The Doctor Is In

By Damon Raskin, M.D. | Special to the Palisadian-Post

Q:I keep reading and hearing about mystery respiratory illnesses going around, including long-lasting coughs. What is happening here in the Palisades and does it seem to be anything out of the ordinary? Is there something we need to be looking out for?

Along with the twinkling lights and festive cheer of the holiday season, coughs and cold symptoms are rampant at this time of year. These respiratory illnesses are like the Grinch who can steal the fun and frolic of these special times, and turn them to misery with unrelenting sniffling and hacking.

I have been inundated with patients with coughs over the past few weeks, but this has been no different than in years past. We do not need Nancy Drew or Sherlock Holmes, and we can stay away from the Mayo Clinic because there are no mysterious respiratory illnesses in the Palisades.

The common cold, which is usually caused by rhinovirus or adenovirus, along with Covid, influenza and RSV are all peaking during the winter months. As more of us are gathering, traveling and celebrating, these illnesses are being transmitted like wildfire.

All these conditions can cause a cough, and even after the acute illness improves and you start to feel better, the cough can persist for several weeks. Some patients’ coughs are shorter and some much longer depending on many factors, including whether the patient has underlying allergies or asthma, a smoking history, or are on medications that may impair the immune system.

With any cough that persists, I highly recommend seeing your medical provider to check you out, especially if the cough is severe, lasts longer than a week, or is associated with fevers, shortness of breath, or pain in your chest. While some coughs are viral, others can be part of a bacterial infection and even represent pneumonia. Your healthcare provider should be able to diagnose the etiology of the cough and may need to do some testing to help with that.

For example, I now have a machine in my office that with a single nasal swab can determine if a cough is caused by the flu, the common cold, influenza or Covid. Because finding out the type of infection can make a difference in medication management, proper diagnosis is important, especially in the early stages of the illness. For some patients, a chest X-ray can find an underlying pneumonia, which may require antibiotics.

Of course, there are other common reasons for a prolonged cough, which have nothing to do with infections. These include allergies and asthma as well as postnasal drip. Interestingly, acid reflux can also be a common cause of a prolonged cough, which many patients find surprising.

There are numerous things you can do this time of year to help mitigate your risk of getting sick, but nothing is foolproof. Washing your hands frequently, wearing a mask in appropriate situations, and encouraging any ill family members to stay home from work or school to help prevent the spread of infection in the community are all good measures.

Getting the annual flu shot can often help as well as the updated Covid vaccine. For those patients 60 years and up, speak to your doctor about getting the new RSV vaccine to protect you as well.

My holiday wish is that we all hear more sounds of carols and jingle bells in town rather than sneezes and wheezes.