It starts with a cough.
[nat sound of me coughing]
Maybe it’s just the flu, or something more serious, like COVID. Either way, if you’re a college student, it interferes with your plans.
LILY SHEN: The first week was actually awful, because it was finals week. And I was just like, I could not sleep because I was just like, coughing all night.
But then, if you’re unlucky, it escalates to something more serious. The cough refuses to go away, and your symptoms change, or get worse.
ALLISON MCLOUGHLIN: You feel kind of like, strung out. You just feel like, really weird and bad.
And, worst of all, those symptoms can linger. Sometimes for weeks.
I’m talking about secondary infections, an often misunderstood phenomenon that plagues college students from coast to coast, and can result in a week-long cold turning into a three month revolving door of stuffy noses and phlegmy coughs.
YIANNIS KATSOGRIDAKIS: Secondary infection is a common term used for people who have an infection after they have a primary infection. So usually, it’s that you have a cold or viral illness and then you develop a secondary infection which is thought to primarily, usually be bacterial.
That was Dr. Yiannis Katsogridakis, an emergency pediatrician. He says some of the most common secondary infections he sees include pneumonia, ear infections, and sinus infections. Those varieties abound among college students as well. Medill sophomore Lily Shen developed bronchitis after a finals week illness.
LILY SHEN: I got it like finals week. So actually, that’s way longer than three weeks ago. That’s like six weeks ago. I think. This is my first time having bronchitis. So I’m losing my broncho-ginity. But overall, the experience has been pretty terrible.
During winter quarter, it can feel as if every third person has a cough or a sinus infection. Dr. Katsogridakis explained why secondary illnesses may not be contagious, but instead develop when your immune system is already down due to factors like another illness, which could explain their prevalence in the colder months at Northwestern.
YIANNIS KATSOGRIDAKIS: Usually, the primary infection is what’s contagious and secondary infection, at least in the examples I just gave you, are usually bacteria that you have, that are within your system, like in your nasal pharynx, in your ear, that usually are kept under control and aren’t causing you to have any symptoms. When you are body is fighting off a viral infection, like the flu, RSV, COVID, your body is fighting off that infection and is preoccupied with that infection. Then there’s debris and other things related to that infection, and so the bacteria that are normally there cause you to have another infection.
College students cited a number of reasons for succumbing to infections. School of Communications junior Anne-Sophie Lacombe Garcia experienced two secondary infections in a row.
ANNE-SOPHIE LACOMBE GARCIA: I had a cold and then I never treated it. I was in three shows. And so I just didn’t treat myself, like I just lived off Dayquil, and it turned into bronchitis, from bronchitis it turned into pneumonia.
She says the symptoms of bronchitis were persistent and painful.
ANNE-SOPHIE LACOMBE GARCIA: With bronchitis I remember specifically, it felt like I was coughing up my lungs. Like, it hurt to cough because I could feel my lungs shaking. I was really tired all the time. And it didn’t matter what I did to get better.
Allison Mcloughlin, a senior from California Polytechnic State University in San Luis Obispo, suffered from sinus infections when they were in middle school
ALLISON MCLOUGHLIN: I’ll probably get like two or three a year. But when I was in middle school and high school, I swear it was like, every other month, I would have a two or three week long sinus infection. And it was miserable.
ALLISON MCLOUGHLIN: The biggest thing that I deal with is like a lack of sleep. Because when I go to sleep, I can’t breathe through my nose. So then I breathe through my mouth and my throat hurts. And it’s kind of like, very disruptive to sleep. So I’m kind of like walking around in a daze.
They also observed college student’s propensity for sickness.
ALLISON MCLOUGHLIN: Everyone’s just sick, like for just months at a time. Like, in my sophomore year, I moved into an apartment and my roommates and I were all sick for like the entire first quarter. Like we didn’t get better until we went home for winter break
College students are often overworked and live in close quarters during their early years; those stressors can weaken the immune system and could contribute to a higher likelihood of developing a secondary infection, such as pneumonia or bronchitis. School of Communication sophomore Ian Castracane got hit with a particularly nasty string of sicknesses, starting when he developed a cough during Thanksgiving break. He initially dismissed it.
IAN CASTRACANE: I was like “It’s just leftover from COVID, It’s fine,” but then I started getting this crackle, they called it, in my lungs.
After going to urgent care, he received a prescription for antibiotics, an inhaler, and the diagnosis of bronchitis. Students and other patients with bronchitis can wait until the cough has lingered for weeks to see a doctor, and often assume the infection is just a part of their original illness.
IAN CASTRACANE: Then I went back to school, and I just had the cough again. And I was like, I guess I just still have bronchitis. So when I got home for break, I went back to the doctor, and they looked at me and said that I had a sinus infection this time, because they looked at the back of my throat and they saw a lot of nasal drip or whatever. Gross. And so I was put on antibiotics for that, and given a nasal spray. Then the cough and pretty much all the symptoms stayed exactly the same since I was initially told I had bronchitis. And so I went back to the doctor, and then they said, “Oh, no, it’s actually walking pneumonia?” So that was unfortunate. And then I was put back on different antibiotics. And I finished those, but I still have the cough. So maybe it’s something different now.
Castracane says he started battling more frequent illnesses starting the fall of his senior year of high school, around the time he got COVID for the first time. Research from the Memorial Sloan Kettering Cancer Center indicates that COVID is capable of weakening the immune system for long after people recover from it.
IAN CASTRACANE: I’ve had COVID, almost at the exact same time for the past three years, like, right at Thanksgiving, which is very weird.
IAN CASTRACANE: Since then I’ve gotten – I don’t know if it’s related – but since then it’s been much easier for me to get sick.
Secondary infections are often brushed off as simply an inconvenience, but the effects of illnesses like pneumonia, and the mental and physical toll of an infection, can be serious. Like most students that have been saddled with a hard-to-fight infection, Castracane has been taking it in stride.
IAN CASTRACANE: I really have adjusted to being sick, which is good, in a way. I guess. Like, I hate blowing my nose. I don’t know why, but I hate it so much. But I have gotten a lot better at it. And I’m just kind of used to not doing as much as I did before. Like, yeah, I don’t go outside in the cold as much because when I go outside, immediately my cough gets worse. So I’m very conscious of not spending too much time outside and stuff like that. Which is unfortunate, because it sucks to be inside all the time.
However, in some cases, the consequences of secondary infections can be life threatening, especially in conjunction with diseases like COVID. Much like the pandemic itself, students on both sides of the country are grappling with the secondary consequences of a previous problem.
For WNUR news, I’m Mika Ellison.
