Methods and systems for a cough detection system are provided. The methods and systems include operations comprising: receiving an utterance comprising a cough from a user; determining one or more environmental factors, one or more health related factors, or both associated with the user; processing the utterance with a machine learning technique to generate an illness prediction, the machine learning technique being trained to establish a relationship between a plurality of training cough utterances and a plurality of illnesses corresponding to the plurality of training cough utterances; applying a weight to the illness prediction based on the one or more environmental factors, health related factors, or both associated with the user; and triggering an alert representing the illness prediction based on the weighted illness prediction.