by Dr. Iain Corness
The summer cough?
We have just gone from winter to
summer, and with the change of seasons comes some different pathogens. The
Summer cough is one of them. Have you had the summer cough yet? If not,
think yourself lucky, just about everyone else has had it. And it isn’t one
of those coughs which goes away in a couple of days, patients are saying it
takes at least a couple of weeks. Or even longer.
There are many reasons for epidemics such as these, and most occur with the
change of seasons, hot to cold, cold to wet and so forth, but with the vast
majority, the common carrier of the bug is the human race. This time we
can’t blame an innocent mosquito!
Yes, we are the ones who go to work and spread our germs to the office,
exploding an aerosol of potentially debilitating diseases into the air,
every time we cough. This is the commonest way of transferring the bugs, by
what we call droplet infection. Every droplet capable of carrying thousands
of microbes, each one looking for another human to infect. You. Or even me.
In our household, my young son brought it home from school, passing it on to
his elder sister and now to his mother. Thank you so much, Evan.
The latest bout has been a form of URTI, which is our acronym for Upper
Respiratory Tract Infection. This is inflammation of the bronchus, that part
of your breathing tube to the lungs before it splits to become the right and
left bronchus. The medical name is therefore “Bronchitis”. The clue is in
the ending - “itis” which generally means inflammation and / or infection.
Thus you can get Appendicitis (inflammation of the Appendix) and Pharyngitis
(inflammation of the pharynx), Laryngitis (inflammation of the larynx) etc.,
etc., you get the picture.
Infection and irritation of the breathing tubes is, as we said in the
beginning, very common. The most usual predisposing cause is, however, our
old friend cigarette smoking! If you don’t believe that cigarette smoke is
irritating, try letting cigarette smoke waft into your eyes and see how they
will sting and water. Your Sinuses and Bronchi do just the same! Once the
irritation begins, the mucosa becomes swollen, and it becomes easier for the
germs to take a hold.
With Bronchitis, it generally begins as a slight irritation deep in the back
of your throat. There can be some soreness as well, even on swallowing.
Unchecked this develops into a ‘productive’ cough, with loads of gunk being
coughed up, which we refer to as ‘sputum’.
One of the signs and symptoms your doctor will want to know is, “What color
is your sputum?” This gives us a chance to see if your cough is from an
irritation or infection. If you are bringing up large lumps of yellow or
green glue then you have an infection, but if the mucous is clear then you
probably do not harbor a nasty little bug in your throat. If however, the
sputum is red and bloodstained then you may have burst a little blood vessel
in the throat - or of course, this could be an early sign of lung cancer but
don’t panic yet!
If the sputum you are coughing up is thick, green and gooey, this is fairly
suspicious of a bacterial infection, and sometimes we will attempt to “grow”
the bug to identify it. No, this is not for germ warfare, it is just so that
we can feed the tracheal bug some different antibiotics to see which ones
exterminate the bug best. This is a much more accurate way of choosing the
correct antibiotic, than selecting ones by the pretty color they are on the
If you have gone over a week and your cough is showing no sign of letting up
then it really is time to line up with all the other coughers at the
outpatients department. Just make sure you can describe the color of your
I should have mentioned that if you are a smoker, the chances of the cough
lasting longer are much higher, as well as being more likely to catch the
cough from someone else.