laryngitis include:

• hoarseness and muffled voice,
• weakening of the voice up to complete voice loss
• sore throat, irritating barking cough and difficulty swallowing,
• swelling, gasping, and wheezing,
• increased temperature,
• chest pain and general weakness.

Incubation period, contagiousness, and transmission of laryngitis

The incubation period of laryngitis depends on its specific form. In acute laryngitis, it ranges between 1 and 3 days - this is when the disease is most contagious. Up to 50% of cases are caused by the parainfluenza virus, which is transmitted through the air, and in addition to laryngitis, it can also cause common respiratory diseases such as the flu.

Laryngitis is young children and infants
Laryngitis is the most dangerous for infants and children under the age of 6 years - their airways are very narrow, so even a gentle swelling can become a big problem. Occurrence of laryngitis is more common during the colder months due to a generally lowered immune response in most people.  

The course of laryngitis presents differently in different people. Sometimes the disease can initially resemble a common cold. The onset of the disease is more often sudden, surprising, and dramatic - it usually manifests itself at night. Although the cough may often sound very dramatic, it is usually not life-threatening for the child. The course of the disease can look like this:

• It begins with deeper breathing, which is accompanied by a wheezing sound (so-called inspiratory stridor), because of narrowing of the airways.
• Then there is an increasing severity of shortness of breath - it is important to keep calm and also make sure your child remains calm, as crying can exacerbate the symptoms.

If the patient is a small child or infant, it is highly recommended to see a doctor who will carry out an assessment and a suitable course of medication.  Children are also at risk of dangerous inflammation of the laryngeal flap (epiglottitis), which is however very rare and has practically been eradicated by the compulsory vaccinations. It manifests with a high fever and due to the narrowing of the larynx, the child may suddenly start to suffocate – at which point it is necessary to call an ambulance immediately.

Laryngitis in adults

This disease may also rarely affect older children and adults. Symptoms are usually milder, mainly due to larger airways. Laryngitis in adults can present as a mild infection of the upper respiratory tract or hoarseness.

However, laryngitis can be dangerous for those that suffer from allergies because their mucous membranes are more prone to swelling caused by external stimuli. The possibility of laryngitis in allergy sufferers can thus be minimized by regular use of anti-allergy medication.

One interesting fact is that laryngitis can also present in dogs. This is the so-called whooping cough, which is scientifically called infectious laryngotracheitis, and sometimes also (incorrectly) canine flu. This acute and contagious disease also affects the lower respiratory tract in dogs and is accompanied by a coughing attack.

Treating laryngitis

In adults, simple home remedies a rest are usually sufficient, - do not strain the vocal cords, get plenty of rest and treat a fever. The symptoms are mainly treated – cough medicine/ suppressants can be administered, as well as tablets and syrups to dissolve mucus and ease coughing. Painkillers with acetylsalicylic acid are also suitable, and local antibiotics in spray can be applied for major respiratory problems. However, we recommend taking the medication only after consulting a doctor.

For children, it is recommended to inhale cold humid air during the initial symptoms- wrap the child up into warm clothes and blankets and take them onto the balcony or the garden. Inhalation with a nebulizer is also recommendable. For repeated laryngitis infections, the doctor prescribes a suppository or corticoid tablets, which can be given as so-called "emergency treatment". All measures should lead to a reduction in swelling in the airways and alleviation the coughing or hoarseness," explains Dr. Barbara Taušová, paediatrician at Canadian Medical.

Its highly important that the child's condition be monitored closely and, in the event of deterioration or worsening of symptoms, medical attention is sought out immediately (see Laryngitis in young children and infants).

Tips, tricks & herbal remedies

• We recommend that children be given some lukewarm linden tea or diluted fresh juice.
• It is good to humidify the air in the room where the patient resides, ideally with a humidifier.
• Aromatherapy may also help - for children, the essence of Eucalyptus Lemon is suitable, and can be used even for very young children. Tangerine and lavender are also suitable. Beware though - aromatherapy should be tried beforehand, as some individuals may be quite sensitive to it.

Recommendations for prevention

Laryngitis is a disease of viral origin, so there is no fool proof way to protect yourself from it.  However, as it is often contracted by children, especially in spring and autumn, doctors recommend following a few basic measures that can protect their immune system. This is, for example, regular ventilation or humidification of the air inside the home, and the child should not live in an environment where they are exposed to smoke. It is also recommended to keep the household clean, to wipe dust, to change bed linen regularly, to vacuum often and not to place carpets in the children's room. In the event that a young child or infant becomes ill with laryngitis, it is always safer to seek medical help, and you can contact experts from the EUC clinic.