A dramatic rise in the cases of prolonged cough have been seen in last 3-4 months and health experts are restless the way patients are coughing and just not responding to the medicines. There is a rise in number of viral infections but what is more alarming is the prolonged cough that is lasting for 4-6 weeks in some and isn’t responding to the usual cough medications.

In an interview with HT Lifestyle, Dr Mahavir Modi, Consultant Pulmonologist at Ruby Hall Clinic, blamed it on the air quality, pollutants, diesel exhaust, extreme temperatures at night and daytime, huge construction works around the city and of course, viruses. Dr Richa Mittal, Consultant, Pulmonary Medicine at Sir HN Reliance Foundation Hospital, explained, “We are constantly exposed to polluted air now and are inhaling it each moment. Long term exposure to polluted air also weakens our immune system. So we are becoming more prone to getting infections.”

She elaborated, “The constant exposure to the irritants leads to hyper-reaction by airways in some individuals and delays the healing process leading to prolonged cough and other respiratory issues. This is known as post-viral cough which lasts for weeks even after the viral infection has settled. Virus affects the lining (epithelium) of our airways and it takes few weeks for the epithelium to grow back and so exposure to toxic or irritant gases (as present in polluted air) till then can irritate and hamper the process causing cough, wheezing or breathlessness. This is expected to happen more in people with underlying respiratory diseases such as asthma but we are now witnessing it even in healthy adults with no such condition as they are reacting more strongly to the pollutants and continuous exposure to the irritants present in the air. The prolonged cough could be due to the constant exposure of the airways with the polluted air that we are breathing every moment.”

Talking about how is anxiety and depression linked to air pollution exposure, Dr Mahavir Modi said, “Decreased energy levels, cognitive decline in children and depression in adults is all closely related to air we breathe. Our asthma and COPD patients get a lot anxious as they cannot control unpredictable weather, outdoor pollution, burning of garbage in the vicinity etc and get worried as they are the triggers of their acute attacks. They can control the home environment, but the air we all breath is just not in control of them.. It's their basic right to breathe fresh, non polluted air. The food we eat is also impacted by the pollution and is a cause of variety of diseases.”

Highlighting the symptoms and precautions to be kept in mind, Dr Richa Mittal said, “In OPD what we are seeing is that it will usually start with fever that will last for 2-3 days which could be with/without runny nose, nasal blockade or sneezing and then patient will start experiencing persistent dry cough, throat irritation and sometimes even wheezing and breathlessness. Cough is severe for some which will lead to poor sleep and affect the daily activities of the person.”

She suggested, “The best measure is to avoid going out as much as one can especially on days when its highly polluted outside. It is easy to check AQI these days and people who are more prone to hazardous effects like children and elderly, pregnant women, or with underlying heart or lung conditions should definitely avoid stepping out. If they do so wear a well-fitted N-95 mask that covers both nose and mouth. Avoid exercising outdoors as it will lead to you breathing more of polluted air. Going out during afternoon and early evening is the best time as air is least polluted then.”

Throwing light on whether inhalers a better and easy treatment option, Dr Mahavir Modi, “The entire patient list of chronic respiratory disease cases and the nagging cough people are getting now a days, responds well to inhalers especially inhaled steroids but they need to be taken on medical prescription, preferably from a specialist and not with self medication. So, patients should not have any misbeliefs about the inhalers.”

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