Causes, Treatment, and When to See a Doctor
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Karen Peterson of Seattle started feeling fluish right after Thanksgiving, with sniffles, aches, cough, and feverish discomfort. About six days later, she was feeling better, but an annoying cough kept hanging on for about three weeks.
“I would often just start coughing when I was dropping off to sleep, which can be especially annoying,” says Peterson. “When I went to a movie theater, I had this irresistible urge to cough, but I didn’t want to disturb anybody.”
Although her cough mostly went away by mid-January, she has still been experiencing an occasional tickle in the throat.
Reports of nagging coughs like Peterson’s have been more common lately, as Centers for Disease Control and Prevention (CDC) data indicates cases of respiratory illnesses such as flu and COVID have been on the rise.
“We’re seeing more coughs lately because more people are getting sick due to the higher frequency of viral infections in the community,” says Daniel Sullivan, MD, an internal medicine specialist at the Cleveland Clinic.
Trish Perl, MD, a specialist in infectious diseases and a professor in the department of internal medicine at UT Southwestern Medical Center in Dallas, has also been noticing increasing cases of coughs as well as sore throats in her part of the country.
“This is all based on anecdotal information because we don’t have a definitive way of tracking coughs in the United States,” says Dr. Perl.
In addition to cases of flu, COVID-19, and RSV (respiratory syncytial virus), Perl has noted more respiratory infections this season due to adenovirus (detailed by the CDC) and human metapneumovirus (hMPV) — both which can cause the common cold and lead to a nasty cough.
Why Are There More Long-Lasting Coughs?
Coughs are divided into three types, according to the Cleveland Clinic. Typically, people have temporary “acute” coughs that last two to three weeks. But Sullivan and Perl say they have been seeing more “subacute” coughs that stay around after you’ve had an infection and last three to eight weeks, as well as “chronic” or persistent coughs that hang on beyond eight weeks.
Khalilah Gates, MD, associate professor of pulmonary and critical care medicine and medical education at Northwestern University Feinberg School of Medicine in Chicago, also has been aware of more people currently having subacute or chronic coughs.
She points out that this would be nothing unusual for a typical winter virus season before the pandemic.
“We had been without much respiratory virus for three years because of our mask mandates and lockdowns,” says Dr. Gates. “We have to remember that under normal conditions it’s not unusual to see these lingering coughs.”
People Who Haven’t Been Vaccinated May Experience More Persistent Coughs
Perl theorizes that the duration of coughs stemming from flu, COVID-19, or RSV may depend on whether or not an individual has been vaccinated. She stresses that symptoms are generally less severe for those who have been vaccinated and a cough may get better more quickly.
According to the CDC, only about half those who are eligible typically get the flu shot, while data as of November 14, 2023, indicates only about 14 percent of U.S. adults have gotten an updated COVID-19 vaccine.
According to infectious disease specialist Helen Chu, MD, with UW Medicine in Seattle, the current flu vaccine is well matched to protect against all three kinds of flu virus circulating now — influenza A (H1N1) viruses, influenza A (H3N2) viruses, and influenza B viruses. She suggests that the new monovalent COVID-19 vaccine should provide good protection against JN.1, the predominant variant, per the CDC.
“This is the first season that the RSV vaccine has been approved, but RSV certainly is circulating and if you’re eligible to get your vaccine, you should be getting it,” adds Dr. Chu.
What Causes a Cough to Hang On and When to See a Doctor?
Rohan S. Mankikar, MD, pulmonologist and clinical instructor of medicine at NYU Langone Health in New York City, speculates that some of these coughs may be longer-lasting because certain viruses may be more “virulent.”
“Some viruses may have the ability to get deeper down in our airways, and rather than only infecting the upper respiratory tract, they also migrate further into the lower tract including the bronchi and bronchioles [smaller airways],” says Dr. Mankikar. “Once they replicate in that region, the symptoms take a longer time to improve.”
A cough often will go away over time, but Mankikar urges patients to see a physician as soon as possible if they develop a persistent fever, chest pain, persistent hoarseness, shortness of breath, or palpitations.
Home Remedies to Treat a Lingering Cough
Peterson found that taking walks and drinking herbal tea eased her coughing, and taking cough syrup helped her sleep at night. Here are a few other tips on how to soothe a cough, according to the CDC and the doctors interviewed for this article:
- Drink extra fluids and liquids to stay hydrated and reduce excess mucus production.
- Use a cool mist vaporizer or saline nasal spray to relieve congestion.
- Take honey to ease cough (for adults and children 12 months or older).
- Exercise to loosen and cough up mucus more effectively.
Note that while some people swear cough suppressants help, research has shown over-the-counter cough medicines are generally ineffective. Mankikar warns that cough suppressants may reduce the ability to expectorate (cough up phlegm) so doctors are cautious when prescribing them because they want to make sure that patients can clear their airways.
“Healthcare providers, however, can provide medications that will diminish the symptoms while the body’s healing,” says Dr. Sullivan. “It may take weeks, but I can say with great confidence, the cough will eventually go away.”
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