Winter coughs and colds can be a nightmare for many people throughout the cold weather, with those most vulnerable encouraged to take extra precautions to prevent disease, such as annual flu jabs and Covid vaccinations. The average cough lasts around 18 days but it can be difficult to determine whether your cough is ‘just a cough’, or it’s more serious.
One doctor has given in-depth advice on how to know if your cough will likely subside on its own, or needs the help of a doctor, as he details the three types of cough, their different symptoms, and different treatments. That advice comes as whooping cough infections are soaring.
Whooping Cough starts with cold-like symptoms but can lead to severe coughing fits lasting up to three months. Because of these long-lasting symptoms, it is sometimes called the 100-day cough.
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While symptoms often start like a cold, they progress to outbursts of coughing which can sometimes cause vomiting or choking. The cough sometimes has a characteristic ‘whoop’ sound.
Across England and Wales there have already been more cases of the highly contagious disease sometimes known as the ‘100-day cough’ in the first three weeks of January than in the whole of 2022. Health chiefs have urged parents and pregnant women to look out for symptoms.
Health authorities have received notifications of 636 suspected cases. Over the whole of last year there were 1,728 suspected cases of Whooping Cough, triple the number in 2022 (560), and 2021 (527).
In Greater Manchester there have been 36 suspected cases, as of January 27, with Manchester recording the highest number of infections with seven.
The three types of cough
Dr Malathy Munisamy, a clinical research physician involved in respiratory research at MAC Clinical Research, has given important advice on how to spot if any cough is becoming more of a problem. He said: “If your cough lasts three weeks or more, you should book a visit to see your GP.
“Standard coughs, which are often ‘harmless’, settle on their own within a couple of weeks. A cough is simply the body’s natural response to any irritations within the airways. Coughs can be categorised into three groups; acute, subacute, and chronic.”
Acute coughs
Acute coughs last less than 3 weeks and are most seen with colds or upper respiratory infections. Other causes include Covid-19 and other lung conditions such as acute bronchitis, tracheobronchitis, pneumonia, acute exacerbations of asthma, COPD, bronchiectasis, pulmonary embolism, or pneumothorax.
Acute coughs can be caused by post-nasal drip, which is usually set off allergies and the mucus caused by them. Symptoms include:
- Dry or tickly cough, usually presenting white mucus
- Feeling of mucus dripping down the throat
- Can cause the throat to feel sore and swollen
A steroid-based nasal spray can ease inflammation in the nose to reduce the mucus, says the doctor
For acute coughs caused by colds and flu, symptoms include:
- Sore throat with a cough that sometimes produces yellow phlegm
- Headaches
- Muscle aches
- Sneezing
- Increased temperature/fever
Colds and flu are caused by viruses spread through droplets in the air from people coughing and sneezing. This means they are contagious and if you’re near someone with either of these, you are susceptible to falling ill also.
The viruses cause the membranes within the nose and throat to become inflamed, which in turn causes coughing and sneezing.
As this cough is caused by a virus, rest, hydration, paracetamol, ibuprofen or cold relief medication are usually effective treatments. If you are taking antibiotics for viruses, these will not work and could lead to bacterial antibiotic resistance, says Dr Munisamy.
Sub-acute coughs
Sub-acute coughs last approximately three to eight weeks and usually occur after an infection such as Mycoplasma pneumonia or Bordetella pertussis (known as ‘whooping cough’).
Sub-acute coughs caused by chest infections, can include symptoms like:
- A chesty cough
- Wheezing, shortness of breath and chest pain
- High temperature, aching muscles, fatigue and headaches
- Lots of dark yellow or green mucus
Chest infections are usually caused by a virus, such as bronchitis. Chest infections can either be viral or bacterial, both are treated with different medications.
Either antiviral medication or an antibiotic can be prescribed alongside the usual advice of rest, paracetamol, and hydration, says the doctor.
A cough caused by Covid could include symptoms such as:
- A new continuous cough, which means you cough a lot for more than an hour or have three or more coughing episodes in 24 hours
- A high temperature
- A loss or change to your sense of smell or taste
- Shortness of breath and/or a sore throat
- Tiredness, runny nose, diarrhoea
Most of us will know that it is caused by a virus called severe acute respiratory syndrome coronavirus 2(SARS‑CoV‑2), which emerged in 2019. While there are vaccinations against developing severe symptoms of Covid, treatment is mostly the same as when you have a cold or flu; staying hydrated, getting lots of sleep, and paracetamol for when you feel uncomfortable.
If you are categorised as ‘vulnerable’, ensure you are up to date with your Covid vaccination to avoid severe symptoms.
Symptoms for coughs caused by pneumonia include:
- A wet cough, sometimes with foul-smelling green or yellow mucus
- Shortness of breath, chest pain, and a wheezing noise when you breathe
- A high temperature
- Aches and pains and feeling very tired
- Loss of appetite
Pneumonia is usually caused by a bacterial or viral infection, much the same as a chest infection, but the infection and its symptoms are much more severe. Hydration and medication, such as antibiotics or antivirals, is recommended, but if you are at risk of serious illness, (for instance, if you are over 65), have cardiovascular disease, a lung condition, or if it is your baby or child that has pneumonia, you may need to go to hospital to receive further treatment and oxygen.
Chronic Coughs
The third type of coughs are known as chronic. They last eight weeks or more and are commonly seen in people exposed to cigarette smoke (either actively or passively) and from a variety of lung conditions including asthma, COPD, bronchitis, bronchiectasis, lung cancer, interstitial lung disease, and heart failure.
Environmental or occupational causes may also contribute to chronic coughing.
For coughs cased by chronic obstructive pulmonary disease (COPD), symptoms include:
- Shortness of breath and a persistent cough
- Wheezing and chest tightness
- Fatigue and frequent respiratory infections
- Increased amounts of mucus, commonly coloured brown
COPD is a term given to a group of lung conditions including bronchitis and emphysema. Prolonged or long-term exposure to damaging irritants, such as smoking, dust, chemicals, and fumes are the primary cause of COPD.
There is currently no cure for this progressive illness, but there are lifestyle changes which can help ease symptoms and aim to prolong life expectancy. These include stopping smoking, bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and oxygen therapy. Speak to your doctor or GP about the options available.
Coughs caused by idiopathic pulmonary fibrosis (IPF), have symptoms including:
- Shortness of breath and a persistent dry, hacking cough
- Chest discomfort or chest pain
- Fatigue and unintentional weight loss
- Clubbing of the fingers and toes
- Producing a brown or red-tinged phlegm
‘Idiopathic’ means that the cause of pulmonary fibrosis is unknown, however, there are several theories proposed for contributing to the development of IPF, such as long-term exposure to various environmental agents, including dust, pollutants, and certain occupational hazards, genetic factors and potentially some viral infections. There are medications, supplemental oxygen, pulmonary rehabilitation, and, in some cases, lung transplantation.
Symptoms for coughs caused by lung cancer might include:
- Constant coughing and shortness of breath
- May also experience shoulder pain, loss of appetite, weight loss, or pain when you take in a deep breath
- Coughing up blood or a pink/red phlegm
With 34,800 deaths per year, lung cancer is the UK’s biggest cancer killer. In 72 per cent of cases, lung cancer is caused by smoking alone.
Treatment depends on the type of lung cancer, but patients will often have to go through surgery, radiotherapy, and chemotherapy. If you are worried about a new persistent cough, or you’re concerned that the symptoms described above fit with your condition, then do consult your GP or doctor at the earliest opportunity.
MAC Clinical Research is also running a paid clinical trials, testing potential new treatments for people with COPD and IPF. There are trials available across the north west, Yorkshire and the north east. Find out if you could be eligible to take part here.
Sarah Carter is a health and wellness expert residing in the UK. With a background in healthcare, she offers evidence-based advice on fitness, nutrition, and mental well-being, promoting healthier living for readers.
