A slight fever, body ache and sore throat. That’s how it starts. Eventually, the fever subsides. But congestion, cough, and fatigue persist. For over a month, in some cases.
Over the past two months, 5,000 to 8,000 cases of fever have been reported daily in Kerala, according to data from the Integrated Disease Surveillance Programme (as of February 19).
Though not indicating a spike in pneumonia or a new respiratory pathogen outbreak, the sustained numbers point to a ‘sickness season’. However, there is no new mysterious epidemic.
“It’s predominantly viral,” says pulmonologist Dr Athul Francis. “Earlier, these infections would settle down within a short span of time. Now, we see coughs lasting three to four weeks.”
Recovery, Dr Athul says, depends largely on the body’s immune system. “Antibiotics are not prescribed against viruses — they are used only to treat bacterial infections,” he points out.
“These viruses occur every year. But this time, the virus appears more potent. One possibility is mutation. There may be genetic changes to the virus. That could be the reason for prolonged recovery time.”
Another factor, he adds, may be the “lung vulnerability among people who had once tested positive for Covid during the pandemic”.
‘Do not self-medicate’
A secondary bacterial infection can develop in people with low immunity, Dr Athul notes. “However, pneumonia cases are relatively low, and most patients are able to continue their daily activities,” he adds. “People with lung conditions and low immunity can take influenza vaccines. Vaccinated individuals experience milder symptoms that subside within two to three days.”
Physician Dr Nithin Yohannan, too, says there is “nothing alarming” as of now. “Coughing is a protective reflex. It helps to expel virus, clear the lungs. It is a symptom rather than a disease,” he adds.
“A cough lasting two weeks is considered acute. Between two to three weeks, it is termed as post-infectious cough. “For most patients, however, it is not a serious condition even if prolonged. However, it might become chronic if prolonged beyond eight weeks. This requires detailed evaluation.”
Moreover, continuous coughing can irritate both lungs and throat. “Warning signs such as blood-stained sputum, night-time fever, or breathlessness demand urgent medical attention,” he says.
“Certain bacterial infections complicate prolonged cough, particularly in vulnerable individuals. Antibiotics are prescribed only for bacterial infections. People should not randomly pop over-the-counter antibiotics. They are to be taken only as per a doctor’s advice.”
Physician Dr Mohiyudheen Hijas Abbas adds another dimension — climatic instability. “We are seeing a volatility in the climate, like intense heat and sudden rains. This supports the rise of viral and bacterial growth,” he says.
“After the pandemic, such illnesses appear more frequently. Pollution and dust also play a role. Young adults commuting long distances on two-wheelers are seen to report severe coughs these days.”
Dr Mohiyudheen, too, warns against self-medication. “Even in the case of cough syrup. For instance, suppressants meant for dry cough should not be used for all kinds of coughs. It can make the phlegm thicker and harder to expel. Hence, medical advice is crucial,” he says.
When to seek help?
“If the cough does not improve within the two-three days of the fever, consult a doctor,” says Dr Athul.
Dr Nithin concurs, adding that a cough persisting more than eight weeks will need investigations such as chest X-rays and blood tests. “For mild cases, warm fluids, steam inhalations and rest are the initial measures that can be taken. Honey may aid cough in children. But it’s not recommended for infants,” he says.
Modern lifestyle
Well, we get to hear this often. Beyond the viral infection and climatic causes, doctors observe a larger pattern — lifestyle. “People are not exercising enough. Regular physical activity and sunlight exposure improve immunity,” Dr Nithin stresses.
“Those who engage in walking and mild cardio appear to be recovering fast. Sedentary lifestyle can contribute to prolonged symptoms.”
Ayurveda’s take
Respiratory complaints have increased after the pandemic, according to Dr Vasudevan Namboothiri, former director of Ayurveda medical education in Kerala. “The Covid infection seems to have left many with a subtly weakened respiratory system,” he notes. “Of late, many patients seek Ayurvedic care. Unlike symptomatic suppression, Ayurvedic therapy does not focus on cough alone. Ayurveda targets metabolism as well.
Strengthening digestion enhances immunity.” For patients experiencing chest congestion and discomfort, certain external therapies are recommended. “Karpooradi thailam and murivenna are applied on the chest and back, followed by steam inhalation. This helps relieve congestion,” says Dr Vasudevan. Like in the case of allopathy doctors, he also warns against the use of immunity boosters such as without medical guidance. “Conditions vary from patient to patient. So individual assessment is crucial for prescribing medicines,” he concludes.
He, however, suggests some simple home remedies:
Adalodakam (Malabar nut plant) — a common plant grown in home gardens. Take 4–5 leaves, wash them well. Steam them in an idli steamer or puttu vessel until wilted. Squeeze out the juice from the leaves. The juice tastes slightly bitter. Mix with a little honey and consume occasionally.
Rock sugar (kalkandam) and black pepper powder — Powder both together. Take in small doses.
Cumin water: boil cumin seeds in water and drink.
Coriander and dry ginger water: Boil coriander seeds and dry ginger in water. This decoction is considered beneficial during respiratory illnesses
Rasam: The traditional rasam used in Kerala sadhya is considered good for throat health and digestion
Goat milk: Believed to aid respiratory health