Investigating into the Possible Causes of a Widespread Persistent Dry Cough

The following is a report indicating the results of a laboratory investigation conducted to establish the cause and possible mitigation procedures of the prevalence of a dry cough in the elementary school. Parents, teachers and guardians to the children in the elementary school were asked to fill in the following table to help with the diagnosis of the ailment affecting the children.

Cough score during daytime (yesterday)

Cough score during night-time(yesterday night)

0- No cough at all

0- no night time cough

1- one or two short coughing episodes in a day

1- One or two short coughing spells

2- cough exceeds two short periods in a day

2- night time cough exceeds two episodes

3- frequent day time coughing with no interference to school schedule

3- frequent coughing that doesn’t interrupt sleep

- frequent day time coughing with interference to school schedule

4- frequent coughing that interrupts child’s sleep

5- severe coughing that impairs child’s responsiveness

5- severe coughing that impairs child’s ability to sleep

Do supervising adults cough too?

Do parents cough too?

Is child allergic to smells?

Is child allergic to smells?

Did the school invest in new structures?

Did parents introduce foreign bodies to home?

Did pupils or teachers have a cold prior to the onset of cold?

Did pupils or parents have a cold prior to the onset of cold?

After the issuance of the above questionnaire, pupils and any other parties that could have been exposed to the causal contaminant were rounded up for a session to take sputum samples. These samples were thereafter screened in the laboratory for signs of common viral or bacterial signatures. The suspect airborne infections in this stage were tuberculosis, whooping cough and post-viral coughing. While tuberculosis and whooping cough were attributed to bacteria, post-viral coughing was attributed to the last stages of common cold dissipation. To test for tuberculosis, the sputum sample was screened by use of smear spectroscopy and an additional fluorescent microscopy to confirm the first test due to the seriousness of the disease. In smear microscopy, a drop of each sample collected was smeared onto a microscope slide and stained to detect possible existence of the bacteria. On finding no bacteria in all the samples, the results were confirmed via florescent microscopy which was more accurate. The results were negative too. The test for whooping cough chosen was the use of polymerase chain reactions since they were more rapid in nature compared to other tests such as a blood test. This procedure involved the screening of Bordetella pertussis, the bacteria responsible for the disease from the sputum samples. The results were negative too. Post viral-coughing was also ruled out since the questionnaires reported few disparate incidences of prior common cold cases. After the administering of the above questionnaires on a daily basis for three consecutive days, it was found that: Coughing was more pronounced during day time than night time Most of the cough scored 2 on the scale provided Teachers coughed too but parents did not The school had recently acquired a new air conditioning system All tested negative for infectious-bacteria and viruses In the light of the above findings, it was found that the cause of the dry cough was not communicable and was thus a product of environmental factors. The school’s new ventilation system is responsible for causing the cough

Progress Report Project:

Investigating into the possible causes of a widespread persistent dry cough

Subject: Local Elementary School

Coordinator: ASU Health Lab under authorization of the mayor

Project Duration: 30 hrs.

Process

Following initial description of the coughs in the elementary schoolchildren, it was plausible that an air-borne infectious viral or bacterial disease has broken out in the school. The first priority is to screen anyone who might have come into contact with the causal contaminant for infectious agents. A list of possible diseases is made so as to carry out diagnostic tests. An environmental scan should then be undertaken so as to rule out the possibility of hazardous materials in the school. Other factors such as potent allergens and improperly configured ventilation systems should then be considered as alternative causal agents of the dry cough (Simoni 743). 

Completed Activities

Three days ago and every day since, questionnaires were issued to all teachers, supervising adults and parents to establish the extent of the dry cough. Sputum samples were also collected on the first day to screen for infectious agents and all came back negative. Three main diseases were tested for. These tests include smear and fluorescent microscopy for tuberculosis and a polymerase chain reaction to test for whooping cough. The possibility of post-viral illness being the causal agent was ruled out via the responses of the questionnaire after an analysis of the responses was conducted today. Alternative causal agents were also investigated. An electric appliance specialist was called in to examine the ventilation systems of the school after responses by the school personnel revealed that maintenance of the systems had been conducted shortly before the coughing fits were observed in the pupils.

Pending Activities

The only pending activity inhibiting the project’s completion is the performance of a hazardous material sweep. The main factors impeding the hazmat sweep is time and cost constraints. This is because the sweep involves the acquisition of hazmat gear that has not yet arrived at the lab since it was ordered. Moreover, acquisition of funding for the gear was delayed by the rigorous funding allocation processes of the city. Materials to be scanned for include hardened concrete, magnesium compounds in the school structures, asbestos that could have been utilized during the construction of the school and recently acquired cleaning products that may contain respiratory inflammations. The above materials are still possible causal agents for the dry cough which could be as a result of reflexive coughing resulting from acute respiration injury that the materials are known to cause.

Current Working Theory

However, even with inconclusive adherence to the due process established above, the lab came up with a working theory regarding prevalence of the dry cough. After ruling out the non-communicable nature of the condition owing to the fact that the condition had not been transmitted to parents, it is apparent that it was due to environmental factors in the school, precisely the acquisition of a new air conditioning system. As was explained by the electrical specialist, through lowering of the school halls’ humidity levels, continued inhalation of the resulting dry air dehumidified the children and teaching staffs throats resulting in a persistent dry cough. A reconfiguration of the system is immediately recommended to stop the dry cough. However, a complete hazmat sweep is still recommended to ascertain that the problem does not recur.

Work Cited

Crofton, John & Andrew Douglas. "Respiratory diseases." Respiratory diseases, 1999, pp. 50-62.

Simoni, Marzia. "School air quality related to dry cough, rhinitis and nasal patency in children." European Respiratory Journal, 2010, pp. 742-749.

Spengler, John D. "Housing characteristics and children’s respiratory health in the Russian Federation." American journal of public health, 2004, pp. 657-662.

Wan, Gwo-Hwa and Chih-Shan Li. "Indoor endotoxin and glucan in association with airway inflammation and systemic symptoms." Archives of Environmental Health: An International Journal, 1999, pp. 172-179.