It’s respiratory illness season, and the country is witnessing a steady rise in flu, COVID-19, and respiratory syncytial virus (RSV) infections. As people spend more time indoors and gather with loved ones for the holidays, the spread of these illnesses has become increasingly noticeable.
Additionally, reports of a severe, persistent cough are becoming more common. One TikTok user described it as “a hacking cough that’s been going on for weeks,” reflecting what many others are experiencing.
Physicians across the nation have also observed this trend. Dr. Scott Braunstein, a double-board-certified internal and emergency medicine physician, shared with HuffPost: “We’re seeing an unusually high number of patients who initially had typical viral upper respiratory infections, but their cough has lingered for weeks to months.”
Experts suspect that another bacterium may be exacerbating respiratory symptoms rather than the usual culprits like the flu or COVID-19.
Dr. Janet O’Mahony, an internal medicine specialist at Mercy Medical Center in Baltimore, Maryland, reported that several of her patients have recently sought care for a persistent cough lasting about two weeks. Many of these cases are also accompanied by post-nasal drip, sore throats, and sinus congestion.
Dr. O’Mahony told HuffPost: “This chest cold comes with a really junky and persistent cough.” She noted that COVID-19 and flu tests for these patients have come back negative. According to her, the lack of response to medications suggests that the illness is “purely viral.”
“This illness is caused by common viruses like rhinovirus, non-COVID coronaviruses, or adenoviruses,” O’Mahony explained.
However, the exact cause remains unclear. Dr. Theodore Strange, an internal medicine specialist with Northwell Health, stated that primary care physicians and urgent care centers typically do not test for these other viruses unless patients are hospitalized with severe symptoms. He added that rhinovirus or adenovirus could be responsible for the ongoing cases.
According to the Cleveland Clinic, these viruses often produce flu-like and cold-like symptoms that may persist for an extended period. Once a virus enters the airways and infects cells, it replicates, causing significant discomfort and inflammation in the chest, nose, and throat. This inflammation can take time to subside.
Dr. Braunstein explained that the persistent cough is likely due to prolonged airway inflammation. The body continues to produce mucus and experiences bronchospasms — tightening of the airway muscles — as part of the recovery process. “This inflammation can last anywhere from two weeks to two months for some individuals,” he noted.
If you cough for weeks, how long are you contagious?
Determining the precise duration of contagiousness for upper respiratory illnesses can be challenging. According to Dr. Theodore Strange, people are likely most contagious in the 24 hours prior to the onset of symptoms.
This heightened contagiousness usually lasts for a few days. Dr. Janet O’Mahony explained, “We typically consider the first three days of a cold to be the most infectious, but contagiousness can linger beyond that.”
Dr. Strange noted that people often remain infectious for five to seven days. Similarly, Dr. Scott Braunstein added that, like COVID-19, individuals are generally considered non-contagious after 10 days. However, some individuals may remain contagious for a longer period.
For example, people with compromised immune systems may continue to shed adenoviruses for months, even if they are asymptomatic.
How to treat your cough
If you’re experiencing upper respiratory symptoms, it’s important to get tested for COVID-19 and the flu. Both illnesses are becoming increasingly common, and while COVID-19 symptoms often include a dry cough and headache, they can sometimes be mistaken for a typical cold.
“Both COVID-19 and the flu involve coughs and can include sore throats,” explained Dr. Janet O’Mahony. She emphasized that knowing which illness you have is important for treatment. For example, Paxlovid may be helpful if you test positive for COVID-19, while antiviral medications like Tamiflu, Relenza, Rapivab, or Xofluza can be effective for the flu.
Even if your COVID-19 and flu tests come back negative, consulting a healthcare professional—such as a primary care physician, urgent care center, or telemedicine provider—is still recommended.
Dr. Theodore Strange noted that there are no specific treatments for rhinovirus, adenoviruses, or RSV. However, your healthcare provider may recommend rest, staying hydrated, and using over-the-counter medications like Robitussin DM or Mucinex DM (if there are no contraindications) to help manage symptoms.
In some cases, they may also prescribe medications like corticosteroids or cough suppressants to reduce airway inflammation and provide symptom relief.
If your symptoms persist for a few weeks, it’s advisable to consult your doctor. Serious bacterial infections, such as pneumococcal pneumonia, legionella, or mycoplasma (commonly known as walking pneumonia), can cause a persistent hacking cough.
Dr. Theodore Strange explained that your doctor can perform tests and prescribe appropriate medications if they suspect any of these conditions. Dr. Scott Braunstein added that some individuals may develop a new viral infection or a secondary bacterial illness. Warning signs of such complications include darker or thicker phlegm and the onset of a new fever.
To prevent the spread of illness, Dr. Strange emphasized covering your mouth and nose when coughing and washing your hands frequently. If you’re feeling particularly unwell, it’s essential to listen to your body and stay home until you recover.
“These viruses are likely to stick around for the next few months, as we are officially in the middle of cold and flu season,” Strange noted. He advised taking extra precautions and exercising common sense if you or those around you fall ill.
This article was first published on HuffPost.
