Flu and colds: Why do we cough?

Coughs are an ever-present wintertime companion. But does coughing serve any purpose at all, or
is it just a clever method that viruses use to spread? Several theories try to explain why we cough
when we have the flu or common cold. Coughing is a normal reflex to clear the airway of small
particles, microorganisms, mucus, or food or drinks accidentally going down "the wrong pipe."
But when we are plagued with a pesky cold or flu infection, cough takes on a new dimension.
What often starts as a tickle in the throat at the first sign of an upper respiratory tract infection can
easily turn into a full-blown dry cough, most likely followed by a hacking, mucus-producing cough
that can be very uncomfortable.

The study of coughing

In an article in the journal BMJ Open Respiratory Research, Prof. Alyn Morice — head of
respiratory medicine at the Centre for Cardiovascular and Metabolic Research at Hull York
Medical School in the United Kingdom — explains how difficult it is to study coughing. Humans
naturally infected with rhinovirus, which is the cause of the common cold, or the flu virus, which
causes influenza, do not make good study subjects as their symptoms vary greatly from person to
person. Instead, cells from our airways and guinea pigs are the models of choice when it comes to
studying cough. While scientists can't agree on one definitive mechanism that elicits the bellowing
cough that you might be listening to while reading this article, there are several theories, says Prof.
Morice.

Inflammation, cell damage, and mucus

Cold and flu viruses attack our bodies through our nasal lining. In response, our immune systems
try to fight back by opening a pandora's box of inflammatory chemicals. Prof. Morice goes on to
explain that human rhinovirus infection is known to lead to high levels of pro-inflammatory
molecules, such as bradykinin — also implicated in causing sore throat — tachykinins, calcitonin
gene-related peptide, and leukotrienes. While these play important roles in the battle against the
common cold, some scientists point the finger squarely at these molecules as the reason for our
cough. Damage to the cell lining in our airways is common in influenza infections and may be
why we tend to experience more severe coughing fits with flu than with the common cold, others
think. Mucus production is also in the mix of factors to lay the blame on, as it is known to stimulate
nerve receptors. This leads us to the crux of cough: nerve endings in our airways.

The vagus nerve and cough

Cough is a neuronal reflex, mediated by the vagus nerve. The nerve endings responsible sit at the
level of our larynx or lower in our airways, and cough signals must penetrate this far into the
airway to cause symptoms. That's why colds confined to the nose and head — so-called head colds
— don't tend to cause cough, explains Prof. Ron Eccles, who was previously director of the
Common Cold Centre in the School of Biosciences at the University of Cardiff in the U.K.

So, it seems that cough comes to no advantage to ourselves. Prof. Alyn Morice said "The most
common form of cough is caused by upper respiratory tract infections and has no benefit to the
host." The beneficiaries are the viruses at the root of our infections in the first place. They hijack
coughs to spread their nasty offspring among the general population, while we are left paying the
price with yet another coughing fit.

Coughing is temporary

The good news is that most coughs clear up within 3 weeks, although some — known as postviral
or postinfectious cough — can last for up to 8 weeks. Unfortunately, there is little evidence to
suggest that cough medicines are effective in easing your cough. Check out our list of home
remedies for treating a cold, and find out whether or not pineapple juice is likely to provide you
with some much-needed relief.