The job of a cough is to help maintain respiratory health, says Julie Marchant, a respiratory physician and researcher at Queensland Children’s Hospital.
“It helps clear the airway in both healthy people and those with lung disease,” Dr. Marchant says.
“And [it] can be voluntary or involuntary.”
High rate of chronic cough among Kimberley kids
Researchers say they were surprised by the rate of wet cough, which can lead to chronic lung conditions, in WA’s Kimberley. But locals say the way the study was carried out will leave a lasting, positive legacy.
Not all coughs are of concern, she says
For example, children are often prone to viral infections, which can cause a cough. However, she says, those usually clear up on their own.
“The question I always ask parents is, when do they last remember a day when their child didn’t cough?” she says.
But chronic coughs that last more than four weeks in children should be investigated, as they could point towards other underlying problems, says Dr. Marchant, the lead author of new guidelines for doctors about how to identify and manage chronic coughs.
“If [children] are coughing every single day without breaks in between infections, then they probably have a chronic cough,” Dr. Marchant says.
Any cough that has lingered for more than two months in adults is “not normal” and should be investigated, says Peter Wark, a specialist in respiratory and sleep medicine at the Alfred Hospital in Melbourne.
“Chronic cough should not be ignored,” says Professor Wark, who was also involved in writing the guidelines.
“It may represent a serious underlying condition, and in most cases, it can be effectively treated.”
Beware of wet coughs in kids
Dr. Marchant says it is important to identify whether a child’s cough is wet or dry.
“I recommend [parents] record their child’s cough [on a smartphone or other recording device] before they go and see the doctor,” she says.
“Because sometimes, particularly with preschool children, it’s difficult to ask them to cough on command.”
Space to play or pause, M to mute, left and right arrows to seek, and up and down arrows for volume.
She says the most common cause of a wet chronic cough in children is protracted bacterial bronchitis.
This condition, which involves inflammation of the large airways, is treated with a prolonged course of antibiotics.
But it can be tricky to diagnose, says Kerry Hancock, chair of the Royal Australian College of General Practitioners Respiratory Medicine Special Interest Group.
“In the early stages, it’s very hard to differentiate between a viral infection [which doesn’t respond to antibiotics] and a bacterial infection [which requires antibiotics],” says Dr. Hancock, who was not a member of the guideline group.
“And protracted bacterial bronchitis often does follow on from a viral infection.”
Dr. Hancock says this raises clinical challenges because “it’s always been emphasised to doctors to not give antibiotics unnecessarily.”.
Another serious source of a chronic wet cough that can be overlooked is choking, Dr. Marchant says.
“The child could have a foreign body in their airway, and the parents haven’t realised,” she says.