Coughing is a tier 1 symptom. It makes people release the pathogen into their surroundings, increasing disease infectivity. Coughing makes a plague more effective in urban areas (+0.05).
- When combined with the Vomiting symptom, the Projectile Vomiting symptom combo is created, which further increases infectivity. This symptom can also be used to increase infectivity without alerting the authorities in Brutal and Mega-Brutal difficulties.
- Evolving this symptom, along with the symptoms: Nausea, Vomiting, Diarrhoea, Pneumonia, Sneezing, and Insomnia, as well as evolving the abilities Livestock 1 and 2 while the cure effort is ongoing, will unlock the Oink oink symptom combo.
- This is the most expensive tier 1 symptom for standard plagues.
- There is a coughing sound effect.
- In the original Plague Inc. trailer, coughing is the one symptom that is specifically stated, until it mutated to become deadly.