Updated 24 August 2017

Causes of acute cough

Acute cough lasts for less than three weeks and is commonly due to an acute throat (upper respiratory tract) infection.


By definition, an acute cough is one that has been present for less than 3 weeks. By far and away the commonest cause of an acute cough is an acute upper respiratory tract infection. 80% of these infections are viral and thus antibiotics are not necessary.

Viruses such as Rhinovirus, corona virus and respiratory syncytial virus are all responsible for these infections known as the common ‘cold’. No doubt influenza and parainfluenza can cause an acute cough but these two viruses are responsible for ‘flu’ and tend to produce a more severe illness with more constitutional symptoms including high spiking fever, sore muscles (myalgia) and sore joints (arthralgia).

Occasionally bacteria can be responsible for the cough by causing bacterial bronchitis and other lower respiratory infections. Obviously the inhalation of irritant gases and foreign bodies can precipitate coughing however the cause is usually pretty self-explanatory. Certainly there are some worrying telltale signs which should alert you immediately to receive medical attention.

When to see a doctor

These include:

  • Severe, high swinging fevers with lethargy & drowsiness
  • Coughing up blood
  • Increasing shortness of breath which is out of the ordinary, associated wheeze or itching (allergy)
  • Cough that is productive of large amounts of purulent (pussy) phlegm
  • Associated chest pain – stabbing pain, worse with deep inspiration

Note: Most coughs lasting less than 3 weeks are related to viral infections and though an irritating nuisance, often resolve on their own and do not need any specific treatment or investigation 

Compiled February 2011 by Dr. Greg Symons [MB. ChB, DipPEC, FCP (SA), Cert. Pulm. (SA)], Consultant Pulmonologist, Division of Pulmonology, Department of Medicine, Groote Schuur Hospital & Clinical Researcher, UCT Lung Institute (Pty) Ltd in George Street, Mowbray. Contact the UCT Lung Institute on ph 021-406-6850.  

Read more:

Treating an acute cough

Sore throat


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Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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