Cough in Pertussis, Influenza, and ARVI: How They Differ

Cough is a reflex that keeps the throat and airways clear. It can be acute, lasting up to 2–3 weeks, or chronic, lasting longer than that. By the character and duration of a cough, a doctor can often suspect which infection caused it.

Cough in ARVI and influenza: what it is like

With a cold and influenza, cough is most often acute: it starts suddenly and usually resolves within 2–3 weeks. Acute cough most often occurs with a cold, influenza, or acute bronchitis. Chronic cough is associated with other causes, discussed below.

Cough in pertussis: characteristic features

The first signs of pertussis resemble a cold: runny nose, sore throat; high fever is uncharacteristic. After about a week, coughing fits appear that last several minutes and worsen at night. Between fits, a whooping inspiration is heard—the "reprise"—although in children under 3 months and in some adults it may be absent. After a fit, breathing may be difficult, thick sputum is produced, vomiting is possible, and the face reddens. The cough may persist for several weeks or months. Suspicion of pertussis arises if the cough lasts 14 days or more with reprises, fits, or ends in vomiting. In the catarrhal period, which lasts 1.5–2 weeks, a dry, gradually worsening cough appears, the temperature is slightly elevated, and a runny nose is possible. In the period of resolution, fits become less frequent and shorter, reprises disappear, sputum is easier to clear, and recovery may last up to several months. In the erased form, the cough does not become paroxysmal, a mild cough persists for 4–6 weeks, and the temperature is normal. In adolescents and adults, symptoms may be atypical.

• Coughing fits lasting several minutes, worse at night
• Whooping inspiration between coughing episodes
• Thick sputum, sometimes vomiting after a fit
• Reddening of the face during coughing

Why cough persists after ARVI and influenza

Cough after ARVI and influenza may persist longer than 2–3 weeks. If a cough lasts longer than 2–3 weeks, it is called chronic. Causes include chronic bronchitis, asthma, allergies, COPD, reflux, smoking, throat diseases, and use of certain medications.

How a doctor distinguishes one cause of cough from another

The doctor asks about the duration of the cough, nighttime fits, sputum, and temperature. In pertussis, the diagnosis is confirmed by laboratory testing. Examinations may include bronchoscopy, sputum culture, and lung examinations. In adolescents and adults, pertussis may be atypical.

When a cough requires seeing a doctor

You should see a doctor if a child under 6 months has signs of pertussis, if a severe cough worsens, or if there was contact with a person with pertussis during pregnancy. A routine consultation is needed for a cough lasting longer than 2–3 weeks.

Cough by itself is not a reason to call an ambulance; 103 or 112—if the lips, tongue, face, or skin suddenly turn blue or gray, if breathing is difficult, if chest pain worsens with breathing or coughing, if a child has seizures. In children under 6 months, pertussis is dangerous: dehydration, breathing difficulty, pneumonia, and seizures are possible.

This material is for reference: it helps you orient yourself but does not replace consultation with a doctor, who will listen specifically to your cough.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer