Person with pink jumper sneezes

Cough, Cold and Fever: When Should You Worry?

Many states in India are witnessing a surge in seasonal cough, cold and fever. These symptoms are very common and can be caused by a great variety of conditions. How do we know when it’s the time to worry? Even’s resident director, Dr Mohammed Hanief breaks it down for us.

Cough

Coughing is a common symptom that can be caused by various respiratory and non-respiratory conditions. While many coughs are self-limiting and resolve on their own, there are certain red flags that indicate a need for further evaluation by a Doctor.

Duration

Acute coughs typically last for a few days to a few weeks and are often caused by viral respiratory infections such as the URTIs (upper respiratory tract infections), common cold and allergies.

However, if your cough persists for more than 3-4 weeks, it may be a sign of a more serious underlying condition such as pneumonia, bronchitis, asthma etc. 

A chronic cough lasting more than 8 weeks should always be evaluated by your Physician/Specialist (Pulmonologist).

Severity of the cough

A persistent, severe cough that is accompanied by other concerning symptoms such as chest pain, shortness of breath, wheezing, coughing up blood, or unintentional weight loss should not be ignored. These symptoms may indicate a more serious underlying issue such as pneumonia, bronchitis, asthma, or even lung cancer.

Changes in the cough

Pay attention to any changes in the character of your cough. If your cough becomes more frequent, severe, or is associated with new symptoms such as chest pain, shortness of breath, wheezing, coughing up blood (hemoptysis), weight loss, or night sweats, it is important to seek medical evaluation promptly.

Smoking / Occupational history

Individuals with a history of smoking or exposure to environmental pollutants, vehicle smoke, dust, chemicals, or fumes may be at a higher risk for developing respiratory conditions such as chronic obstructive pulmonary disease (COPD), lung cancer, interstitial lung diseases, occupational lung disease or irritant-induced respiratory symptoms.

If you are a current or former smoker or your cough is exacerbated by work or environmental exposures and experience a persistent cough, it is essential to undergo a thorough evaluation by a healthcare provider, including lung cancer screening if indicated.

Age

In children, especially infants and young children, a persistent cough may be a sign of conditions such as pneumonia, bronchiolitis, or croup. Parents should monitor their child’s cough closely and seek medical attention if there are accompanying symptoms such as high fever, difficulty breathing, or dehydration.
Whereas in elderly individuals, a persistent cough may be a sign of underlying aspiration pneumonia, or medication side effects.

Older adults may also be more vulnerable to complications of respiratory infections such as influenza or pneumonia. If you are an older adult and experience a new or worsening cough, it is important to seek medical attention promptly.

Systemic symptoms

If your cough is accompanied by systemic symptoms such as fever, fatigue, unintentional weight loss or night sweats, it may indicate a more serious underlying condition such as tuberculosis, sarcoidosis or autoimmune diseases affecting the lungs. These systemic symptoms should not be ignored and warrant further evaluation by a healthcare provider.

Cold

The common cold is a viral respiratory infection that typically resolves on its own within a week or two. While the common cold is usually a mild and self-limiting illness, there are certain signs and symptoms that may indicate a need for further evaluation or medical attention.

Duration of symptoms

In most cases, symptoms of the common cold, associated with sore throat, runny nose, cough, sneezing and mild fever, typically improve within 7-10 days and gradually improve without specific treatment. If your symptoms persist or worsen after this time frame, it may indicate a secondary bacterial infection or a different respiratory condition such as sinusitis or bronchitis, otitis media (ear infection), tonsillitis etc. Strep throat may require antibiotics, so it’s important to see a healthcare provider for evaluation if these symptoms occur. 

Ear pain or drainage

Common cold viruses can sometimes lead to ear infections, particularly in children. Symptoms of an ear infection include ear pain, ear drainage (pus or fluid), hearing loss, or a feeling of fullness in the ear. If you or your child experiences these symptoms during or after a cold, it’s essential to seek medical evaluation, especially if the symptoms are severe or persistent.

Persistent nasal congestion

While nasal congestion is a common symptom of a cold, if it persists for an extended period, it may lead to sinusitis, a condition where the sinuses become inflamed and infected. Symptoms of sinusitis include facial pain or pressure, headache, green or yellow nasal discharge and tooth pain. If you experience these symptoms, it’s advisable to consult with a healthcare provider for evaluation and treatment.

Fever

Fever is the temporary increase in the body’s temperature in response to a disease or illness. An AM temperature of >37.2°C (>98.9°F) or a PM temperature of >37.7°C (>99.9°F) would define a fever.

Duration

If the fever persists for more than a few days (usually 3 days), it may indicate an underlying infection or other medical condition that requires further evaluation.

Accompanying Symptoms

Pay attention to other symptoms accompanying the fever, such as cough, sore throat, difficulty breathing, chest pain, abdominal pain, headache, rash, joint pain, or neurological symptoms.

Comorbid conditions

Individuals with pre-existing medical conditions, such as diabetes, heart disease, or compromised immune systems, may be at higher risk of complications from infections and should be monitored closely.

Age

In infants younger than three months, any fever should be promptly evaluated by a healthcare professional due to the risk of serious infections. Similarly, fever in older adults may indicate underlying medical issues and should not be ignored.

History of Travel

Fever in individuals who have recently traveled to regions with endemic infectious diseases may require additional consideration and evaluation.

Vaccination Status

In some cases, fever may be a side effect of certain vaccines. However, if fever persists or is accompanied by severe symptoms, it should still be further evaluated.

If you or someone you know experiences a fever that is persistent, accompanied by severe symptoms, or concerning for any reason, it’s important to seek medical attention promptly. A healthcare professional can perform a thorough evaluation, including a physical examination, medical history review, and any necessary diagnostic tests, to determine the underlying cause and appropriate treatment.