Why we cough
Coughing is a protective reflex that helps clear the airways of irritants, mucus, and germs. It’s not a disease in itself but a signal that something in the respiratory tract needs attention. For many people, a cough arises with a common cold or flu and resolves as the illness improves. In others, it can persist for weeks, raising questions about its cause and the best way to manage it.
Where coughs come from today
Viral infections
Colds and influenza remain common triggers of coughing. Alongside these familiar culprits, other infectious agents can cause prolonged coughs, including Mycoplasma pneumoniae. These bacteria are among the smallest known and can lead to persistent cough or even pneumonia. After the COVID-19 era, such infections reappeared as immunity in the population shifted, with autumn peaks among schoolchildren and adolescents. Symptoms often include a mild fever, sore throat, and a loud, persistent cough.
Whooping cough (pertussis)
Whooping cough is another highly contagious respiratory infection that can start with mild flu-like symptoms and evolve into paroxysmal coughing with thick mucus. It poses a particular risk to infants and young children. Vaccination significantly reduces the risk of severe disease, though it does not guarantee complete protection. Adult cases do occur and can contribute to transmission in households and communities.
COVID-19 and SARS-CoV-2
Coronavirus SARS-CoV-2 continues to circulate, with year-round activity. Current waves are typically less intense than the major pandemic periods, largely due to vaccination and prior infections boosting population immunity. Nevertheless, SARS-CoV-2 remains a potential trigger for cough in some people, alongside other respiratory pathogens.
Do cough remedies really work?
In most cases, cough itself is a symptom rather than a disease—and there is no universally effective cure. In the early phase of a cold, some expectorants (medications that loosen mucus) are sometimes advised, especially for people with chronic lung conditions such as COPD. For many healthy adults, these remedies offer little benefit and add cost. A general guiding principle is to use the simplest approach that relieves symptoms without unnecessary medications.
Many cough medicines contain multiple active ingredients that can interact with each other or cause side effects. In certain situations—such as pregnancy or interacting conditions—some ingredients should be avoided. The maxim to follow is less is more, and cough should be allowed to work as a natural defense while comfort measures are used when needed.
Managing cough at night
Good sleep supports recovery and reduces airway irritation. Some medicines that suppress cough act on the brain to reduce the urge to cough; however, they can cause drowsiness and, with long-term use, dependence. Agents containing codeine or dextromethorphan are best reserved for nighttime relief and only after careful medical advice.
Cough in children
Medicines for children are approached with even greater caution. Cough syrups containing codeine are generally not recommended for children under 12, and many antitussives—whether synthetic or plant-based—are discouraged due to limited efficacy and potential side effects. Pediatric guidelines warn against multi-ingredient formulations and emphasize safety and evidence. Non-drug measures remain important for kids: adequate fluids, humidified air, and comforting remedies. A widely used home remedy is honey for children over 1 year old; never give honey to infants under 1 year due to the risk of botulism. In the first year, simple warmth, fluids, and soothing teas can help.
When to consult a doctor
- Persistent cough lasting several weeks or more
- High fever, marked fatigue, or shortness of breath
- Cough with green or bloody sputum, chest pain, or night sweats
- Pregnancy, a history of serious illness, or cough in a very young child
Most coughs associated with a cold are benign, but a clinician should evaluate red flags to rule out pneumonia, asthma, COPD exacerbations, or other conditions requiring treatment.
Prevention and self-care
Preventing infections and easing throat irritation can reduce the risk of a prolonged cough. Simple measures include saltwater gargles and nasal saline irrigation, which help clear nasal passages and reduce post-nasal drip. Gargling with warm tea containing ginger or sage, green tea, and even pomegranate juice may offer anti-inflammatory relief for some people. Health experts like Thomas Rosemann recommend five-minute gargles as a practical preventive step whenever early symptoms appear, such as throat tickle or runny nose. Beyond that, staying hydrated, resting well, and practicing good hygiene remain the best defenses against respiratory infections.
Bottom line
A cough is a useful protective mechanism, guiding the body to expel irritants and secretions. While most coughs resolve on their own, recognizing warning signs and using measured, evidence-based remedies can ease discomfort without overmedicating. If uncertainty persists or symptoms worsen, consulting a clinician ensures appropriate assessment and care.
