Overview

Whooping cough (pertussis) is a contagious illness. It causes intense fits (paroxysms) of coughing. It mainly affects babies and young children.

Whooping cough used to be called the "100-day cough" because it can last for weeks to months. The illness often starts like the common cold, with a runny nose, sneezing, and a mild cough or fever. After 1 to 2 weeks, severe coughing starts. The cough often ends with a whooping sound as air is inhaled. During coughing spells, it is hard for babies and children to eat, drink, or breathe. These spells can last for weeks. In babies, it may cause periods of not breathing (apnea). Whooping cough is worse for children under 1 year of age. It is fatal is some cases.

The pertussis vaccine can help prevent the illness. But the vaccine is not 100% effective. And epidemics have occurred in areas where vaccine rates have fallen. If pertussis is spreading in an area, there is a chance that a person who has had the vaccine can still catch the disease. The vaccine's protection also wears off over time. Teens and adults who have not had a booster may spread the disease during an outbreak.

Causes

Whooping cough is caused by Bordetella pertussis bacteria. It is very contagious. It’s spread from child to child through coughing and sneezing. Once the bacteria are in a child's airways, it causes swelling of the airways and mucus.

Risk Factors

A child is more at risk for whooping cough if he or she has not had the vaccine and is around someone with the illness.

Symptoms

Symptoms start about 1 to 3 weeks after contact with the bacteria. They occur in 3 stages.

The catarrhal stage can last 1 to 2 weeks. Symptoms include:

  • Mild cough
  • Low fever
  • Runny nose

The acute stage may last for 1 to 6 weeks, but can last up to 10 weeks. Symptoms include:

  • Cough that gets worse and comes in severe fits
  • Cough that can be started by many factors, including feeding, crying, or playing
  • Cough that is dry and harsh
  • Cough that ends with a whoop sound when breathing in

The child may also vomit with the coughing and appear to be strangling on the vomit.

The recovery stage lasts weeks to months:

  • Vomiting and the whooping cough stop first.
  • The cough usually decreases around week 6, but may continue on occasion for the next 1 to 2 months.

Symptoms can occur a bit differently in each child. In babies, the cough may be very hard to hear. Infants may have a pause in breathing (apnea) instead of a cough. If you notice this, call your child's healthcare provider or take your child to the hospital right away. 

The symptoms of whooping cough can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

Diagnosis

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. A sample of fluid from the nose or mucus from a cough may be tested for the bacteria. This is often done to confirm the diagnosis.

Treatment

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

In some cases, your child may to go to the hospital for treatment. This is for supportive care and monitoring. Sometimes, your child may need oxygen and intravenous (IV) fluids until he or she starts to recover.

Your child may also take antibiotic medicine. Antibiotics may not make your child get better faster. But they will prevent the spread of infection to others. Anyone who has been in close contact with a child with whooping cough is usually given antibiotic medicine. This is the case even if someone has had the pertussis vaccine.

Home treatment may include:

  • Keeping your child comfortably warm
  • Feeding your child small meals often
  • Giving your child plenty of fluids
  • Preventing things that cause coughing

Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines.

Complications

Whooping cough can lead to lung infection (pneumonia).

Prevention

The whooping cough vaccine is routinely given to children in the first year of life. But cases of the illness still occur, especially in babies under 6 months of age.

The CDC recommends that children get 5 DTaP shots for maximum protection against pertussis. A DTaP shot is a combination vaccine that protects against 3 diseases: diphtheria, tetanus, and pertussis. The first 3 shots are given at 2 months, 4 months, and 6 months of age. The fourth shot is given between 15 months and 18 months of age. The fifth shot is given at 4 to 6 years of age.

At regular checkups, 11- or 12-year-olds should get a dose of Tdap. The Tdap booster protects against tetanus, diphtheria, and pertussis.

Immunity from the vaccine only lasts about 10 to 20 years. Older adults who have been in close contact with a child with whooping cough, such as a grandparent, are at extra risk and should have the Tdap vaccine. All pregnant women should have the vaccine, even if they have had the Tdap before. Talk with your healthcare provider about having the vaccine.

When to Call a Healthcare Provider

Call the healthcare provider if:

  • Your child has symptoms that don’t get better, or get worse
  • Your child has new symptoms
  • Your baby has pauses in breathing (apnea) instead of a cough  

Key Points

  • Whooping cough (pertussis) is a contagious illness caused by bacteria. It mainly affects babies and young children.
  • The illness often starts like the common cold, with a runny nose, sneezing, and a mild cough or fever. After 1 to 2 weeks, intense fits (paroxysms) of coughing start. The cough often ends with a whooping sound as air is inhaled.
  • The pertussis vaccine can help prevent the illness. But the vaccine is not 100% effective. And epidemics have occurred in areas where vaccine rates have fallen.
  • The cough usually decreases around week 6, but may continue on occasion for the next 1 to 2 months.
  • In some cases, a child may to go to the hospital for treatment. This is for supportive care and monitoring. Your child may also take antibiotic medicine.
  • The CDC recommends that children get 5 DTaP shots for maximum protection against pertussis.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.