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Doctor's Consultation  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 pharmacist’s shelves.
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 sputum!
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.


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The summer cough?