to the editor: I was disappointed that the cover art for the October 15, 2011 issue of American Family Physician’s article on chronic cough showed a man coughing into his clenched fist. This act will contaminate his hand, thus spreading any viral or bacterial secretions onto whatever he touches. In addition, some viral or bacterial secretions will not land on his fist but will fly into the surrounding air, possibly contaminating the air for others.

In my opinion, the illustration should have portrayed a person coughing into several layers of disposable tissues or the upper part of his or her sleeve. Both of these methods will help prevent the spread of any transmissible diseases.

editor’s note Although the cover might illustrate typical behavior among people with colds, Dr. Bett makes a good point that it would be better to model the recommended method of coughing to reduce the spread of infection.