Whooping Cough (Pertussis)

What Is Whooping Cough (Pertussis)?

Whooping cough (pertussis) is an infection of the respiratory system caused by Bordetella pertussis bacteria. It mainly affects babies younger than 6 months old who aren't yet fully protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade.

Whooping (HOO-ping) cough causes severe coughing spells, which can sometimes end in a "whooping" sound when the child breathes in.

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 dry, irritating cough changes into coughing spells that can last for more than a minute. During a spell, a child may turn red or purple. At the end of a spell, the child might make the characteristic whooping sound when breathing in or may vomit.

Many infants and younger kids with whooping cough have the coughing fits and accompanying whoop, but not all do. And sometimes babies don't cough or whoop as older kids do. Infants may look as if they're gasping for air, look red in the face, and may actually stop breathing (called apnea). During very bad spells, their face might turn purple or blue for a few seconds.

Adults and teens may have milder or different symptoms, such as a lasting cough (rather than coughing spells) or coughing without the whoop.

How Is Whooping Cough Diagnosed?

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

How Is Whooping Cough Treated?

Doctors treat whooping cough with antibiotics. It's thought that antibiotics work best to shorten the length of the infection when people take them early in the illness, before coughing spells begin. But even when they're started later, antibiotics are important because they can stop the infection from spreading to others. If someone in your family has whooping cough, ask the doctor if preventive antibiotics or vaccine boosters 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 (particularly during a coughing spell), and dehydration.

Whooping cough can be life-threatening for infants younger than 6 months, so they almost always need hospital treatment. In the hospital, children may need suctioning to clear their airways. Their breathing will be watched closely and they'll get 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 become airborne when the person sneezes, coughs, or laughs. Others then can get infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses.

The incubation period (the time between infection and the start of symptoms) for whooping cough is usually 7 to 10 days, but can be as long as 21 days.

Infected people are most contagious in the earliest stages of the illness for up to about 2 weeks after the cough begins. Antibiotic treatment shortens the period of contagiousness to 5 days after treatment starts.

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. Giving cough medicine probably will not help, as even the strongest usually can't ease the coughing spells of whooping cough. The cough is actually the body's way of trying to clear the airways. (Due to potential side effects, cough medicines are never recommended for children under age 6.)

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; tobacco smoke; and smoke from cooking, fireplaces, and wood-burning stoves.

Kids with whooping cough may vomit 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, sunken eyes, a dry or sticky mouth and tongue, dry skin, crying without tears, and fewer trips to the bathroom to pee (or in infants, 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 in case immunity fades, kids ages 11–18 should get a shot of the new combination booster (called Tdap), ideally when they're 11 or 12 years old.

The Tdap booster is similar to the DTaP vaccine but with lower concentrations of diphtheria and pertussis. Adults who did not get it as preteens or teens also should get it. It's also recommended for all pregnant women during the second half of each pregnancy to protect newborn babies.

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 infants and children from the infection.

As with all immunization 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. Young kids who have not had all 5 doses of the vaccine may need a booster dose if they're exposed to someone with whooping cough.

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 vomits after coughing.
• There's a whooping sound after the cough.
• Your child has trouble breathing or seems to have brief periods of not breathing (apnea).
• Your child seems very sluggish.
• You're worried that your child may be dehydrated.

If your child has been diagnosed with whooping cough and is being treated at home, get medical care right away if they have trouble breathing or shows signs of dehydration.