Whooping Cough (Pertussis)

What is whooping cough?

Whooping cough, also known as pertussis, is a respiratory illness caused by a bacterium called Bordetella pertussis. It affects the lungs and makes it hard to breathe.  

 Whooping cough causes long, severe coughing fits. After coughing, people often make a “whoop” sound as they try to breathe in. 

It is important to treat whooping cough as early as possible. Early treatment can help your child feel better, keep the illness from getting worse, and prevent the spread of the infection to others. Babies younger than 6 months are the most likely to get very sick and need to be hospitalized. In some cases, whooping cough can be life-threatening.  

Whooping cough spreads easily from person to person. The best way to protect against whooping cough is to get the DTaP or Tdap vaccine. Antibiotic medicines are used to treat whooping cough. Antibiotics may also be given to people who have been in close contact with someone infected to help prevent the illness.  

Symptoms of whooping cough

Whooping cough often begins with symptoms that look like a common cold. Early symptoms are mild. During the first 2 weeks, signs and symptoms of whooping cough may include:

• Runny nose
• Feeling tired or cranky
• Red, watery eyes
• Sneezing
• Low-grade fever less than 100.4°F (38.0°C) 
• Mild, occasional cough

After 2 weeks, the cold gets better, but the cough gets worse. Symptoms may include:

• Severe dry coughing fits that last for 1 minute or longer
• A “whooping” sound when breathing in after coughing
• Trouble catching their breath
• Vomiting during or after coughing
• Extreme tiredness
• Trouble sleeping
• Broken blood vessels in the eyes
• A fractured or broken rib

Babies who have whooping cough might not cough much. Instead, they may have:

• Pauses in breathing (apnea)
• Red, blue, or purple color of the skin, lips, or nails
• Trouble eating or drinking

These symptoms can last for weeks or even months. Pertussis is sometimes known as the “100-day cough.”  

Diagnosis of whooping cough 

To find out if your child has whooping cough, your health care provider will usually start by asking about symptoms and listening to their cough. The care team may also look at how long your child has been coughing, what the cough sounds like, and if your child has been around someone with whooping cough.  

Whooping cough is often diagnosed based on symptoms. Your health care provider can do a swab of the nose or throat to collect a sample for testing. A lab test confirms the diagnosis. Your care team may do other tests, such as blood tests or chest x-rays. 

Treatment of whooping cough 

Antibiotics are used to treat whooping cough. These medicines may include:   

• Azithromycin
• Clarithromycin
• Erythromycin
• Sulfamethoxazole-trimethoprim

If antibiotics are started early, they can make symptoms less severe and help stop the spread of the infection. People who have been in close contact with someone who has pertussis can be treated with antibiotics to help prevent infection. Be sure to give the medicine exactly as prescribed.

Along with taking antibiotics, children also need lots of rest and fluids. Try to keep your child calm and comfortable. Monitor for worsening symptoms or warning signs such as dehydration, seizures, or breathing problems.

Babies and young children might need extra care. Sometimes, they will need to see a doctor more often. If symptoms are very bad, they may need to stay in the hospital.

Whooping cough vaccine 

The best way to protect against whooping cough is by getting the whooping cough vaccine. There are 2 main vaccines that protect against 3 diseases: diphtheria, tetanus, and pertussis. 

• DTaP vaccine: This is given to babies and young children. Babies usually get their first vaccine at 2 months old. They will get 4 more doses as they grow.
• Tdap vaccine: This is a booster shot for older children (usually at age 11), teens, and adults. Pregnant women should also get a Tdap shot during each pregnancy to protect their newborn.

Vaccines do not stop every case of whooping cough. But they can help reduce symptoms. They also lower the risk of serious problems, especially in babies. Staying up to date with shots also helps stop the spread of whooping cough to others.  

How whooping cough spreads 

Whooping cough germs live in the mouth and nose of the person who is sick. The illness spreads easily from one person to another through the air when someone coughs or sneezes. When other people breathe in the bacteria, they can get sick. 

Whooping cough in children with weak immune systems

Whooping cough can be very serious, mostly for babies and young children. Most children can recover with treatment, but whooping cough can be dangerous for some. Those at higher risk for severe illness from whooping cough include:

• Babies younger than 6 months
• Children with weak immune systems
• Children with lung or heart problems

In babies and children, whooping cough can cause:

• Severe coughing fits that make it hard to breathe
• Trouble eating or drinking
• Stopping breathing for short periods
• Pneumonia and other lung infections

If your child is exposed to pertussis or shows signs of whooping cough, contact your doctor right away. Early treatment can help protect your child and prevent the illness from getting worse.

When to call your care team

If you think your child might have whooping cough, contact your care team right away. This is very important if your child is a baby. Early treatment can help prevent serious illness. It can also help stop the infection from spreading to others.

Contact your care team if your child:

• Makes a “whooping” sound when breathing in and after a coughing fit
• Has trouble breathing
• Turns blue or red in the face while coughing
• Vomits after coughing
• Seems very tired after coughing
• Has been around someone with whooping cough
• Is under 1 year old and shows any signs of illness

If your child is having trouble breathing, not eating or drinking, or seems very sleepy or hard to wake up, call 911 or go to the emergency room right away.

How to prevent whooping cough 

You can protect yourself and others by getting the whooping cough vaccine. All babies, children, and teens should get this vaccine as part of their routine checkups. People 19 and older who did not get the vaccine as a preteen or teen should get 1 dose of Tdap. 

Pregnant women should get 1 dose of Tdap during each pregnancy, usually between 27–36 weeks. The vaccine’s protection is passed on to the baby. 

Other things you can do to help stop the spread include:

• Wash your hands often.
• Cover your mouth and nose when you cough and sneeze.
• Keep your child home when they are sick.
• Keep your child away from anyone who is sick. 

Questions to ask your care team

• What are the signs of whooping cough I should watch for?
• If my child has whooping cough, do they need antibiotics?
• How long will the cough last?
• When should we go to the doctor?
• Are my child’s vaccines up to date?
• What should I do if my child is exposed to someone with pertussis?

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