How Long Will This Cough Linger After the Flu?

I'm a 41-year-old male. About five weeks ago, I had the flu. It kept me out of commission for two full weeks. I did not see a doctor. I'm pretty sure I'm past the flu, and I have returned to work. However, I seem to have a chronic cough that won't go away. All the other symptoms stopped three weeks ago. This dry cough keeps persisting. Otherwise I feel good. Could you shed some light on the subject?


Influenza (the flu) is characterized by the abrupt onset of fever, cough, headache, body aches and variable nasal symptoms. The fever typically lasts three to five days, but it can persist up to a week or more. Many people who claim to have the flu or are diagnosed with the infection do not actually have it. Rather, they may have another viral illness with respiratory symptoms. In either case, cough is often the last symptom remaining at the end of the acute illness. Sometimes, a post-viral cough may persist for up to eight weeks. In my office this flu season, I have seen quite a number of patients with this troubling complaint.


There are several possible explanations for prolonged cough after a respiratory illness. The person may have developed a second infection, or perhaps the first infection was not caused by a simple virus such as influenza. Quite a number of adults who have prolonged cough with other symptoms early in the illness have pertussis, the same infection that causes whooping cough in children.


Usually, however, a prolonged infection is not the cause of the lingering cough. The problem may be due to post-nasal drip. A clue to post-nasal drip is that the cough increases while the person is lying in bed. Treatment with decongestants and antihistamines may help.


Another common contributing factor is bronchospasm, a hypersensitivity reaction in which the airways constrict as they do in asthma. In some people, bronchospasm triggers cough. A physician who listens to the lungs of a patient with this cause of lingering cough will hear wheezing. Treatment with bronchodilators such as albuterol (Ventolin) or pirbuterol (Maxair) can be helpful.


You should definitely talk to your physician. While your medical history and physical examination may help your doctor make the diagnosis, sometimes the best treatment approach involves trial and error. Post-nasal drip is such a common cause of lingering cough that I usually start treatment with a combination decongestant/antihistamine.

by Harold Oster



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