It feels overwhelming when your child is sick, and you don’t know what is causing their illness, especially when there are so many childhood viruses and infections. Whooping cough (pertussis) can cause serious illness in people of all ages but is most dangerous for babies under age one.
Learn more about this respiratory infection, the pertussis vaccine, and how to keep your family safe and healthy. As adults, you have an important role to play in keeping young children healthy.
What is whooping cough?
Whooping cough is an infection of the lungs and respiratory tract that can cause coughing fits. Whooping cough is also known as pertussis. A bacteria called Bordetella pertussis causes this highly contagious (easily spread) infection. Whooping cough spreads easily when an infected person coughs, spraying droplets filled with bacteria into the air. Other people are then infected when they inhale these droplets.
What are the symptoms?
Whooping cough starts with mild symptoms and is often mistaken for a cold. It usually takes five to ten days for symptoms to appear after first being infected, but it can take as long as three weeks. It is extremely contagious, and for a long period of time. Without treatment, it can spread to others for weeks after the cough first appears.
After the early days of cold-like symptoms (runny nose, congestion, fever, red and watery eyes, and cough), pertussis symptoms worsen to include:
- Uncontrollable coughing fits
- Thick mucus in the lungs, which triggers a hacking cough
- Gagging or vomiting as a result of coughing
- A blue tint around the mouth from lack of oxygen after a coughing fit
- A reddening of the face from the work of coughing
- Low-grade fever (less than 100.4° Fahrenheit)
- Dehydration (not having enough fluid in your body)
- Coughing ending with a high-pitched “whoop” sound during the next inhalation of air.
Not everyone with pertussis will make this “whooping” or barking sound when they cough. Babies may not cough at all. Instead, they can struggle to breathe and may even temporarily stop breathing (apnea).
On the other hand, sometimes the only symptom of whooping cough in adults and adolescents is a hacking cough that goes on for six weeks or longer (pertussis has been known as the 100-day cough). While it can help make a diagnosis, healthcare providers don’t require this type of coughing to diagnose whooping cough.
How is whooping cough diagnosed?
While some healthcare providers diagnose whooping cough based on symptoms alone, others use medical tests to diagnose the infection. These possible tests are:
- A swab of the back of the throat (like the test for Strep throat)
- A blood test (checking for signs of infection in your blood, used to tell the severity of the infection, but not to diagnose whooping cough)
- An X-ray of the chest to check for a lung infection. An X-ray can show if the whooping cough bacteria has caused a lung infection (pneumonia).
Because the signs and symptoms of whooping cough can be tricky to identify in young infants and children, call your healthcare provider if prolonged coughing spells cause you or your child to:
- Turn red or blue
- Struggle to breathe or have noticeable pauses in breathing
- Inhale with a whooping sound
How serious is whooping cough?
While it is rare for someone to die from whooping cough, deaths can occur in infants. Infants under 12 months who are unvaccinated or not yet fully vaccinated are at the greatest risk for severe complications and death, according to the U.S. Centers for Disease Control and Prevention (CDC). Unfortunately, babies do not start building their own protection against whooping cough until they get their first pertussis vaccine when they are two months old. That’s why it’s crucial for pregnant people — and others in close contact with infants — to be vaccinated against whooping cough. The CDC recommends the vaccine (and boosters) for people of all ages.
Is there a vaccine?
Yes. There are two vaccines in the U.S. to prevent the spread of whooping cough: DTaP and Tdap. These vaccines protect against three infections: pertussis, tetanus, and diphtheria.
The CDC recommends that babies and young children get five shots of DTaP between 2 months and 6 years. Older children and teens should get one shot of Tdap when they are 11 to 12 years old. Although it seems like a lot of doses, repeated small doses of the pertussis vaccine help to build immunity over time and keep your baby protected. The vaccine isn’t perfect, but it greatly reduces the risk of catching it and makes the illness milder for those who do get it.
Pregnant people should get Tdap during the early part of the 3rd trimester of each pregnancy. There are three good reasons to get the Tdap vaccine during pregnancy.
- Pregnancy causes immune system changes that make it more likely a pregnant person will get sick or have complications from an illness. So, if they are vaccinated with Tdap, they can protect their own health.
- We now know that babies are protected for about two months from vaccination during pregnancy. That’s right! Your choice to get vaccinated against whooping cough is a “vaccination” for your newborn. Research suggests it’s about 78% effective for the first two months of life. Perfect timing, as your baby can get their first dose of Dtap at their 2-month visit.
- If expectant parents and adult caregivers and family are vaccinated (and boosted) before the birth, then the infant will be at a much lower risk of catching whooping cough in the two months before they are old enough to get their first DTaP vaccine.
How is whooping cough treated?
Healthcare providers usually hospitalize infants with whooping cough for close monitoring and treatment because the infection is more severe for infants. Intravenous fluids (via a small tube in their veins) may be needed if your baby can’t keep down liquids or food. Your child will also be isolated from others so they don’t get other babies sick. They will be monitored for severe complications like apnea, pneumonia, and seizures.
Antibiotics (medications to kill the bacteria causing pertussis) are the preferred treatment for whooping cough. Exposed family members may be given antibiotics to prevent them from getting infected. These medications can make it less likely your baby will infect others, but unfortunately, they don’t stop the cough. Early treatment can be beneficial if you know you or your child have been exposed. Healthcare providers do not recommend treatment with over-the-counter cough-suppressing medications.
Older children and adults can usually safely recover at home while taking prescribed antibiotics. Make sure your child has plenty to drink (water, juice, and soup) to avoid dehydration (not having enough fluids). Signs of dehydration to watch for are dizziness, dry, cracked lips, no tears when crying, and not peeing as often as usual. Resting in a cool, dark bedroom or room without any lung-irritating smoke from a fireplace or cigarettes will help your child recover faster and have fewer coughing spells. A cool-mist vaporizer can help ease breathing, loosening secretions in your child’s lungs. It’s not uncommon for children with a severe cough to lose control of their bladder. It’s important to reassure them that accidents of this kind are normal and will not happen when they are well. Watch for episodes of passing out or severe pain in the chest (it’s possible to break a rib from the force of coughing).
If someone you live with is diagnosed with whooping cough, you can minimize its spread to other family members by the same COVID-19 protections you are already familiar with, such as:
- Limiting contact with the infected person (having them isolate in their bedroom, for example).
- Wash your hands often.
- Wearing a mask when around them.
Talk to your healthcare providers about whether other family members or close contacts need antibiotic treatment. Vaccinating against pertussis is the best way to protect you and your family, especially if you are pregnant or have young children at home with you. With widespread vaccination, pertussis outbreaks are rare and cause very few complications or deaths. Talk with other adults and caregivers around your family to make sure they are up to date on their vaccines and boosters.
Reviewed by the Ovia Health Clinical Team
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Skoff T, Blain A, Watt J, Scherzinger K, et al. “Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation”. Clinical Infectious Diseases. 65(12):1977-1983. December 15, 2017.
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