So bronchiectis is a devastating chronic respiratory disease, and it was previously considered to be an orphan disease. In fact, in 2011, the ERS White Book described it as the most neglected disease in respiratory medicine. There was really no common standard of care, very few specialist services, uh, it was a Cinderella condition that very few people cared about, and it's wonderful to see that, the way that that has transformed in the last, uh, 14 or 15 years. Um, when I say it's a devastating condition, it's one that has a huge effect on patients. So patients suffer a daily cough, sputum production, and most patients have an average of 2 or 3 exacerbations per year. So it has a huge impact on quality of life, the quality of life scores in these patients are worse than conditions that we think of as more severe, so if you look at a, a Saint George's respiratory questionnaire, a measure of quality of life in bronchiectasis on average it's worse than in idiopathic pulmonary fibrosis or in severe COPD. So I think even today there's a lack of understanding of just how impactful the disease is on patients. Uh, and because of the frequency of exacerbations, the number of hospital admissions, the amount of contact that patients have with health systems, also how expensive and damaging it is for healthcare systems. Um, so bronchiectis is a major problem, it's actually the 3rd most common respiratory disease after COPD and asthma. Uh, the prevalence is rising because we're recognizing the disease more, uh, and we're addressing historical underdiagnosis. The current estimates in my country, in the UK and it's similar in the US is that about 1 in 200 people are affected by bronchiectis. So you'll sometimes see it referred to as a rare disease, it isn't even close to being a rare disease, it's a, it's a common disease and it's something that, that all, uh, physicians, uh, not just respiratory physicians, need to know about and need to be aware of because it needs to be recognized and it needs to be treated early.
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