Cough

Cough is the body's reflex to clear the airways. Most coughs are from a short-lived viral infection, but in India several important treatable causes — asthma, GERD, TB, smoking-related COPD, and air-pollution-related lung disease — present mainly with persistent cough.

Patterns

• Acute (under 3 weeks) — viral upper respiratory infection, flu, COVID, acute bronchitis, pneumonia.
• Sub-acute (3–8 weeks) — post-viral cough, post-nasal drip, early asthma, pertussis.
• Chronic (over 8 weeks) — asthma, GERD, post-nasal drip, tuberculosis, chronic bronchitis/COPD, bronchiectasis, lung cancer, interstitial lung disease, medication-induced (ACE inhibitor class).

Red flags — see a doctor

• Cough for more than 2 weeks + fever / night sweats / weight loss / contact with TB — get tested for TB (sputum, CBNAAT/GeneXpert). Free at government TB/DMC centres and health posts. Early diagnosis limits spread.
• Coughing up blood (haemoptysis) — TB, bronchiectasis, pulmonary embolism, cancer — needs urgent evaluation.
• Breathlessness, chest pain, fast or strained breathing.
• Coughing fits in children followed by a "whoop" — pertussis; infants under 6 months need hospital.
• Older smoker/ex-smoker with persistent cough, voice change, weight loss — rule out lung cancer.
• Sudden choking with a persistent cough — possible foreign body, especially in young children.

Self-care for viral cough

• Warm fluids, salt-water gargles, honey-lemon (honey only for age > 1).
• Steam inhalation if it helps — but don't pour boiling water onto small children.
• Paracetamol-class for body ache/fever.
• Rest, hydration; avoid smoking and secondhand smoke.
• Most viral coughs settle in 2–3 weeks. Night cough persisting long after a cold may be allergic asthma — ask the doctor.

Cough syrups — caveats

• Codeine- or dextromethorphan-containing syrups are widely sold in India but of limited proven benefit and not recommended for children under 6.
• Avoid giving adult cough syrup to young children — several serious poisoning incidents have occurred with substandard or contaminated products.
• "Ayurvedic" cough syrups with undisclosed steroid or sedative content have also been flagged — stick to established pharmacy brands.