Whooping Cough (Pertussis)

What Is Whooping Cough (Pertussis)?

Whooping cough (pertussis) is a contagious infection of the respiratory system caused by Bordetella pertussis bacteria. It causes severe coughing spells, which can sometimes end in a "whooping" sound when a child breathes in.

Whooping cough can make some people very sick. Babies younger than 1 years old and people with medical conditions that affect the immune or respiratory systems are most at risk for getting really sick from the illness.

What Are the Signs & Symptoms of Whooping Cough?

The first symptoms of whooping cough are similar to those of a common cold:

• runny nose
• sneezing
• mild cough
• low-grade fever

After about 1 to 2 weeks, the mild cough changes into violent coughing spells that can make it hard to breathe. During a spell, a child may turn red or purple. At the end of a spell, the child might make the telltale “whooping” sound when breathing in or may throw up (vomit).

Many babies and young kids with whooping cough have the coughing fits and “whoop” sound, but not all. Some may look as if they're gasping for air, turn blue, and stop breathing for a short time (called apnea).

Adults and teens may have milder or different symptoms, such as a lasting cough (rather than coughing spells) or coughing without the whoop. Some, especially those who are not up to date on their vaccines, can develop more serious problems from whooping cough.

How Is Whooping Cough Diagnosed?

See the doctor if you suspect that your child has whooping cough. The doctor will take a medical history and do an exam, which may include nose and throat mucus samples to be checked in a lab. Doctors also might order blood tests and a chest X-ray.

How Is Whooping Cough Treated?

Doctors treat whooping cough with antibiotics. Antibiotics work best to prevent someone from getting really sick when they are taken early in the illness, before coughing spells begin. They can also help stop the infection from spreading to others. If someone in your family has whooping cough, ask the doctor if preventive antibiotics for other family members are needed.

Some kids with whooping cough need care in a hospital. Babies and younger children are more likely to be hospitalized because they're at greater risk for problems like pneumonia. Other possible problems include trouble breathing, periods of apnea, needing oxygen (usually during a coughing spell), and dehydration.

Whooping cough can be life-threatening for babies younger than 1 year, so they often need hospital treatment. In the hospital, children may need mucus and fluids removed from the nose, mouth, or back of the throat with a bulb syringe or a catheter. This is called suctioning and helps to clear the airways. Breathing will be watched closely, and children will get extra oxygen if needed.

A child who shows signs of dehydration or has trouble eating might get intravenous (IV) fluids. Precautions will be taken to prevent the infection from spreading to other patients, hospital staff, and visitors.

Is Whooping Cough Contagious?

Whooping cough is very contagious. The bacteria spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may spread when the person sneezes, coughs, or laughs. Other people then can get infected by breathing in the drops or getting the drops on their hands and then touching their nose or mouth.

It often takes 1 to 3 weeks for symptoms to start after someone is infected. 

Infected people are most contagious in the earliest stages of the illness for up to 2 to 3 weeks after the cough begins. Once antibiotics are started, it takes 5 days of treatment until the person is no longer contagious.

How Long Does Whooping Cough Last?

Whooping cough usually causes cold symptoms that last for 1 to 2 weeks, followed by up to 3 months of severe coughing.

The last stage consists of another few weeks of recovery with gradual clearing of symptoms. In some children, the recovery period can last for months.

How Can Parents Help?

If your child is being treated for pertussis at home, follow the schedule for giving antibiotics exactly as your doctor prescribed. Do not give cough medicine unless your doctor recommends it, and never give it to children younger than 4 (it can cause potential size effects). Giving cough medicine usually doesn’t ease the coughing spells of whooping cough. The cough is actually the body's way of trying to clear the airways. 

During recovery, let your child rest in bed and use a cool-mist humidifier to help soothe irritated lungs and breathing passages. (Follow the directions for keeping it clean and mold-free.) Keep your home free of irritants that can trigger coughing spells, such as aerosol sprays and tobacco smoke; and smoke from cooking, fireplaces, and wood-burning stoves.

Kids with whooping cough may throw up or not eat or drink much because of the coughing. Offer smaller, more frequent meals and encourage your child to drink lots of fluids. Watch for signs of dehydration, such as:

• thirst, irritability, restlessness, lack of energy or sunken eyes
• a dry or sticky mouth and tongue or dry skin
• crying without tears
• fewer trips to the bathroom to pee (or in babies, fewer wet diapers)

Can Whooping Cough Be Prevented?

Whooping cough can be prevented with the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization.

DTaP immunizations are routinely given in 5 doses before a child's sixth birthday. For added protection since immunity fades, kids ages 11 to 12 should get a shot of the pertussis booster (called Tdap).

Teens and adults who have not had a booster should get it. Tdap is also recommended for all pregnant women during the second half of each pregnancy to protect newborn babies. After that, a tetanus and diphtheria booster is recommended every 10 years. People should ask their doctor about when that booster should also include pertussis.

Getting the vaccine is especially important for people who have close contact with infants. That's because babies can have severe and even life-threatening problems from whooping cough. An adult's immunity to whooping cough lessens over time, so when they get vaccinated, they're also protecting their babies and older children from the infection.

As with all vaccine schedules, there are important exceptions and special circumstances. Your doctor will have the most current information.

People who live with or have close contact with someone who has pertussis should get antibiotics to prevent the spread of the disease, even if they've already been vaccinated against it.

When Should I Call the Doctor?

Call the doctor if you think that your child has whooping cough or was near someone with whooping cough, even if your child already got all scheduled pertussis vaccines.

This is especially important if your child has long coughing spells and:

• The coughing makes your child's skin or lips turn red, purple, or blue.
• Your child throws up after coughing.
• There's a whooping sound after the cough.

Get medical care right away if your child has trouble breathing, has periods of not breathing, seems very sluggish, or shows signs of dehydration.