Everything To Know About Whooping Cough (Pertussis)
Whooping cough may begin like a common cold, but unlike a cold, the coughing can last for weeks or months.
Symptoms of whooping cough usually develop within 5 to 10 days after you come into contact with the bacteria that cause it. Sometimes symptoms do not develop for as long as 3 weeks.
Early symptoms: Stage 1
When to see a doctor
See a doctor if you or your child are:
- Struggling to breathe
- Turning blue or purple
- Coughing violently
- Coughing rapidly, over and over
- Not drinking enough fluids
Any time someone is struggling to breathe, it is important to get them to a doctor right away.
Early symptoms can last for 1 to 2 weeks and usually include:
- Runny or stuffed-up nose
- Low-grade fever (less than 100.4°F)
- Mild, occasional cough (babies do not do this)
- Apnea (life-threatening pauses in breathing) and cyanosis (turning blue or purple) in babies and young children
In its early stages, whooping cough appears to be nothing more than the common cold. Therefore, doctors often do not suspect or diagnose it until the more severe symptoms appear.
Later symptoms: Stage 2
One to 2 weeks after the first symptoms start, people with whooping cough may develop paroxysms—rapid, violent, and uncontrolled coughing fits. These coughing fits usually last 1 to 6 weeks but can last for up to 10 weeks. Coughing fits generally get worse and become more common as the illness continues.
Coughing fits can cause people to
- Make a high-pitched “whoop” sound when they are finally able to inhale at the end of a coughing fit
- Vomit during or after coughing fits
- Feel very tired after the fit, but usually seem well in-between fits
- Struggle to breathe.
The infection is generally milder in teens and adults than in babies and children, especially those who have gotten vaccinated against whooping cough. It may seem like a common cold. The “whoop” is often not there for people who have a milder illness.
However, teens and adults can have serious cases of whooping cough. Teens and adults, especially those who did not get whooping cough vaccines, may have lengthy coughing fits that keep them up at night. Those who get these coughing fits say it’s the worst cough of their lives. It can also cause major disruptions to daily life and serious complications.
Vaccinated people may not get as sick
Whooping cough vaccines are effective, but not perfect. The infection is usually not as bad for people who have gotten vaccinated against whooping cough but still get sick.
In vaccinated people who get whooping cough:
- The cough usually won’t last as many days
- Coughing fits, whooping, and vomiting after coughing fits are less common
- Apnea and cyanosis are less common (in vaccinated babies and children)
CDC recommends whooping cough vaccines for people of all ages. Learn more about whooping cough vaccination.
Recovery: Stage 3
Recovery from whooping cough can be slow. The cough becomes milder and less common as you get better.
Coughing fits may stop for a while but can return if you get other respiratory infections. Coughing fits can return many months after the whooping cough illness started.
Causes
Whooping cough, also known as pertussis, is a very contagious respiratory illness caused by a type of bacteria called Bordetella pertussis. The disease is only found in humans.
Whooping cough bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins (poisons), which damage the cilia and cause airways to swell.
How it spreads
Babies can get whooping cough from family or caregivers who don’t know they have it.
The bacteria that cause whooping cough spread easily from person to person through the air. When a person who has whooping cough sneezes or coughs, they can release small particles with the bacteria in them. Other people then breathe in the bacteria. It also spreads when people spend a lot of time together or share breathing space, like when you hold a newborn on your chest.
People can be contagious for weeks
People can spread the bacteria from the start of the very first symptoms and for at least 2 weeks after coughing begins.
Taking antibiotics early in the illness may shorten the amount of time someone is contagious. Learn more about treatment.
People can spread the disease even if they don’t know they have it
Some people have mild symptoms and don’t know they have whooping cough, but they can still spread the bacteria to others.
Many babies who get whooping cough are infected by older siblings, parents, or caregivers who don’t know they have it. Learn what you can do to protect babies from whooping cough.
Diagnosis & Treatment
Treating whooping cough (pertussis) early with antibiotics may make the infection less serious and help prevent spreading the bacteria that cause it to others.
See a doctor if you think you or your child may have whooping cough.
Diagnosis
Doctors diagnose whooping cough by considering if you have been in contact with someone who has whooping cough and by doing a
- History of typical signs and symptoms
- Physical exam
- Laboratory test of a mucus sample from the back of the throat
- Blood test
Treatment
Doctors generally treat whooping cough with antibiotics. There are several antibiotics available to treat whooping cough.
It’s very important to treat whooping cough early, before coughing fits begin.
Treating whooping cough early can
- Make the illness less serious
- Help prevent spreading the bacteria that cause it to others
Starting treatment after three weeks of illness is unlikely to help even though most people will still have symptoms. By then, your body has gotten rid of the bacteria, but the symptoms are still there due to the damage already done to your body.
Managing symptoms at home
Manage whooping cough symptoms and reduce the risk of spreading the bacteria to others.
Do not take cough medicine unless your doctor recommends them.
- Take antibiotics exactly as prescribed by the doctor.
- Keep your home free from irritants – as much as possible – that can trigger coughing, such as smoke, dust, and chemical fumes.
- Use a clean, cool mist humidifier to help loosen mucus and soothe the cough.
- Wash hands often with soap and water for at least 20 seconds.
- Eat small meals every few hours to help prevent vomiting.
- Get plenty of fluids, including water, juices, and soups, and fruits to prevent dehydration (lack of fluids).
- Do not take cough medicine unless your doctor recommends them. Giving cough medicine probably will not help and is often not recommended for children younger than 4 years old.
Report signs of dehydration to your doctor immediately.
Signs of dehydration include
- Dry, sticky mouth
- Sleepiness or tiredness
- Thirst
- Decreased urination or fewer wet diapers
- Few or no tears when crying
- Muscle weakness
- Headache
- Dizziness or lightheadedness
Getting treatment in a hospital
Whooping cough can sometimes be very serious and can cause complications, especially for babies. People with serious illness or complications need care in the hospital. About a third of babies younger than 1 year old who get whooping cough need care in the hospital.
Hospital treatment of whooping cough usually focuses on
- Keeping breathing passages clear. This may require suctioning (drawing out) mucus.
- Monitoring breathing and giving oxygen, if needed.
- Preventing or treating dehydration. People might need intravenous (IV, through the vein) fluids if they show signs of dehydration or have difficulty eating.
Prevention
Whooping cough (pertussis) is a highly contagious respiratory illness that’s making a comeback in the United States.
Learn what you can do to protect yourself and others.
Vaccines
The best way to prevent whooping cough is to get vaccinated. CDC recommends whooping cough vaccination for everyone.
Preventive antibiotics
Preventive antibiotics, also known as postexposure antimicrobial prophylaxis (PEP), are medicines given to someone that has been exposed to a harmful bacteria in order to help prevent them from getting sick.
Doctors and local health departments generally determine who should get preventive antibiotics. For people exposed to whooping cough, CDC recommends preventive antibiotics only if they:
- Live with the person who has been diagnosed with whooping cough.
- Are at increased risk for serious disease (e.g., babies, people with certain medical conditions) or will have close contact with someone who is at increased risk for serious disease (e.g., women in their third trimester of pregnancy, people who work with or care for high risk individuals).
If you’ve been exposed to the bacteria that cause whooping cough, talk to your doctor about whether you need preventive antibiotics. This is especially important if there is a baby or pregnant woman in your household or you plan to have contact with a baby or pregnant woman.
Good hygiene
CDC recommends practicing good hygiene to prevent the spread of the bacteria that cause whooping cough and other respiratory illnesses.
Cover your cough or sneeze
- Cover your mouth and nose with a tissue when you cough or sneeze.
- Throw away used tissues in the waste basket right away.
- Cough or sneeze into your upper sleeve or elbow if you don’t have a tissue. Never cough into your hands because you can spread germs this way.
Wash your hands often
- Wash your hands often with soap and water for at least 20 seconds.
- Use an alcohol-based hand sanitizer if soap and water are not available.
Temporary immunity after getting sick
People who have had whooping cough have some natural immunity (protection) to future whooping cough infections. Getting sick with whooping cough doesn’t provide lifelong protection.
CDC recommends whooping cough vaccination even if you have had the disease before, since natural immunity fades and does not offer lifelong protection.
Whooping cough (pertussis) can cause complications in people of all ages. Some people will get serious complications and need care in the hospital.
Serious and sometimes deadly complications are more likely in babies under a year old.
Complications
Whooping cough (pertussis) can cause complications in people of all ages. Some people will get serious complications and need care in the hospital.
Serious and sometimes deadly complications are more likely in babies under a year old.
Babies and children
Serious complications are more likely in babies under a year old.
Whooping cough can cause serious and sometimes deadly complications in babies and young children. Babies and children who have not had all recommended whooping cough vaccines are more likely to get serious complications.
About one third of babies younger than 1 year old who get whooping cough need care in the hospital. The younger the baby, the more likely they will need treatment in the hospital.
Of those babies younger than 1 year old who are treated in the hospital with whooping cough about:
- 2 in 3 (68%) will have apnea (life-threatening pauses in breathing)
- 1 in 5 (22%) may suffer from pneumonia (lung infection)
- 1 in 50 (2%) will possibly have convulsions (violent, uncontrolled shaking)
- 1 in 150 (0.6%) chances of encephalopathy (disease of the brain)
- 1 in 100 (1%) may die
Teens and adults
Teens and adults can also get complications, like pneumonia, from whooping cough.
If they have a severe cough, teens and adults can
- Pass out
- Fracture (break) a rib
- Lose bladder control
- Lose weight
Complications are usually less serious in this older age group, especially in those who have been vaccinated against whooping cough. However, if complications are serious, some people may need care in the hospital.
