What is whooping cough (pertussis)?

Whooping cough (pertussis) is a very contagious respiratory illness. It mainly affects babies and young children, but adults can also get it. Whooping cough caused thousands of deaths in the 1930s and 1940s. The whooping cough vaccine has made the death rate go down dramatically. Whooping cough vaccines work very well. But if the disease is spreading in a community, it is possible that even a fully vaccinated person could catch it. Babies who are too young to get the vaccine are also at very high risk of catching whooping cough. The illness can be very serious, even sometimes fatal, in young infants. Many babies infected with the disease have caught it from an adult.

What causes whooping cough?

Whooping cough is caused by bacteria (Bordetella pertussis). The bacteria attach to tiny, hair-like extensions, called cilia, that are part of the upper respiratory system. This includes the nose, mouth, throat, and voice box. The bacteria then release poisons (toxins). These toxins damage the cilia, cause airways to swell, and result in coughing spells that end with a whooping sound as air is breathed in. 

Who is at risk for whooping cough?

People of all ages can get whooping cough. But it usually strikes people who have not been vaccinated against it. It is a serious illness that can even be life-threatening, especially in babies. About 3 in 10 to 1 in 2 babies who get whooping cough have to be hospitalized for treatment. 

What are the symptoms of whooping cough?

The disease starts like the common cold. First there is a runny nose or congestion, sneezing, and sometimes a mild cough or fever. Then, after 1 to 2 weeks, severe coughing starts. The coughing spells end with a whooping sound as air is breathed in. Talk with your healthcare provider or call 911 right away if you notice pauses in your breathing. 

Symptoms of whooping cough may include:

• Coughing violently and quickly, until all the air has left the lungs and a person is forced to inhale. This causes a whooping sound.

• Sneezing that continues

• Fluid draining from the nose

• Fever

• Sore, watery eyes

• Lips, tongue, and nailbeds that turn blue during coughing spells

Whooping cough can last up to 10 weeks or longer. It can lead to pneumonia and complications from severe coughing, such as fainting, rib fractures, or temporary loss of bladder control.

The symptoms of whooping cough may look like other health conditions. Always see your healthcare provider for a diagnosis.

How is whooping cough diagnosed?

First, your healthcare provider will take a complete health history, do a physical exam, and evaluate your symptoms. Then they may take a mucus sample from your nose or the back of your throat. This is sent to a lab to confirm the diagnosis. Blood testing may also be done.

How is whooping cough treated?

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

Antibiotics are given up to 3 weeks after symptoms start. They may be given for an additional 3 weeks to pregnant people and some patients with chronic illnesses. They can lessen the severity of the infection and prevent it from spreading to others. But once the coughing fits start, antibiotics are less helpful. The bacteria may already be gone and the symptoms are due to past damage. Other treatment may include:

• Keeping warm

• Eating small meals often

• Drinking plenty of fluids

• Limiting things that make you cough

You may need to stay in the hospital if you have a severe case of pertussis.

Can whooping cough be prevented?

A vaccine has been developed against whooping cough. But cases of the disease still happen. This is especially true in infants younger than 6 months.

Since the 1980s, the number of cases of whooping cough has risen, especially in children and teens. Also in babies younger than 6 months. This is because fewer children are getting vaccinated in some communities. Also, the current vaccine doesn't last as long as the older versions of the vaccine. This means more adults are now at risk for whooping cough after the vaccine has worn off.

Adults who did not get a booster for tetanus, diphtheria, and pertussis (Tdap) as a preteen or teen should get this booster. All adults should get a tetanus-diphtheria (Td) booster every 10 years. But if you need the pertussis portion, it can be given before the 10-year mark. Always talk with your healthcare provider for advice.

The CDC recommends that pregnant people get a Tdap vaccine between 27 and 36 weeks of each pregnancy. This is so that antibodies can be transferred to the baby before birth. Always talk with your healthcare provider for advice.

Key points about whooping cough in adults

• Whooping cough is a very contagious respiratory illness. It mainly affects babies and young children, but adults can also get it.

• It starts like the common cold with a runny nose or congestion, sneezing, and sometimes a mild cough or fever. This is often followed by severe coughing. The coughing spells end with a whooping sound as air is breathed in.

• Whooping cough can last 10 weeks or more. It can lead to pneumonia and other complications.

• People of all ages can get whooping cough. But it particularly strikes people who have not been vaccinated against it.

• If you did not get a booster for tetanus, diphtheria, and pertussis (Tdap) as a preteen or teen, you should get this booster.

• All adults should get a tetanus-diphtheria (Td) booster every 10 years.

Next steps

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

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• 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.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your 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 you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions, especially after office hours and on weekends and holidays.