Fight coughs, colds and flu
Coughing can be a symptom of many illnesses but at the present time one must consider COVID-19 viral infection. The cough itself may be an irritating tickle or a rattling productive cough, or anywhere in between. There may be fever and aching.
- deal with symptoms
- ensure you do not infect other people
- be sure there is nothing more serious
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Coughing is a natural protective reflex designed to propel unwanted substances such as dust, mucus and smoke from the lungs. Coughs are usually caused by a viral infection. At the current time, if you have a sore throat, a persistent cough and headache with a fever, you should ring us or use the NHS 111 coronavirus service online. Only call 111 if you cannot get help online. You will be asked a series of questions to decide if you should self-isolate or attend for testing for COVID-19. Other causes include bacterial infections, asthma, allergic rhinitis, chronic obstructive pulmonary disease (COPD), chronic bronchitis, acid reflux (gastro-oesophageal reflux) and smoking. Uncomplicated coughs usually clear up within 21 days.
Coughs can be broadly categorised into dry tickly coughs and productive chesty coughs. Dry coughs usually happen when the throat or upper airways are inflamed, activating the same reflexes in the central nervous system that make you cough when you inhale something like smoke. This can cause further irritation and perpetuate the cough. Chesty coughs usually occur because cells in the lung are producing fluid resulting in phlegm. Coughing in this circumstance is helpful because it can help clear the phlegm.
Whooping cough is caused by a bacterium called Bordetella pertussis. Since the childhood vaccination programme was introduced many years ago it has become a relatively rare illness in children and is now more common in adolescents and adults. However there was a surge in cases in 2012 leading to many deaths in small babies. This led to the introduction of vaccination in pregnancy between 28 and 36 weeks gestation, with a view to protecting new babies through their mothers' immunity via breast milk.
Whooping cough usually lasts for about three months and is often known as the 100 day cough. It is frequently diagnosed only when a cough has dragged on and on. Typically there are very prolonged bouts (paroxysms) of coughing during which the sufferer cannot breathe. The ‘whoop’ refers to the loud noise made during the taking in of a deep breath after such a long bout of coughing. It is treated with an antibiotic called erythromycin if diagnosed in the first three weeks of the illness but this only prevents spread and does not improve symptoms for the sufferer.
Various epidemics of influenza have occurred over recent years including swine flu and bird flu and specific vaccines are developed annually to protect vulnerable people, or people such as nurses doing vital jobs, from the most prevalent strain of virus that year. Some antiviral treatments, for example Tamiflu, are available for flu virus. Influenza will normally be associated with general muscle aching, fever, exhaustion and sweating. These symptoms last for around ten days in contrast to a simple a cold or 'man flu' as it has been popularly labelled.
The viruses causing the common cold and all other similar upper respiratory tract and chest infections are typically transmitted via airborne droplets (aerosols) usually produced by coughing or sneezing. The infected droplets are either inhaled directly by another person or passed on because they land on and contaminate other objects or surfaces (fomites) are then transmitted by hand into someone else's nose or eyes. It is thought that hand to hand and hand to surface contact are the most important routes of transmission, therefore hygiene, particularly vigorous hand washing, using soapy water for at least 20 seconds, is very important to avoid contracting cold viruses. Cold viruses can live for up to 18 hours in the environment and so the advice ‘Catch it, bin it, and now wash your hands’ is key to prevent spread of colds and flu.
A combination of over-the-counter pain killers such as paracetamol and ibuprofen, together with decongestants such as Sudafed tablets and Otrivine nasal drops are fantastic for helping with a blocked nose. Sedating antihistamines and cough suppressants found in many proprietary products can also make those difficult nights of knowing that when you put your head on the pillow you will start coughing, very much easier. Because a lot of combination products have paracetamol in them it is very important to check the dose and make sure that you are not inadvertently taking an overdose if you are using a mixture of products. It is also very important to stay at home, rest and drink plenty of fluids if you think you have flu. This will help you to recover more quickly and stop you from spreading your infection to others. You can find further information about the medicines available, their mechanisms of action and what to take by clicking here
Other conditions can give similar symptoms such as:
- influenza (flu)
- whooping cough
- allergic rhinitis
When should you ring a doctor
- cough lasts more than three weeks
- difficulty breathing or are breathless at rest
- if you have chest pains
- coughing up blood
You may need a chest X-ray, a phlegm culture to look for bacterial infection, spirometry (breathing into a machine to see whether there is an underlying airway problem as with asthma) or allergy testing.
At the current time, if you have a sore throat, a persistent cough and headache with a fever, you should ring us or use the NHS 111 coronavirus service online. Only call 111 if you cannot get help online. You will be asked a series of questions to decide if you should self-isolate or attend for testing for COVID-19.